Lesson 3: More Advances in Birth Control
Ortho Evra, the Birth Control Patch

Ortho Evra is about a 2-inch square patch that is placed on one of four different areas of a woman's body for one week at a time. It can be placed on the buttocks, abdomen, upper outer arm, or upper torso, but not on the breasts. The patch is used for three weeks, and then there is a patch free week during which the woman should have her period.

The patch should be changed every week on the same day it was first applied, for three weeks. On the fourth week, no patch is applied to the skin and the woman should have her period during this week. The patch change day can be altered during this week. For example, if you would like to change from a Monday to a Thursday, the new patch for the next cycle should be applied on the Thursday following the Monday the patch was removed.

The patch works by releasing hormones through the skin into the blood stream. The hormones, estrogen and progestin, prevent pregnancy by stopping egg production (no ovulation), and thicken the cervical fluids. The patch should be applied to the skin either within the first 24 hours of a woman's period starting, or on the Sunday following the beginning of the period. If applied within 24 hours of bleeding, no back up method is needed. If the patch is applied on the Sunday following the start of the period, a back up method should be used for seven days. There is a slight chance (2%) that the patch will fall off. If this happens, the user should try to reapply the patch immediately. If the patch will not adhere to the skin, it should be disposed of and a new patch applied.

When applied and changed as directed, the patch is 99% effective at preventing pregnancy. Women weighing more than 198 pounds should not use the patch, as it is not as effective.

Side effects reported during trials of the patch included; skin irritation, headache, nausea, breast tenderness or swelling, irregular bleeding, mood swings, bloating, upper respiratory infection, abdominal pain, and menstrual cramps.

There are many pros to using the patch including; convenience, fully reversible, highly effective, can be worn under clothing, costs similar to the pill, and can be worn during a shower, swimming, and other water/sweat activities. Some of the cons to using the patch include; need a prescription, must be changed weekly, does not protect against STDs, not effective if weight is over 198 pounds, some medications and herbs can decrease effectiveness, side effects, and may leave a 'dirty ring' on skin when removed.