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The Birth Control Patch
It's Not So New Anymore
by Marjorie Greenfield, M.D.
reviewed by Marjorie Greenfield, M.D.
The birth control patch, Ortho Evra, is very similar to the birth control pill. It works in pretty much the same way, except that the hormones enter your system through your skin instead of orally.
The matchbook-sized patch can be worn on the abdomen, buttocks, or upper arm. Each 28-day pack contains three patches. For the first three weeks, a new patch is put on in a slightly different location each week. Then in the fourth week, the patch is discontinued for seven days to allow a period to occur--similar to taking the plain sugar pills that are provided at the end of each pack of oral contraceptives.
Benefits of the patch
- Compared to the Pill: Women may find the patches easier to remember. For some people, remembering to take a pill every day can be a challenge, particularly if they have a busy schedule that can change on a whim. In such cases, keeping track of a weekly dose (only changing the patch every Sunday, for example) is a lot easier to manage than a daily commitment. And effectiveness is excellent, just like the Pill, although research has indicated that there may be a slightly higher failure rate in women who weigh close to or more than 200 pounds.
- Compared to injectables: While birth control injections eliminate the need to follow a daily or weekly dosage schedule and therefore have a certain added level of convenience, the patch has the benefit of clearing from your system within a day or so of discontinuing its use. Injectables, on the other hand, can take as much as eight months to leave your system. This means that if you want to get pregnant, or have any unwanted side effects from the medications, you can get rid of the patch hormones a lot faster than you can clear those from a shot.
Downsides of the patch
- Factors that increase the risk of the Pill, such as smoking after age 35 or a history of blood clots in the legs or lungs, are also reasons not to use the patch.
- In the research done in order to get FDA approval, about 20 percent of patch users experienced breakthrough bleeding during the first few cycles--a higher percentage than those who typically get bleeding on the Pill. Breast tenderness was a bit more common on the patch as well. A small percentage of the study participants ended up discontinuing use because of irritation at the patch site.
- About 5 percent of patches in the study fell off. If the patch is replaced within a day, however, it will still be effective. Many doctors write an extra prescription for just this situation. You can hold on to this prescription in case you need it. The replacement patch comes with a form that you can send in to get reimbursed for the cost. If the patch is off for more than a day, you must start a new 28-day cycle of patches and use a backup method of birth control for a week.
- Like the Pill, the patch doesn't prevent transmission of infection. For couples who are not in a permanent monogamous relationship, and for those who have concerns about STDs, condoms should be used in addition to any hormonal birth control method.
All in all, the patch is basically for women who could take oral contraceptives but prefer the convenience of weekly use. Even though the patch isn't that much different from the Pill, it still adds one more option to the choices of available birth control methods.
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Created November 29, 2001
Reviewed August 23, 2004
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