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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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 forms of the 2
female hormones estrogen and progesterone. These hormones
are also in birth control pills, monthly shots, and vaginal
rings. The hormones are on the adhesive 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 torso. Put it in an area
where it will not be rubbed by tight clothing. Do not put
the 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.
You can wear a patch in a different place each week to avoid
irritation.
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.
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. If
you do this within 24 hours, no backup birth control is
necessary. 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.
- You don't have to insert any birth control devices, and
there is no interruption of sex.
- You don't have to remember to take a pill for birth
control every day.
- You do not have to go to an office to get a shot every
month.
What are the disadvantages?
Side effects you might have while you are using the patch
are:
- changes in your menstrual periods and cycle, such as
spotting, irregular bleeding, or no periods at all
- nausea or vomiting
- swelling of your hands, ankles, or abdomen
- breast swelling or tenderness
- weight gain or loss
- headaches
- rash (caused by an allergic reaction)
- jaundice (yellowing of the skin or whites of the eyes)
- yeast infection of the vagina
- contact lens problems
- depression.
You might increase your risk of the following problems:
- blood clots in the arteries, veins, lungs, or brain
- heart attack
- brain hemorrhage (stroke)
- gallbladder disease
- tumors in the liver or breast cancer
- eye problems (such as double vision or blood clots).
Smoking increases the risks especially if you are 35 years
or older and smoke 15 or more cigarettes a day.
The patch may not keep protecting you against pregnancy if
you are taking antibiotics or medicines for seizures or
fungal infections. If you weigh 198 pounds or more, the
patch may not prevent pregnancy.
The patch does not protect you from getting AIDS or sexually
transmitted disease.
Who should not use the birth control patch?
You should not use the patch if you have the following
medical history or conditions:
- an allergy to any hormones
- blood clots in your legs, lungs, or eyes
- diabetes
- disease of the heart valves
- gallbladder, kidney, or liver disease
- headaches along with symptoms such as vomiting, double
vision, unsteadiness, weakness, or personality changes
- heart attack or stroke
- high blood pressure or high cholesterol
- breast cancer or cancer of the lining of the uterus,
cervix, or vagina
- unexplained vaginal bleeding
- yellowing of the eyes or skin (jaundice) during pregnancy
or during past use of birth control pills.
When should I call my health care provider?
Call your health care provider if:
- You need help or advice from your provider for side
effects or problems with the patch.
- You have chest pain.
- You have redness, swelling, or pain in your legs.
- You have abnormal or irregular vaginal bleeding.
- You become jaundiced (your skin looks yellow).
- You think you might be pregnant.
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