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Birth Control Patch Takes a U.S. Bow

Patch a match for the Pill

FRIDAY, May 3, 2002 (HealthDayNews) -- American women now have another birth control option, and it could be the easiest, most convenient form of contraception yet.

Just released into the marketplace: Ortho Evra, the first contraceptive skin patch to be sold in the United States. Manufactured by Ortho-McNeil, it is designed to mimic combination birth control pills -- the ones containing synthetic estrogen and progesterone. A single patch works for a full seven days.

"It is definitely convenient and definitely easy to use, and is likely to increase compliance, since women only need to replace the patch once a week," says Dr. Patricia Stephenson, a principal investigator in the clinical trials that tested the patch for safety and efficacy. "I think it brings birth control to a new level, making it much easier, particularly for busy women."

The patch, available only by prescription, measures about one and three-quarter inches square, with a self-adhesive backing. It can be placed on any one of several areas of the body, including the lower torso (front or back) or the outside of the upper arm. One patch stays put for seven days, and a new one is placed in a new location on the eighth day. The hormone-laced patches are used for three weeks and followed by one week without a patch.

Both the Pill and the patch work in similar ways to prevent pregnancy -- primarily by blocking ovulation. Although both are said to be about 99 percent effective, this can vary greatly with compliance.

"Miss one pill and your odds change," Stephenson says. Likewise, forget to change your patch after seven days or let too many hours go by without putting on a new one, and you could dramatically decrease your protection as well, experts say.

For Dr. Yvette Martas, who did not participate in the studies, the patch is an important step forward in contraception. She has already started prescribing it to patients.

"I think the ease of use will make it a great contraceptive for young women, and I think the even, continued flow of hormones will be very beneficial to women in the perimenopause, helping to ease some of their transitional symptoms, while protecting against unwanted pregnancy," says Martas, an obstetrics/gynecology instructor at New York University School of Medicine.

Stephenson says the patch may also work well for women with PMS, particularly those whose symptoms are caused or exacerbated by sensitivity to fluctuations in hormone levels.

"It wasn't tested for this purpose, but using it in this way makes good sense," Stephenson says.

Although all birth control pills, as well as the patch, contain virtually the same type of synthetic estrogen, there is great variety in the type of progesterones that are used. Some, experts say, can cause decidedly more side effects than others, including mood swings and painful breasts.

The synthetic progesterone found in the patch, Stephenson says, is the one least likely to cause side effects, making it easier for all women to tolerate.

In terms of practical problems, both Stephenson and Martas report that some patients had poor reactions to the adhesive. For those with sensitive skin or conditions such as psoriasis, it's probably not the best option.

Although the patch is designed to stay on during bathing, showering or swimming, it can't be used in conjunction with skin lotions, including sun block. If you apply any product to your skin in the area where the patch will be applied, or if you use products too close to the patch after it's applied, you might disturb the adhesive quality.

If the patch falls off and can't be reapplied, you'll have to start a new one -- though most doctors prescribe a spare.

Currently, the patches come in just one color, light beige, which does not go over well with minority patients, Martas says.

Just in case you're thinking you'll be a little creative with a marker pen or even some eye liner, guess again. Doctors say you can't draw on or otherwise adorn the patch. Doing so could disrupt the membrane that holds the hormones, and ultimately alter the dosage you receive.

However, the manufacturer says they are working on a broader range of skin tones, as well as patches in "fashion colors" and "designer" shapes and patterns, making contraception of the future not only easy, but stylish.

Right now, a one-month supply of OrthoEvra patches will cost you about the same as a one-month prescription of birth control pills.

What To Do

For answers to frequently asked questions about the new birth control patch, visit Ortho-McNeil Pharmaceutical.

For more information on the Pill and other birth control options, check out Planned Parenthood.

SOURCES: Patricia Stephenson, M.D., partner and physician, Stoneridge OB/GYN, Sellersville, Pa; Yvettte Martas, M.D., clinical instructor, OB/GYN, New York University School of Medicine, New York City.
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