by Karen Schroeder, MS, RD
December 10, 2001 – In the new year, American women will have a new option for
birth control. Ortho-Evra—a contraceptive skin patch—was approved by the Food
and Drug Administration (FDA) in November and will be available in early 2002.
A new hormonal delivery system
Ortho Evra contains the same hormones as birth control pills—estrogen and
progestin. The beige, smooth, 1¾-inch square patch delivers a steady, low level
of these hormones across the skin and directly into the bloodstream. The
hormones work in two ways to prevent pregnancy:
- Prevent ovulation, therefore an egg is not released by either of the
ovaries for fertilization
- Thicken the cervical mucus so that sperm is less likely to enter the
uterus
In clinical studies, Ortho Evra was more than 99% effective at preventing
pregnancy. This is comparable to birth control pills.
Sticking with it
The patch can be applied to any of the following spots on the body:
- Buttocks
- Abdomen
- Upper torso (front and back, but not the breasts)
- Upper outer arm
A woman will change the patch once a week for three weeks, and go patch-free
for the fourth week, during which she'll have her period. The patch should be
applied to a slightly different spot each time, to help prevent a reaction at
the attachment site.
Ortho Evra patches adhere well to the skin, even in moist conditions. So it is
safe to exercise, bathe, use a sauna or whirlpool, and swim while using this
patch. The company will also sell packages of single replacement patches, in
case a patch falls off and cannot be reattached. In clinical studies, about 5%
of women had at least one patch fall off.
Side effects
The side effects associated with the patch are similar to those of birth
control pills. During clinical study, the side effects most often reported by
women wearing the patch were:
- Nausea
- Breast discomfort
- Headache
- Mild to moderate skin reaction at application site
Other possible side effects include:
- Upper respiratory infection
- Menstrual cramps
- Abdominal pain
Serious, but rare effects include:
- Blood clots
- Heart attack
- Stroke
The risk for these effects is greater if a woman smokes, especially if she is
over age 35.
Not for everyone
Women who weigh more than 198 pounds should not use the Ortho Evra patch.
They may not receive a high enough level of hormones to provide contraception.
The patch should also not be worn by women who:
- Have blood clots
- Have certain cancers
- Have a history of heart attack or stroke
- May be pregnant
Ortho Evra, which will be available by prescription and will cost about $40
per month, is a reversible, long-term form of birth control. It is not a barrier
method, and therefore does not protect against HIV or other sexually transmitted
diseases.