From the Guidelines
The birth control patch, such as Ortho Evra, is a viable contraceptive option, but its use should be carefully considered due to increased estrogen exposure and potential risk of venous thromboembolism, as noted in studies 1.
Benefits and Risks
The patch contains ethinyl estradiol and norelgestromin, which prevent pregnancy by stopping ovulation, thickening cervical mucus, and thinning the uterine lining. Benefits include:
- Weekly application rather than daily dosing
- Continued effectiveness during vomiting or diarrhea
- Potential improvement of menstrual symptoms like cramps and heavy bleeding However, users should be aware of risks including:
- Increased blood clot risk (particularly for smokers over 35)
- Potential side effects like nausea, breast tenderness, and headaches
- A slightly higher estrogen exposure compared to some birth control pills, with 1.6 times higher exposure than with a low-dose COC 1
Application and Effectiveness
The patch is applied to clean, dry skin on the buttocks, abdomen, upper arm, or upper torso (except breasts) for three consecutive weeks, followed by one patch-free week when menstruation typically occurs. Users should apply a new patch on the same day each week and be aware that certain medications, including some antibiotics and anti-seizure drugs, may reduce its effectiveness. Typical use failure rates are similar to those of COCs at 9% 1, and the risk of pregnancy with correct use of the patch is slightly higher for women who weigh more than 198 pounds than for women who weigh less (0.9% vs 0.3% in first 12 months of use) 1.
Considerations
While the patch doesn't protect against sexually transmitted infections, it provides a convenient contraceptive option for those who prefer not to take a daily pill. However, the potential health risks associated with the patch, including increased estrogen exposure and risk of venous thromboembolism, should be carefully considered, especially for adolescents and women with certain health conditions 1. Ultimately, the decision to use the birth control patch should be made after careful consideration of the benefits and risks, and in consultation with a healthcare provider 1.
From the Research
Benefits of the Birth Control Patch
- The birth control patch, such as Ortho Evra, has been shown to have efficacy similar to oral contraceptives in preventing pregnancy when used as directed 2.
- It provides excellent cycle control, with most users experiencing regular menstrual periods and some reporting a shorter duration and lighter flow of their periods 3.
- The patch has been found to be user-friendly and has a high degree of acceptability, with a low level of skin irritability 4.
- Compliance with the patch is significantly higher than with oral combined contraceptives, which is a major point for effective contraception 4.
Risks of the Birth Control Patch
- The patch has been associated with an increased risk of venous thromboembolism (VTE) compared to some oral contraceptives, although the risk may not be materially different for women aged 39 years or younger 5.
- Common adverse reactions include breast symptoms, headache, application-site reactions, nausea and vomiting, dysmenorrhea, and abdominal pain 2.
- The patch may be less effective in women weighing more than 90 kg, and its use is not recommended for women in this weight category 2, 4.
- Some users may experience mild-to-moderate application-site reactions, and a small percentage may discontinue use due to irritation or other side effects 2, 3, 6.
Comparison to Other Contraceptive Methods
- The patch has a similar side effect profile to established oral contraceptives, with the exception of a higher incidence of application site reactions and breast discomfort 6.
- The patch may offer an advantage in terms of compliance, as it is easier to use and remember to apply than oral contraceptives 2, 4.
- However, more research is needed to determine if the patch offers any significant efficacy or safety advantages over current methods of hormonal contraception 2.