Ortho Evra® is a fairly new method of birth control, approved by the FDA in 2001. Ortho Evra® is a small, thin, flexible patch that women apply directly to their skin, like a Band-Aid®. The patch can be worn on the buttocks, abdomen, front or back of the upper torso (but never on the breasts), or the upper outer arm. The patch should be worn in a different place each week (even if the change is simply from the right to left buttock). The patch is small and smooth so it can be easily worn under clothing without being noticed.
 
When the patch is in contact with the user's skin, it releases a steady flow of the hormones progestin and estrogen, into her bloodstream. The patch works similar to a nicotine patch. Ortho Evra® uses the same form of progestin found in Ortho Tri-Cyclen®, a popular birth control pill, and works as a contraceptive in similar fahion. The estrogen released by Ortho Evra® prevents ovulation, so most eggs will not be released from the woman's ovary. Therefore, the chance of fertilization is greatly reduced and pregnancy is unlikely. The progestin in the patch provides secondary contraceptive protection. It thickens the cervical mucus, making it less likely that sperm can enter the woman's uterus.
 
Ortho Evra® is a once-a-week contraceptive. At the end of one week the old patch is discarded and a new patch is applied. It does not matter the time of day the patch is changed nor where the new patch is located on the body (as long as it is one of the designated areas noted above). If the patch is changed on the same day of every week and is positioned in one of the acceptable places, Ortho Evra® will work effectively. Three consecutive patches (equivalent to 3 weeks) are worn followed by one off-week. This last patch-free week triggers the onset of menstruation, as no hormones are being introduced to the bloodstream at this time.
When a woman chooses Ortho Evra® as her preferred method of birth control, she may opt for the “Sunday Start” method, which resembles the same method as The Pill. A new patch is used the first Sunday of a woman’s period. The patch is changed on the following Sunday, and again on the next Sunday. Then, the patch is then not worn for one week to allow for menstruation. A back-up contraception, such as condoms, should be used during the first two weeks of applying the patch.
 
Ortho Evra® is 99% effective when used correctly. It has a strong adhesive so it should stay on during warm or humid weather, bathing, showering, swimming or exercising. If, however, the patch does come off before the week is through, single back-up patches are available at no cost. It is important to use a back up method of birth control if the patch comes off.
Applying Ortho Evra® is a very simple process. The prescription comes with easy-to read, detailed, pictured instructions for proper application and use. The patch should never be applied to a woman's breasts. A woman's breasts have their own natural hormonal balance and wearing Ortho Evra® on them may upset the balance.
There are several advantages to Ortho Evra®. Unlike the pill, which is taken on a daily basis, Ortho Evra® is only dealt with once a week. It can be applied and removed by the woman in the privacy of her own home. The patch will also help to maintain sexual spontaneity, since it is applied at a time separate from sexual activity.
 
Ortho Evra® is currently in the United States by prescription only. It is estimated to cost around the same price currently paid for birth control pills, approximately $40 a month, but less according to health insurance plans.
It is very important to remember that although Ortho Evra® is effective in preventing pregnancy, it offers no protection against STDs or HIV. A condom should be used along with Ortho Evra® to help prevent the spread of diseases. Also, hormonal contraceptives are not for everybody. It is important for women to speak with a healthcare professional about what method of birth control would be best for them.
 
Ortho Evra is available by prescription only. If you are interested or you think the patch is the right contraception for you, please consult your doctor. For more information, visit www.orthoevra.com or call toll-free 1-877-377-3872.
 
Is Ortho Evra® Three Times More Likely to Cause Blood Clots?
According to the Associated Press and FDA reports, patch users are three times more likely to suffer from fatal or life-threatening blood colts than women using oral contraceptives. In 2004, the AP reported that twelve women among some 800,000 had died from blood clots they believe to be related to Ortho Evra®. In addition, data from the FDA showed that the patch is associated with several other cases of heart attack, stroke, and non-fatal blood clots. The occurrence of blood clots in Phase III trials of Ortho Evra® is allegedly six times greater than women using the birth control pill.
The AP has found that the FDA and the Ortho-McNeil pharmaceutical company knew of the greater risk related to the patch before its approval in 2001. However, the labeling on this highly advertised product seems to be unclear, stating that the patch is expected to be associated with similar risks as the pill AND that it is unknown if the risk of blood clots from the patch is different from the pill.
There have been a few instances that have contributed to the concern among health officials and women in regards to the possible increased risks of using the patch. On April 6, 2004, an 18-year-old model and fashion student from New York died suddenly when a blood clot entered into her lung three weeks after she had switched to the patch. Medical examiners later determined that her death was a result of Ortho Evra®. On July 17th, 2005, another patch-related death shocked health care professionals. 25-year-old Kathleen Thoren, died after suffering agonizing headaches caused by blood clots that were linked to the use of Ortho Evra® a few weeks prior to her death.
Although the hormones in the patch and birth control pill are basically identical, questions are being raised about the way these hormones are metabolized in the body. Dr. Pamela Berens, associate professor of obstetrics and gynecology at the University of Texas Medical School at Houston, has noted that the pill is processed through the intestinal tract before the hormones enter into the blood, while the patch releases the hormones directly into the bloodstream. Others however have their doubts about the significance of the spreading concerns.
Dr. Philip Darney, a professor of obstetrics and gynecology at the University of California, San Francisco, and a leading contraceptive researcher, claims that the pool of women from which the FDA has drawn its data is not representative of the women using birth control in general. According to Darney, the women using the patch are likely to be new users or women who have experienced problems with other forms of hormonal therapy and are seeking something new. Furthermore, Darney argues that doctors and patients are more likely to report problems of new drugs than others that have been on the market for a while, hence a greater discrepancy between patch and pill users.
Professionals are still uncertain to whether the patch does in fact increase the risk of blood clots, heart attack, and stroke relative to the pill, although recent evidence suggests that women exercise extreme caution when selecting the right form of contraceptive. Be sure to inform your health care provider if you have any heart conditions, blood clots, certain cancers, a history of stroke or heart attack, smoke, or may be pregnant.
 
Created November 14, 2005, last updated May 31, 2007