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Contraceptive Patch (Ortho Evra)

What is it?

The patch is a prescription-only, reversible, contraceptive method worn on a woman’s skin that releases estrogen and progestin into the woman’s bloodstream.

How does it work?

The Patch prevents pregnancy by delivering continuous levels of hormones (progestin and estrogen) into the bloodstream through the skin. Following this process, the Patch works the same way that pills do: by preventing ovulation. This means that the ovary does not release an egg to be fertilized. It also thickens the cervical mucus, which makes it more difficult for sperm to enter the uterus, and it changes the endometrium, which is the mucus membrane that lines the uterus, to reduce the chance of implantation. 

The Ortho Evra patch is worn for one week at a time and is changed on the same day of the week 3 times a month.  The fourth week is patch free.

Where do I put it?

Choose a place on your body to put the Patch.

The Patch may be placed on your upper outer arm, abdomen, buttock or upper torso in a place where it won't be rubbed by tight clothing; for example, do not place the Patch at the waistband of your clothing. Do not put the Patch on your breasts, on cut or irritated skin, or on same location as the previous Patch.

When do I change it?

The Patch works for seven days (one week). Apply a new patch on the same day each week (your Patch Change Day) for three weeks in a row. Make sure you have removed your old patch prior to applying the new patch.

During week 4, DO NOT wear a patch. Make sure you removed your old patch. (Your period should begin during this week.) Following week 4, repeat the cycle of three weekly applications followed by a patch-free week

What if my Patch becomes loose or falls off?

The Patch must stick securely to your skin to work properly.

If a Patch edge lifts up:

Press down firmly on the Patch with the palm of your hand for 10 seconds, making sure that the whole Patch adheres to your skin. Run your fingers over the entire surface area to smooth out any "wrinkles" around the edges of the Patch.

If your Patch does not stick completely, remove it and apply a replacement Patch. (Ask your healthcare professional for a replacement Patch prescription so you always have an extra Patch available).

Do not tape or wrap the Patch to your skin or reapply a Patch that is partially adhered to clothing

If your Patch has been off or partially off:

For less than 1 Day, try to reapply it. If the Patch does not adhere completely, apply a new patch immediately. (No backup contraception is needed and your Patch Change Day will stay the same)

For more than 1 Day or if you are not sure for how long, you may become pregnant. To reduce this risk, apply a new Patch and start a new 4-week cycle. You will now have a new Patch Change Day and must use non-hormonal backup contraception (such as a condom, spermicide, or diaphragm) for the first week of your new cycle.

How Effective is it? The Patch is as effective as oral contraceptives:

  • Typical Use:  92%
  • Perfect Use:  99.7%   

What are the advantages unique to the patch?

Weekly routine compared to daily

No pills to swallow

What are the disadvantages unique to the patch?

Skin irritation and 1-2% experience partial or complete detachment of patch

Patch may be less effective for women over 198 lbs.

Only one formula and color are available at this time.

It does not protect against the transmission of sexually transmitted infections including HIV (AIDS).  Use latex condoms for increased protection against the transmission of sexually transmitted infections including HIV (AIDS).

May be exposed to approximately 60% more estrogen as compared to taking the pill.  Why? Birth Control pills go through the digestive system and are therefore diluted; not so for the hormones in patch.

What are the possible side effects of ORTHO EVRA®?

  • Most Common Side Effects: Include nausea, breast symptoms (discomfort, engorgement, or pain), headache, and skin problems.
  • Skin Irritation: Skin irritation at the site of application. If this occurs, remove the Patch and apply a new Patch at a new location until the next Change Day.
  • Vaginal Bleeding: Irregular vaginal bleeding or spotting may occur. If bleeding occurs in more than a few cycles or lasts for more than a few days, call your healthcare professional.
  • Problems Wearing Contact Lenses: If you wear contact lenses and notice a change in vision or an inability to wear your lenses, contact your healthcare professional.
  • Fluid Retention: Edema (fluid retention) in the ankles or fingers and/or a rise in blood pressure may occur. Contact your healthcare professional if you experience fluid retention.
  • Melasma: A spotty darkening of the skin, particularly on the face, is possible. This may persist after you stop using ORTHO EVRA®.
  • Other Side Effects: Weight gain, feeling dizzy, migraine, stomach pain or bloating, vomiting, diarrhea, acne, muscle spasms, vaginal infections, tiredness, painful or heavy periods, more frequent periods, uterine cramps, vaginal discharge, and mood problems such as mood swings, depression, or anxiety.


What are health risks with using the patch?

Hormones from ORTHO EVRA® get into the bloodstream and are processed by the body differently than hormones from birth control pills. You will be exposed to about 60% more estrogen if you use ORTHO EVRA® than if you use a typical birth control pill containing 35 micrograms of estrogen. In general, increased estrogen may increase the risk of side effects such as serious blood clots, especially in women who have other risk factors, such as smoking, obesity, or age greater than 35 years. This increased risk is highest when you first start using hormonal birth control. Some studies have reported that women who use ORTHO EVRA® have a higher risk of getting a blood clot. Talk with your healthcare provider about your risk of getting a blood clot before deciding which type of birth control is right for you.

Do not use ORTHO EVRA® if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects (heart and blood vessel problems) from hormonal contraceptives, including death from heart attack, blood clots, or stroke. The risk increases with age and the number of cigarettes you smoke.

Other rare but potentially serious health risks of using the Patch are: stroke, heart attack, gall bladder disease, liver tumors, and slight increase in breast cancer.