by Dr. Wendy (OB/Gyn)

Question

What is the Ortho Evra Contraceptive Patch

Answer

The patch combines estrogen and progesterone in a skin patch that is worn weekly, three out of four weeks of the month. The patch is rotated from upper arm, buttocks, thighs and stomach (do not place on the breasts) each of three consecutive Sundays, and no patch is worn on the fourth Sunday, during which menses will occur. Instead of having to remember to take a pill on a daily basis, the patch user only has to remember to apply the patch 3 times per month.

Efficacy is comparable to the pill, with greater than 99% pregnancy protection. Side effects are similar to those of OCP users; in addition, patches can fall off and patients can develop skin rashes and reactions from the adhesive. It is less effective in women who weigh more than 198 lbs.

RECENTLY, CONCERN HAS ARISEN WITH THE PATCH OVER AN INCREASED RISK OF BLOOD CLOTS BECAUSE OF A HIGHER DOSE OF ESTROGEN BEING DELIVERED INTO THE BLOODSTREAM. WE DO NOT ROUTINELY USE THE PATCH BECAUSE OF THIS, HOWEVER, IN SELECTED PATIENTS WHERE THE RISK BENEFIT RATIO LEANS IN FAVOR OF USING IT, PATIENTS ARE APPROPRIATELY COUNSELED AND CAUTIONED, AND THIS MAY BE USED.

Wendy Fried, M.D., FACOG, FACS, is an OB/Gyn with Northern Obstetrics and Gynecology, PC in North Hills, New York

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