Introduction
Before using Ortho Evra® (the Patch), you need to know the possible advantages, disadvantages, risks, and warning signs to watch for. We have listed them here for you. Be sure to read the manufacturer's information, too. We are happy to answer any questions you have.
We will also give you information about the use, effectiveness, advantages, disadvantages, risks, and warning signs of other methods. You should read these materials, as well. Let us know if you have any questions about them.
Description
The Patch is a new combined hormone method of birth control. It is a thin, beige, plastic patch that sticks to the skin. The sticky surface contains the hormones norelgestromin and ethinyl estradiol. They are similar to the estrogen and progestin made by a woman's body. Constantly absorbed into the bloodstream through the skin, they keep the ovaries from releasing eggs. The patch is applied once a week for three weeks in a row, followed by a Patch-free week.
The Patch is very effective if used correctly. Of every 100 women who use the Patch, fewer than one will become pregnant with consistent and correct use. Although no studies have yet been published, it is assumed that typical use of the Patch will be more effective than the Pill.
While the Patch may be less effective for women who weigh more than 198 lbs (90kg), it may still be a good option for them. It may also be less effective if it is taken with certain drugs, especially some that are used to control seizures. Be sure to talk with your clinician if you take any other medicine. Tell other clinicians you see that you are using the Patch.
Should you miss two periods in a row, it is possible that you may be pregnant. You need to call your clinician. If you are pregnant, remove the Patch immediately, and notify your clinician.
The Patch offers no protection against sexually transmitted infections (STIs). Condoms are the best way for sexually active people to reduce the risk of STIs. Always use a condom if you or your partner has other sex partners.
Benefits
- No medicine to take every day;
- Nothing to do right before sex to make it work;
- Ability to become pregnant should return quickly.
Because the Patch works like the Pill, it probably offers the same non-contraceptive benefits: These include:
- More regular periods;
- Fewer menstrual cramps;
- Less blood loss;
- Less iron deficiency anemia;
- Less acne;
- Some protection from non-cancerous breast tumors and ovarian cysts;
- Some protection against cancers of the ovaries and uterus;
- Decreased risk of PID (pelvic inflammatory disease);
- Decreased risk of ectopic pregnancy.
Disadvantages
Some women may forget to apply and remove it on schedule.
It may cause lens wearers a change in vision or an inability to wear their lenses.
Possible side effects that usually clear up after two or three months include:
- Breast discomfort
- Headache
- Skin irritation at the patch site
- Nausea
- Abdominal pain
- Menstrual cramps
Risks
Ortho Evra® users have a slightly greater risk than non-users of developing certain serious problems that may cause death in rare cases, including:
- Blood clots in the legs that can travel to the lungs;
- Heart attack or stroke;
- Liver tumors.
The risk of developing serious health problems increases with age - being over 35 years old - and when certain other health risk factors are present, such as:
- Smoking more than 15 cigarettes a day;
High blood pressure;
- High levels of blood cholesterol or fat;
- Diabetes.
Other current and/or past conditions may also make it inadvisable to use the Patch or may require special tests and follow up in order to use it. Tell your clinician if you have had any of the above or any of the following:
- High risk for heart attack or stroke;
- A heart attack, angina or certain types of stroke;
- Serious heart valve problems;
- Blood clots in the veins or arteries;
- Serious liver Cancer of the breast, uterus liver, or meningioma;
- Migraine with aura;
- Depression;
- Prolonged bed rest, for example, after major surgery;
- Yellow jaundice during a pregnancy or with birth control pill use;
- Unevaluated abnormal genital bleeding;
- Active gall bladder disease;
- Seizure disorders that require using certain anti-convulsants.
The Patch is not recommended for women who are, or think they are, pregnant.
Warning Signs
Because the Patch is new, we assume it has risks similar to the Pill. Call the clinic right away if you have:
- Sharp or crushing chest pain or coughing blood;
- Shortness of breath;
- Unusual swelling or pain in the legs or arms;
Sudden severe headaches;
- changes in the frequency, severity, or associated symptoms of your headache;
- Eye problems such as blurred or double vision or loss of vision;
- Severe pain in the stomach or abdomen;
- Yellowing of the skin or eyes;
- Severe depression;
- Unusually heavy bleeding from the vagina;
- New lump in your breast;
- No period after having a period every month.
STAY HEALTHY
Regular physical examinations for routine health care and for screening for sexually transmitted infections and for cancer are strongly recommended.
When to Use the Patch
The Patch is worn for one week. Put on a new Patch each week for three weeks (seven days each for a total of 21 days). Change the Patch on the same day of every week - "Patch change day". Do not put on a patch for the fourth week. That's when your menstrual period should start. Put on a new patch on the "patch change day" after the end of the fourth week. Your clinician will advise you when to start using the Patch - usually, it will be during the first five days of your next period.
How to Put On the Patch
Each patch is sealed in a pouch to protect it until you are ready to wear it. Tear it open along the top edge and the side edge. Peel the foil open and lay it flat. Take the patch and plastic layer off the foil. Peel one half of the clear layer of plastic away from the Patch. Be careful not to touch the sticky part. Apply the sticky half of the Patch to clean, dry skin on your buttocks, abdomen, upper outer arm, or upper torso. Never put the Patch on your breasts. Remove the other half of the plastic, and press the whole Patch to your skin. Hold in place with your palm for 10 seconds.
The Patch is meant to stay in place while swimming, taking saunas, using whirlpools, or sweating. But, rarely, the Patch can loosen or come off the skin. Check your patch every day to make sure it is sticking properly.
If the Patch Becomes Loose or Falls Off
For less than 24 hours: Apply a new patch immediately. The "patch change day" stays the same
No back-up contraception is needed
For more than 24 hours or an undetermined amount of time: You could become pregnant.
Start a new four-week cycle by putting on a new patch
This is day 1 and your new "patch change day"
Use back-up contraception for the first week of this new cycle.
Don't try to put a patch back on if: It isn't sticky any more. It gets stuck to itself or something else. It's gotten loose or fallen off.
WARNING: Never use tape or anything else to keep the Patch in place. If it doesn't stick to your skin by itself, it won't be effective. If a patch won't stick any more, put on a new patch right away.
If you Forget to Change Your Patch
At the start of a patch cycle - "patch change day" of the first week: You could become pregnant. Put on the first Patch of your new cycle as soon as you remember. This becomes your new "patch change day". Use back-up contraception for the first week of this new cycle.
In the middle of a patch cycle (week 2 or 3):
If you forgot to change the patch for one or two days: Put on a new patch as soon as your remember. Put on your next patch on your normal "patch change day." No back-up contraception is needed.
If you forgot to change your patch for more than two days: You could become pregnant. Put on a new patch as soon as your remember
This starts a new four-week cycle. You have a new "patch change day". Use back-up contraception for the first week of your new cycle.
At the end of a patch cycle (the fourth week):
Take the patch off as soon as your remember. Start your next cycle on your normal "patch change day".
No back-up contraception is needed.
When to Expect Your Period
Most women who use the Patch bleed sometime in the patch-free week - fourth week. You still may be bleeding - usually spotting - when it's time to put on a new patch. Put on the Patch, even if you are still eding, in order to stay protected against pregnancy.
Storing and Discarding Ortho Evra®
Keep the Patch at room temperature. Don't store it in the refrigerator or freezer. Keep patches sealed in their pouches. Put them on as soon as you remove them from the pouch.
Used patches still contain some active hormones. Be sure to fold each used patch in half to stick it to itself. Put it in a plastic bag, seal it, and throw it away. This reduces the chance of estrogen seeping into the soil and water supply. It also protects children who might play with a used patch. Do not flush patches down the toilet.
This document is for informational purposes only and is not intended to constitute medical advice, diagnosis, or treatment.
