Contraceptive Patch

The Ortho Evra Skin Patch

Photo Finish
ortho evra

What is a contraceptive patch?

The Ortho Evra transdemal contraceptive patch is a small, adhesive polyester square that is attached to the skin to prevent pregnancy. Like combined oral contraceptives, the contraceptive patch contains two synthetic hormones. These are absorbed into the body through the skin to prevent pregnancy. The patch must be prescribed by a doctor and is purchased by prescription. It is worn for three weeks at a time and replaced once a month.

How does the contraceptive patch work?

The patch is believed to work by multiple mechanisms. Ortho Evra contains estrogen (ethynil estradiol) and progestin (norelgestromin), which are artificial variations of natural female hormones.

  1. In most cases the drugs prevent ovulation. No egg is released so sperm cannot fertilize it.
  2. The patch may also prevent fertilization by changing the consistency of natural secretions in the vagina, making it harder for the sperm to reach the egg.
  3. Women may experience breakthrough ovulation which can lead to fertilization. When this occurs, the patch works by making it harder for the embryo to implant in the womb by keeping the lining of the uterus thin.

How effective is the contraceptive patch?

7%

Annual Failure Rate

Because the patch is a relatively new method, the failure rate is not yet known. It is assumed that the failure rate is the same as for oral contraceptives, which have an overall annual failure rate of 7%. That means each year about 1 in 14 users will experience an unplanned pregnancy. These methods have a lower annual failure rate of 6% for married couples, but a higher rate of 14% for cohabiting couples. These methods are also less effective for teens and couples in their early twenties, with a failure rate of about 14%.

Side-effects and health risks of the contraceptive patch:

There are many potential side-effects, health risks, and drug interaction concerns involving the patch. A few are listed here, but not all are provided due to space limitations. Users of the patch are exposed to about 60% more estrogen than is found in typical birth control pills, therefore these risks may be increased.

Problems caused by Estrogen Problems caused by Progestin
Nausea
Breast swelling & tenderness
Vaginal discharge
High blood pressure
Decreased sex drive
Headaches
Mood swings
Fluid retention
Permanent dark patches on face
Drug interaction problems
Gallbladder disease
Eye or vision problems
Skin irritation or pigmentation
Embolism (rare)
Heart attack (rare)
Stroke (rare)
Breast tumor growth (rare)
Weight gain
Depression
Fatigue and tiredness
Headaches
High blood pressure
Acne and/or oily skin
High cholesterol
Insulin resistance
Bloating
Constipation
Irregular menstrual bleeding
Breast tenderness
Heart attack (rare)
Breast tumor growth (rare)

Considerations for Christians:

Most medical organizations define pregnancy as beginning with implantation. By this definition anything that prevents implantation is still considered contraception, including the contraceptive patch. However, life begins when fertilization occurs, so many Christians would consider oral contraceptives an abortifacient -- a drug that causes a very early abortion. Brochures about the patch may downplay the abortive mechanism to keep Christian women buying this product.

Related Links


Source for Failure Rates: N Ranjit, A Bankole, JE Darroch, S Singh, "Contraceptive Failure in the First Two Years of Use: Differences Across Socioeconomic Subgroups," Family Planning Perspectives, 2001, 33(1):19-27. (pdf)


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