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.

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

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 health care 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, try to put it back on the same place or put a new patch on right away. No backup birth control is necessary if a patch is back on your skin within 24 hours. Your 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 health care 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 is 99% effective in preventing pregnancy. This means that, for every 100 women who use patches for a year, 1 woman will 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.

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:

• irregular vaginal bleeding or spotting
• skin irritation where you apply a patch
• nausea or vomiting
• swelling of your hands or ankles
• severe pain, swelling, or tenderness in the abdomen
• breast lumps or tenderness
• weight gain
• dizziness
• headaches
• rash (caused by an allergic reaction)
• jaundice (yellowing of the skin or whites of the eyes)
• vaginal infection (usually yeast)
• vision or contact lens problems
• mood swings
• trouble sleeping, weakness, lack of energy, fatigue, or depression.

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 not protect 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.

Some women with chronic diseases or other problems should not use the birth control patch. For example, women who have blood clots, certain cancers, or a history of heart attack or stroke should not use the patch. Your health care provider will discuss your medical history with you.

When should I call my health care provider?

Call your provider if:

• You need help or advice from your provider for side effects or problems with the patch.
• You start having severe headaches.
• You have chest pain.
• You have redness, swelling, or pain in your legs.
• You have irregular vaginal bleeding or spotting that happens in more than 1 menstrual cycle or lasts for more than a few days.
• You become jaundiced (your skin looks yellow).
• You think you might be pregnant.