The Contraceptive Patch - Right for You?

Medical Author: Melissa Stoppler, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.

Women who desire an effective hormonal method of birth control now have the option of wearing a contraceptive patch. The patch is an especially appropriate choice for women who may have trouble remembering to take the pill.

The contraceptive patch (its brand name is Ortho Evra) releases birth control hormones through the skin into the bloodstream, a phenomenon known as transdermal delivery of a drug. Patch technology has been used as a successful route of administration for other drugs, including those used for hormone therapy, motion sickness, and smoking cessation.

The contraceptive patch has been approved by the U.S. Food and Drug Administration since 2001. The patch contains the same hormones - estrogen and progestin - as contraceptive pills and acts to prevent ovulation (the release of an egg from the ovaries). This, in turn, means that fertilization cannot take place.

The patch is not difficult to use. A woman puts on a new patch once a week for three weeks and then pauses for one week (in which a menstrual period occurs) before applying another patch. The patch can be applied to any of a number of different locations including the chest (but not on the breast area), upper arm, buttock, or stomach.

Clinical trials have shown that the patch is as safe and effective as oral contraceptive pills . Like the pill, the patch is 99% effective in prevention of pregnancy.

Because the patch delivers the same hormones as birth control pills, women who use the contraceptive patch may have the same side effects. The side effects that are more likely to occur when a woman starts using the patch include breast tenderness, nausea, headaches, and emotional swings. The patch may also irritate the skin at the site of application.

Serious risks with the patch, as with contraceptive pills, include blood clots, stroke or heart attacks. These risks are increased if the woman smokes. (Like the pill, the contraceptive patch provides no protection against HIV or other sexually transmitted infections .)

The patch has the advantage of once-a-week application without having to remember to take a pill on a daily basis. Studies have shown that women are more likely to use the patch correctly than the pill.

However, pregnancy can occur if the patch falls off for more than a day, or if a woman wears the same patch for longer than one week. The patch is also less effective in women who weigh more than 198 pounds. The cost of the patch is similar to the cost of oral contraceptive pills.

Taking your whole health history into account, your doctor can help you decide if the patch would be an appropriate contraceptive method for you. If the answer is "yes," you will need to be instructed on how to use the patch effectively.

Reference: Burkman RT. The transdermal contraceptive system. Am J Obst Gynecol. 2004 Apr:190 (4 Suppl): S49-53.