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Health Topics: Contraception: The Patch
(Ortho Evra)
For information about receiving prescription contraceptives at Hudson Health Center, click here.
Ortho Evra is a thin plastic patch, which is placed on the skin of the buttocks, stomach, upper arm or lower torso once a week for three out of four weeks. It releases combined hormones similar to the estrogen and progesterone made by the woman's ovaries. It:
- Prevents the ovaries from releasing an egg evolution.
- Also thicken the cervical mucous to prevent sperm from joining the egg
- In rare cases, prevents a fertilized egg from implanting in the uterus
It is 95 - 99 % effective (Research suggests that Ortho Evra is less effective among women with a baseline body weight greater than or equal to 198 lbs.)
To use it, the woman should apply her first patch on the first Sunday after her period starts. She must use a back up contraceptive method for the first week of her cycle. The patch should be applied to clean, dry, healthy skin on the buttock, abdomen, upper or outer arm or upper torso. Place it where it won't be rubbed by tight clothing.
The patch is worn for seven days (one week). On the Patch Change Day (the 8th day), the used patch is removed and a new one is applied immediately. The used patch still contains some active hormones. It should be folded in half so that it sticks together before throwing it away. New patches are applied for Week Two on day 8 and for Week Three on day 15. The patch may be changed anytime during the Patch Change Day. Each new patch should be applied to a new spot on the skin to help avoid irritation, although they may be kept within the same area. Week four is patch free. An artificially induced period should occur during this time.
The next four-week cycle is started by applying a new patch on Sunday (Patch Change Day). Under no circumstances should there be more than a seven-day patch-free interval between patch cycles.
If the patch is partially or completely detached:
- for less than one day, the woman should try to reapply it to the same place or replace it with a new patch immediately. No back-up method is needed. The Patch Change Day will remain the same.
- for more than one day, (24 hours or more) she may not be protected from pregnancy. She should stop the current contraceptive cycle and start a new cycle immediately by applying a new patch. There is now a new day 1 and a new Patch Change Day. A back-up contraceptive method must be used for the first day of the new cycle.
If the woman forgets to change her patch:
- at the start of any patch cycle (Week One/Day 1: She may not be protected against pregnancy. She should apply the first patch of her new cycle as soon as she remembers. There is now a new Patch Change Day and a new Day 1. The woman must use a back up method for the first week of the new cycle.
- in the middle of the patch cycle (Week Two/day 8 or Week Three/day 15), for one or two days (up to 48hrs): She should apply a new patch immediately. The next patch should be applied on the regular patch change day. No back up method is needed. For more than two days (48 hours or more) the woman may not be protected against pregnancy. She should start a new four-week cycle immediately by putting on a new patch. There is now a new "Patch Change Day" and a new Day 1. The woman must use a back up method for the first week.
Advantages:
- Highly effective
- Protects against pregnancy for one month
- No pill to take daily
- Ability to become pregnant returns quickly when use is stopped
- More regular, shorter periods
- Less menstrual flow and cramping, iron deficiency anemia
- Protects against ovarian and eudiometrical cancers, pelvic inflammatory disease, ovarian cysts
Disadvantages:
- Skin reaction at the site of application
- Menstrual cramps
- For wearers of contact lenses, a change in vision or the inability to wear the lenses
- May not be effective for women who weigh more than 198 pound
- Possible fluid retention or raised blood pressure
A woman should not use Ortho Evra (the Patch) if she has any of the following conditions:
- A history of heart attach or stroke
- Blood clots in the legs, lungs, or eyes
- Chest pain
- High blood pressure
- Headaches with neurological symptoms or migraines
- Disease of the heart valves
Smoking increases the risk of serious cardiovascular side effects from hormonal contraceptive use. This risk increases with heavy smoking (15 or more cigarettes a day) Women who use hormonal contraceptives including the Patch are strongly advised not to smoke.
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