Ortho-Evra (The Patch)

Ortho Evra™, the birth control patch, is a new option for women who wish to use a hormonal method of pregnancy prevention.

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WHAT IS IT?
Ortho Evra™ is the new birth control patch. The square patches are a pale peach color and each side is 1 3/4 inches long. The patches are smooth, and are sticky on the side that is attached to the body. The patches contain a combination of hormones – estrogen and progestin – that are naturally produced in the female body. When the patch is on the body, it releases the hormones over time; they are absorbed by the skin into the rest of the body. These hormones stop the process of ovulation (the release of the egg). If a woman doesn’t ovulate, she cannot become pregnant.

WHERE CAN I GET IT?
Ortho Evra™ requires a prescription. A woman who is interested in using them should contact her health care provider or local reproductive health clinic. Most clinicians require that a woman have a full physical exam (including a pelvic exam and a Pap test) before starting on Ortho Evra™.

HOW DO I USE IT?
When a woman obtains a prescription for Ortho Evra™ from her health care provider, she will be given specific instructions on how and when to begin using it. On the designated start day, the woman should open the first patch and apply it to her body, where it will remain for a week (7 days). The patches can be worn on the upper arm, on the shoulder, on the lower back, the lower abdomen, or the upper thigh. Patches should never be worn on the breasts, to prevent delivery of estrogen directly into the breast tissue.

After a week, the woman should remove the old patch and apply a new one. She can wear patches on the same body part for the entire cycle, but she should not apply them in exactly the same place. The patch will stay on for a week, at which time she will remove it and apply a new one. After a week with the third patch on, she should remove it and go without a patch for a week. At some point during that week, she will have a period. Women who use Ortho Evra™ usually report that the periods they have while using it are lighter, shorter, more regular, and less uncomfortable than their natural periods. After seven days without a patch, the woman should begin a new cycle of patches.

According to the manufacturer, women should be able to participate in their normal activities (like swimming, bathing, showering, and exercising) without fear of their patch becoming dislodged. If a patch comes off and cannot be re-stuck to the skin, the woman should call her health care provider for instructions on what to do.

WHAT ARE THE POSSIBLE SIDE EFFECTS?
Side effects of Ortho Evra™ are similar to those of the birth control pill and other hormonal contraceptives and include:

o Periods that are lighter, shorter, more regular, and less uncomfortable
o Moodiness
o Breakthrough bleeding
o Nausea (upset stomach)
o Headaches
o Breast tenderness
o Skin irritation underneath patch from adhesive (sticky stuff)
o Appetite changes
o Weight gain (though some women lose weight)

These side effects are generally mild and may go away after the first few months of patch use.

It is important for women to know that there are some potentially serious side effects that can occur as a result of using Ortho Evra™, like heart attack, stroke, and blood clots. These side effects are rare, and are more likely to occur in women who are over 35 years old and who smoke 20 (a pack) or more cigarettes a day. Although these side effects are rare, it is important for all women to be aware of the symptoms:

o Pain or swelling in the legs
o Vision problems (like blurriness)
o Sudden pain in the abdomen/chest/arm
o Worsening of depression
o Jaundice (yellowing of the skin or eyes)

If a woman has been using the patch and she notices any of these things, she should contact her health care provider immediately.

HOW WELL DOES IT WORK?
Properly used, Ortho Evra™ is over 99% effective in the prevention of pregnancy. Because the patches only need to be changed once a week, there is less opportunity for user error, which can decrease the effectiveness. In order to be most effective, Ortho Evra™ must be used exactly as directed. Ortho Evra™ does not provide any protection against Sexually Transmitted Infections (STIs) or HIV.

WHAT ARE SOME OF THE ADVANTAGES AND DISADVANTAGES OF THE METHOD?
Advantages:
o Only needs to be remembered every seven days, which makes it very convenient adn also reduces the possibility of user error
o More comfortable periods

Disadvantages:
o Possible for patches to become dislodged or lost
o Patches are visible on the body so this may not be a good method for women who want to keep their use of birth control private

HOW MUCH DOES IT COST?
The cost of the exam that may be required before a woman starts on Ortho Evra™ varies by provider. Some women may be able to get their exams for free, while others pay $20 to $150 or more, depending on their insurance coverage, if any.

How much someone pays for the patches themselves depends on where she gets them. A woman who gets her patches from a pharmacy should expect to pay $30-$40 per pack (a 28-day supply), depending on the brand and the store. If a woman chooses to get her patches from a reproductive health clinic, the cost may be lower. Some health insurance companies will pay for Ortho Evra™, and some will not.