Подпись: Ortho Evra patch A thin, peach-colored patch that sticks to the skin and time-releases synthetic estrogen and progestin into the bloodstream to inhibit ovulation, increase cervical mucus, and render the uterus inhospitable; also referred to as the "patch." Hormonal PatchПодпись:The Ortho Evra patch is a hormonal method of birth control that was introduced in 2002. It is a thin, peach-colored patch that sticks to the skin and time-releases hormones into the bloodstream. The Ortho Evra patch costs about $30 to $35 per month, and the initial office visit often costs between $35 and $125.

How It Works Like birth control pills and the NuvaRing, the Ortho Evra patch uses synthetic estrogen and progestin to inhibit ovulation, increase cervical mucus, and render the uterus inhospitable to implantation. Although we used to believe that the patch contained similar levels of estrogen as oral contraceptives, in late 2005 the FDA updated labeling for the Ortho Evra contraceptive patch to inform users that the patch exposes them to higher levels of estrogen than most birth control pills (U. S. Food and Drug Administration, 2005). This is important for women who might have certain risk factors, including potential blood clots.

The Ortho Evra patch is placed on the buttock, stomach, or upper torso once a week for 3 weeks. No patch is used during the 4th week; this is when a woman will usually have her period. It works best if the patch is changed on the same day of the week for 3 weeks in a row. A woman can maintain an active lifestyle with the patch in place—she can swim and shower without worrying that the patch will fall off.

Effectiveness Like NuvaRing, the patch has not been available long enough to generate typical use effectiveness rates. However, it is similar to NuvaRing, with perfect use effectiveness rates around 99.7% (Hatcher & Nelson, 2004). However, it may be less effective in women who weigh more than 198 pounds (Hatcher & Nelson, 2004). As with other hormonal methods, certain medications, such as antibiotic and seizure drugs, can decrease effectiveness. Heat, humidity, and exercise have not been found to inter­fere with adhesion or effectiveness rates (Zacur et al., 2002), nor have saunas, water baths, or swimming (Burkman, 2002).

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The Ortho Evra patch currently comes only in a peach-tone color, which makes it very visible on African American women. Other colors and a clear patch are being evaluated by the manufacturer for future development (orthoevra. com, 2005).

Advantages Like other hormonal methods of birth control, the Ortho Evra patch has a high effectiveness rate; does not interfere with spontaneity; reduces menstrual flow, menstrual cramps, and premenstrual syndrome; and increases menstrual regularity (Hatcher & Nelson, 2004). The patch may also offer some protection against ovarian and endometrial cancer and ovarian cysts. The patch has over a 90% perfect dosing level because it is applied to the skin (Burkman, 2002).

Disadvantages The Ortho Evra patch offers no protection from STIs and may cause a variety of side effects, including breakthrough bleeding, weight gain or loss, breast tenderness (especially in the first 3 months of use), nausea, mood changes, changes in sexual desire, skin changes or irritation, and a change in vision. Some women may not be able to use their contact lenses because of these changes. In addition, some women report that they dislike the fuzz and lint that the patch collects from their cloth­ing, and that it is nearly impossible to conceal the patch from a partner. Because this method is new, there are no data on extended use.

Cross-Cultural Use We don’t know a lot about Ortho Evra’s use outside the United States because it is so new. However, early estimates have found that approxi­mately 2 million women worldwide use the contraceptive patch (Bestic, 2005).

| progestin-only birth control method

Contraceptive hormonal method that does not contain estrogen and works by changing a woman’s menstrual cycle.

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