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Hormonal Methods of Birth Control (cont.)

Contraceptive patch: Ortho-Evra

An adhesive patch has been developed that will provide a contraceptive through the skin. This method is called a transdermal (through the skin) delivery system. The patch is about the size of a half-dollar and can be worn on the arm, abdomen or buttocks. A woman wears the patch for a week and then replaces it with a new patch.

These patches, called Ortho-Evra, are similar to the pill in that it contains both estrogen and progesterone. Ortho-Evra should be just as effective in preventing pregnancy as the pill. Ortho-Evra is similar to the pill in that it suppresses ovulation. Because the hormone in Ortho-Evra is delivered in a continuous steady flow, much like the Norplant implants, the cyclical "peak and valley" aspects of the pill are largely avoided. In general, a woman should not experience side effects such as nausea or vomiting with Ortho-Evra because the hormones from the patch enter the body through the skin rather than the digestive system. However, women who have medical reasons why oral contraceptives are not recommended may find that their prescribing physician also recommends against Ortho-Evra, because of the similarity in the hormone ingredients of both types of contraceptives.

A woman only needs to remember to replace the patch once a week instead of being required to remember taking a pill every day. The patch is stopped for 1 week every 4 weeks, to allow for a menstrual flow to occur.

It is important to ensure that the patch makes good contact with the skin. The patch could be a problem for those women who sweat a lot and/or take frequent showers because moisture can interfere with the patch's contact with the skin. Some women may also experience skin irritation at the site of the patch.

The Ortho-Evra patch, approved for use by the FDA in 2001, is similar in effectiveness to Norplant or progesterone IUD.

As with all other hormonal methods of birth control, the Evra patch will not protect a woman against sexually transmitted infections.

Vaginal ring (Nuvaring)

A ring-shaped device that contains the female hormone estradiol can be placed in the vagina. It remains in place for 3 weeks continuously, then it is removed for 1 week to allow for a menstrual period. It continuously releases low levels of the hormone into the bloodstream for the entire 3 weeks.

There is currently one brand available, called NuvaRing. It is about 99% effective in preventing pregnancy, the same high effectiveness as the other hormonal methods of contraception.

NuvaRing does not protect against sexually-transmitted infections. As with other non-oral forms of contraception, it is not known whether the same side effects or risks apply to NuvaRing as for oral contraceptives. It is probably safest to assume that contraindications are the same for patches and vaginal rings as for oral contraceptives.


Last Editorial Review: 10/3/2003




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