Ethinylestradiol (34mcg) and Norelgestromin (203mcg)

Ortho Evra Patch (norelgestromin/ethinylestradiol) is a type of combined hormonal birth control for women.

As the name implies, the medication is administered via a patch, which is placed on the upper arms, upper thighs, shoulders, lower abdomen, or buttocks. Patches are changed once-weekly, making the method somewhat more convenient than others. For comparison:

• Birth control pills are taken once daily.
• Patches are applied once per week.
• Vaginal rings are inserted once per month.
• Subdermal implants and intrauterine devices are administered every 3 years.

While vaginal rings, implants and IUDs are lower maintenance, they do have their drawbacks; all three can produce discomfort, and implants and IUDs require administration in a doctor's office. Since hormonal birth control occasionally needs to be interrupted for certain medical or dental procedures, or to prevent interactions with other medications, this can be quite inconvenient.

Patches are Easy to Use

Ortho Evra patches resemble a large, square Band-Aid. They do not restrict activities any way; women wearing a patch may shower, swim, exercise and otherwise participate in routine activities.

The most commonly-used Ortho Evra patch schedule is as follows:

• Apply the first patch within 24 hours of starting a period.
• Replace the patch with new patch every 7 days for 3 weeks.
• On the fourth week, do not apply a patch.
• After a patch-free week, apply new patches once per week for 3 weeks.
• Repeat for as long as birth control is desired.

In the unlikely event a patch falls off, try to reapply it. If it will not stick, a new patch can be applied and the schedule can resume as usual. If a patch has been off for longer than 24 hours, the schedule should be restarted and alternative birth control methods used for two weeks into the new schedule.

Other Benefits

Like birth control pills and other hormonal contraceptives, Ortho Evra patches provide additional, beneficial side effects, most notably the reduced risk of developing:

• Acne
• Ectopic pregnancy
• Ovarian cysts
• Pelvic inflammatory disease
• Non-cancerous breast tumors
• Vaginal dryness
• Endometrial cancer
• Ovarian cancer
• Pre-menstrual symptoms

Some women use hormonal contraceptives to skip periods altogether, either on occasion for special events or long-term, spanning months or years. To accomplish this the contraceptives are taken continually, rather than going a week without a patch or taking the 7 days of placebo pills. Because Ortho Evra patches contain more estrogen than pills, patches my not be the ideal choice. Speak to a doctor before using patches for this purpose.

Precautions Before Use

For the most part Ortho Evra patches are similar to birth control pills as far as risks and side effects. There are, however, a few things to keep in mind while using patches:

• Never apply an Ortho Evra patch, or any other hormonal patch, directly to the breasts; doing so may increase risk of breast cancer.
• Rotate application sites so new patches don't go on the exact same spot as the last one; this will reduce the risk of skin irritation.
• Do not use damaged patches; the medication may not be released correctly.
• Never apply more than one patch a time, this may considerably increase risk of side effects.

One of the side effects of combined hormonal birth control, or any medication containing estrogen, is blood clots, which can cause permanent disability or death. Women with preexisting risk factors are at greater risk for developing blood clots while using combined hormonal contraceptives:

• obesity
• Heavy smoking
• Over 35 years old
• History of blood clots
• Largely restricted to sitting or laying down

There is conflicting evidence that Ortho Evra patches may (or may not) further increase risk of women developing blood clots compared to birth control pills. Women with the above risk factors in particular should discuss the safety of using combined hormonal contraception with a trusted doctor before starting treatment.