Birth Control Patch (Ortho Evra)

What is the birth control patch?

The birth control patch is a way to prevent pregnancy. The patch, which is put on your skin, contains the female hormones estrogen and progesterone. These hormones are also in birth control pills and vaginal rings. The hormones are on the sticky side of the patch. The brand name of the patch is Ortho Evra.

The patch is a weekly form of birth control. When a patch is on your skin, the hormones are absorbed through the skin. The hormones move into your bloodstream and stop ovulation (release of eggs from the ovaries). The hormones also help prevent pregnancy in 2 other ways. They cause a thickening of the mucus on the cervix and they change the lining of the uterus. The thickened mucus on the cervix makes it hard for sperm to enter the uterus. The change in the lining of the uterus helps prevent a fertilized egg from attaching to the uterus.

How is it used?

Each patch is worn on your skin for a week. Place a patch on a clean, dry, healthy area of skin on your buttock, abdomen, upper outer arm, or upper body. Put it on an area where it will not be rubbed by tight clothing. You can wear a patch in a different place each week to avoid irritation.

Do not put a patch on skin that is red, irritated, or cut. Do not put it on your breasts. Also, do not apply the patch over makeup, creams, lotions, powder, or other skin products because the patch may not stick well. These products may also affect the absorption of the hormones into the skin.

When you use birth control patches for the first time, you may start by putting a patch on your skin the first day of your menstrual period. Leave the patch on for 7 days and then take it off and replace it with a new patch every 7 days for a total of 3 weeks. On the first day of the fourth week, remove the third patch and do not wear a patch for 1 week. You should have a menstrual period at this time. After 7 days without a patch, start a new patch. Repeat this cycle every 4 weeks, regardless of when you have your menstrual periods. Apply the patch on the same day of the week each week. This is your "patch change day."

Another way to start using patches is to start a patch on the first Sunday after your menstrual period starts. You will then put a new patch on each Sunday for 3 weeks. On the fourth Sunday you will take off the third patch and not put on another patch until the next Sunday. If the first time you use a patch is the first Sunday after your menstrual period, rather than the first day of your menstrual period, you should use some other form of birth control during the first week, such as condoms, a diaphragm, or a spermicide.

In some situations, you may be able to use the patch continuously for 12 weeks instead of just 3 weeks to lower the amount of bleeding that you have. However, you should discuss this option with your healthcare provider to see if this is safe for you.

If you have recently been pregnant or are breast-feeding, discuss with your healthcare provider the best time for you to start using the patch.

Use a backup method of birth control (such as condoms and spermicide) until you have been wearing a patch for 2 weeks.

Most women can get pregnant soon after they stop using the patch unless they had irregular menstrual periods before using the patch. If you want to get pregnant, it is best to wait until you have had 2 normal periods after stopping birth control. This will help your healthcare provider know when your baby is due.

What should I do if the patch falls off?

If a patch becomes loose or is off your skin, you should replace the patch with a new one. No backup birth control is necessary if a patch is back on your skin within 24 hours. Your usual patch change day will stay the same.

If a patch is loose or is off your skin for more than 24 hours, or you are not sure how long the patch has been off, start a new cycle with a new patch. In this case, your patch change day will change and you should use some form of backup birth control for the next 7 days. If you have any questions when this happens, call your healthcare provider for advice.

Do not use tape, bandages, or wraps to hold a patch in place. Always use only 1 patch at a time.

What are the benefits?

• The birth control patch can be up to 99% effective in preventing pregnancy. This means that, for every 100 women who use patches for a year, 1 woman may become pregnant. Your chance of getting pregnant increases if you do not use the patches exactly according to the directions.
• You do not have to remember to take a pill for birth control every day.
• You do not have to interrupt lovemaking to use a birth control device or spermicide.
• Periods become regular and usually lighter. Menstrual cramps may be less severe.
• Long-term use lowers the risk of cancer of the ovary.
• Birth control patches may reduce symptoms of premenstrual syndrome (PMS).

What are the disadvantages?

If you have oily skin, it may be hard to keep the patch on your skin.

Some of the side effects you might have while you are using the patch are:

• skin irritation where you apply a patch
• irregular vaginal bleeding or spotting
• dizziness
• nausea and vomiting
• swelling of your hands or ankles
• pain, swelling, or tenderness in the abdomen
• breast swelling or tenderness
• more appetite and weight gain
• trouble sleeping, weakness, lack of energy, fatigue, or depression
• headaches
• vaginal infection (usually yeast)
• allergic reaction, rash, itching
• amenorrhea (absence of menstrual period)
• less interest in sex
• changes in hair growth patterns
• vision or contact lens problems
• acne
• yellowing of the skin or whites of the eyes (jaundice)

You should not smoke. Smoking increases the risk of serious side effects, such as heart attack, stroke, and blood clots. This is especially true if you are over 35 years old and smoke 15 or more cigarettes a day.

The patch may be less effective in protecting you against pregnancy if you weigh over 198 pounds or are taking certain medicines, such as some antibiotics or seizure medicines. Tell your provider about all medicines or natural remedies that you are taking.

The patch does not protect you from getting AIDS or other sexually transmitted disease. Latex or polyurethane condoms are the only safe way to protect against AIDS.

Who should not use the birth control patch?

Some women with chronic diseases or other problems should not use the birth control patch. For example, women who have had blood clots, certain cancers, abnormal vaginal bleeding, high blood pressure, heart attack, or stroke should not use the patch. If you think you may be pregnant, you should not use the birth control patch. Your healthcare provider will discuss your medical history with you.

When should I call my healthcare provider?

Call your provider right away if you have any of the following symptoms:

• sharp chest pain or sudden shortness of breath or are coughing up blood
• sudden severe headache or vomiting, dizziness or fainting, or problems with vision or speech
• sudden partial or complete loss of vision
• yellowing of the skin or whites of the eyes (jaundice), especially with fever, tiredness, loss of appetite, dark urine, or light-colored bowel movements
• unexplained pain, weakness, or numbness in the calf of one of your legs
• severe pain, swelling, or tenderness in the abdomen

Call during office hours if:

• You need help or advice from your provider for side effects or problems with the patch.
• You have problems with your menstrual periods, such as bleeding between periods, prolonged periods, or 2 missed periods, or you think you are pregnant.
• You have more headaches than you used to have.
• You have severe mood changes, such as nervousness or depression.
• You have vaginal discharge with itching.
• You develop a rash.