Patient case (clinical description): A 43-year-old woman, gravida 3 para 3, comes to the clinic complaining of recently painful menstrual cycles.  The patient's last menstrual period was 2 weeks ago. Urine β-hCG is negative. Menarche was at age 12, and menstrual periods occur every 28 days and lasts for 5 days.  She is sexually active with her husband and does not have pain with intercourse. BMI is 23 kg/m2 and Vital signs are normal.  On physical examination, the uterus is uniformly enlarged and tender. She is candidate for hysterectomy with the diagnosis of adenomyosis.

Patient's own account: I'm 43, and I paid a visit to my doctor because my last few periods were insanely painful. My last periods were 2 weeks ago. I already had three pregnancies that gave me the three lovely children. I did a urine test to check for potential pregnancy, and it came back negative. I started to have my periods at the age of 12, and I have been pretty regular with periods every 28 days for 5 days. I'm sexually active with my husband and I do not have any pain when we have sex. My BMI is 23 and my vitals were normal. The doctor performed a physical exam and found that my uterus was tender and enlarged. She proposed me a hysterectomy and diagnosed me with adenomyosis.

Clinical trial: Continuous Use of the Contraceptive Patch and the Personal Economic Impact.

Eligibility criteria:
Inclusion Criteria:

          -  Healthy, women 18 through 40 years of age at the time of enrollment who have severe
             menstrual related symptoms

          -  Willing and able to comply with the study protocol

          -  Has not used oral contraceptives, vaginal rings, or injectable contraceptives during
             the last month and has had one regular menstrual period preceding enrollment OR is
             within seven days post induced abortion

          -  Has been determined to be eligible for hormonal contraceptive use

          -  Willing and able to be contacted by research staff.

        Exclusion Criteria:

          -  Does not speak or read English

          -  Is breastfeeding

          -  Has contraindications to use of estrogen-containing contraceptives including
             thrombophlebitis or thromboembolic disorders including a past history of deep vein
             thrombophlebitis or thromboembolic disorders

          -  Cerebrovascular or coronary artery disease

          -  Known or suspected carcinoma of the breast, endometrium or suspected
             estrogen-dependent neoplasia

          -  Undiagnosed abnormal genital bleeding

          -  Biliary tract disease

          -  Cholestatic jaundice of pregnancy or jaundice with prior contraceptive steroid use

          -  Hepatitis

          -  Cirrhosis

          -  Hepatic adenomas or carcinoma

          -  Hypertension (>140 systolic or >90 diastolic)

          -  Diabetes

          -  Migraine with focal neurologic symptoms

          -  Is pregnant or less than 3 months postpartum

          -  Concurrent use of medications that induce liver enzymes

          -  Has severe or chronic constipation

          -  Drug or alcohol abuse (current or within the last 12 months)

          -  Unable or unwilling to comply with protocol

          -  Is HIV-positive

          -  Has history or presence of cancer

          -  Treatment (other than hormonal contraception) has been recommended for menstrual
             symptoms

          -  Taking prescription medication because of menstrual related symptoms
Female
Accepts Healthy Volunteers
Subject must be at least 18 Years old.
Subject must be at most 40 Years

Eligibility (NLI label): Contradiction