Weekly Birth Control Patch Increases Estrogen Exposure
ROCKVILLE, Md., Nov. 11 – Women using Ortho Evra, a weekly transdermal contraceptive, are exposed to 60% more estrogen than women who use daily birth control pills that contain 35 üg of estrogen, the FDA has acknowledged.
The agency announced a revision to the label for Ortho Evra, the only FDA-approved transdermal contraceptive. The new label includes a bold-face warning about higher exposure to estrogen.
“Higher levels of estrogen may put some women at increased risk for getting blood clots,” the FDA said. “When thinking about prescribing or using Ortho Evra, healthcare professionals and women need to balance the increased exposure to estrogen against the chance of pregnancy if a birth control pill is not taken daily.”
Ortho Evra has come under increased scrutiny since last July when the Associated Press reported that deaths from heart attacks and strokes were three times higher among women using the patch than among women using daily birth control pills. That report triggered a number of liability actions among women using the patch.
The patch is made by Ortho-McNeil, a division of Johnson & Johnson. Ortho-McNeil said that the patch leads to higher steady state concentrations of estrogen, which increases estrogen exposure compared with birth control pills.
Since smoking increases the risk of heart attack and stroke, women who use Ortho Evra “are strongly advised not to smoke,” said the FDA.
How To Start Taking The Minipill
Before starting the minipill, talk to your doctor about what day to begin.
You can start using this pill on any day of your menstrual cycle, but depending on where you are in your cycle, you may have to use a backup birth control method for a few days.
If you start taking the minipill during the first 5 days of your period, you should be fully protected, and you wont need any additional contraception.
If you start on any other day, youll need to use an extra method of protection for at least 2 days.
If your period has a short cycle, you should use additional birth control until youve been on the minipill for at least 2 days.
All oral contraceptives have potential side effects, and they vary in intensity from person to person.
The Cleveland Clinic reports these side effects from the progestin-only minipill:
If you want hormonal birth control without estrogen, the minipill is just one option. There are several other progestin-only birth control options. Each one works differently and has unique side effects and risks.
Heres a quick rundown of your options.
Depo-Provera is an injection. It works the same way as the progestin-only pill. It thickens the mucus around your cervix to prevent sperm from reaching an egg. Additionally, it stops your ovaries from releasing eggs.
Each injection lasts around 3 months.
Like the minipill and progestin injection, an implant releases small amounts of progestin into your system.
This causes:
Does It Matter Which Patch I Use From The Box
No. Each patch delivers the same amount of medication each week. Therefore, the patches can be used in any order. However, a new patch must be applied on the same day of the week for 3 consecutive weeks. The 4th week is “patch free.” This patch-free week is similar to the placebo or 4th week with birth control pills during which inactive pills or no pills are taken.
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Disadvantages Of The Birth Control Patch
Patches might not be the best choice if you:
- Need protection against STDs like HIV and chlamydia. The male condom is the best contraceptive for that.
- Are over 35 and you smoke.
- Weigh more than 198 pounds. The patch may be less reliable for heavier people.
- Are pregnant or think you might be.
- Are prone to blood clots, have had breast or uterine cancer, or take drugs for epilepsy. Because the patches continually deliver estrogen, they may raise your chances of these problems slightly more than a regular birth control pills does. than typical birth control pills, which may raise your chances of problems.
When To See A Doctor
If your mood swings are mild or moderate, exercise, healthier eating, relaxation, and other lifestyle changes may bring you relief. See your doctor if you feel depressed, feel no energy, or have other severe symptoms that interfere with your daily life.
American Family Physician: âDo the emotional side-effects of hormonal contraceptives come from pharmacologic or psychological mechanisms?â âManaging Adverse Effects of Hormonal Contraceptives.â
Medical Hypotheses: âDo the emotional side-effects of hormonal contraceptives come from pharmacologic or psychological mechanisms?â
Mayo Clinic: âCombination Birth Control Pills.â
Contraception: âThe relationship between progestin hormonal contraception and depression: a systematic review.â
International Journal of Environmental Research and Public Health: âDo Progestin-Only Contraceptives Contribute to the Risk of Developing Depression as Implied by Beta-Arrestin 1 Levels in Leukocytes? A Pilot Study.â
American Society for Reproductive Medicine: âHormonal Contraception.â
Womenshealth.gov: âWhat happens during the typical 28-day menstrual cycle?â âPremenstrual syndrome ,â âPremenstrual dysphoric disorder .â
UpToDate: âPatient education: Premenstrual syndrome and premenstrual dysphoric disorder .â
JAMA Psychiatry: âAssociation of Hormonal Contraception With Depression.â
CDC: âNational Health Statistics Reports: Contraceptive Methods Women Have Ever Used: United States, 1982-2010.â
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How Effective Is The Birth Control Patch
The birth control patch is an effective way to prevent pregnancy. According to Planned Parenthood, with perfect use, it is 99% effective.
However, many people tend to be forgetful and make mistakes when using different forms of birth control, including the patch. According to the Centers for Disease Control and Prevention , with typical use, the patch is ineffective in 9% of cases.
The correct use of the birth control patch is, therefore, essential. When people do not use it correctly, pregnancy can occur.
The birth control patch may not prevent pregnancy due to a person:
- forgetting to apply a new patch every week
- taking certain antibiotics, such as rifampin or isoniazid and rifampin
- using griseofulvin , an antifungal medication
- taking certain antiseizure medications
- using the herbal supplement St. Johns wort
People taking any of the above medications should consider using an additional form of birth control, such as condoms. Anyone who is taking the medication in the long term should consider switching to a different type of contraceptive.
Poor storage conditions may also lessen the patchs efficacy. It is important to keep the patches at room temperature and out of the sun. People should not open the pouches until it is time to apply a patch.
If the patch falls off for several days in a row, this could also make it ineffective. People should refer to the product instructions to see what to do in this situation.
Quick Read Dont Awfulize Stroke Risk
- Estrogen-containing birth control pills can slightly increase stroke risk.
- The risk is higher for women who smoke or have migraines with aura.;
- The pills have some health benefits, such as lowering ovarian cancer risk.
Youve probably heard that taking birth control pills can increase your stroke risk. That sounds pretty scary, but what does it actually mean? How much is the risk increased? And how worried should you be?
To answer these questions and more, we consulted two experts: Elizabeth Micks, M.D., M.P.H., an OB/GYN and contraception specialist at the Womens Health Care Center at University of Washington Medical Center-Roosevelt; and Malveeka Sharma, M.D., a neurologist at Harborview Medical Centers Stroke Clinic.
Both want to reassure women that, while birth control pills do come with a slightly elevated risk for stroke, the chances of a stroke happening are very low.;
Each year, according to Micks, approximately 8 out of every 100,000 women taking birth control pills will have a stroke.
With birth control, as in all aspects of medicine, were always weighing the risks versus the benefits, Micks says.
Trying to decide if the pill is right for you, or want to know more about its ties to stroke? Here are more facts about birth control and stroke.
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Who Should Not Use A Birth Control Patch
While the FDA still claims that the Patch is a safe choice for some women, other experts are not so sure. In 2008. Johnson & Johnson paid almost $69 million to settle lawsuitsfiled on behalf of women who suffered from blood clots, heart attack, stroke, or death after using the Patch.
For women who are not at a particular risk for blood clots or stroke, the FDA still defends the Patch as a safe birth control method. However, the FDA does not compare the relatively safety of different birth control products with each other, they compare each to pregnancy, which also increases the chances of a healthy woman developing a blood clot, heart attack, stroke, or death. The FDA recommends that all women, especially women who smoke or are at risk for blood clots, talk with their health care provider about which method of birth control is best for them. Perhaps the most important question is: why take a risk with the Patch when safer alternatives are available?
To read more about the dangers of birth control pills containing drospirenone, click;here.
To find out more about the symptoms of blood clots, click;here.
All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.
References
How Do I Use The Birth Control Patch
Youll first need to talk with your healthcare provider about the pros and cons of the birth control patch, as well as any health risks. The patch is only available by prescription.;
After receiving a prescription, youll apply the first patch during the first 24 hours of your period. It will become effective immediately with no need for backup contraceptive methods . Another option is to apply the first patch on the first Sunday after your period has started, which will require using a backup method for the next seven days. The first day you apply the transdermal patch will become your patch change day, so mark it on your calendar!
Talk to your doctor about your options if you are switching from a different birth control method to the patch, or are beginning the patch after an event such as childbirth or miscarriage.
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Where Is The Birth Control Patch Available
A doctor or a nurse practitioner must prescribe the patch. He or she will ask questions about health and family medical history, and may also do a complete physical exam, including a blood pressure measurement and a pelvic exam. If recommending the patch, the doctor or nurse practitioner will write a prescription and give you instructions on how to use it.
Those who start using the patch may be asked to return within a few;months for a blood pressure measurement and to make sure that there are no problems. After that, a doctor may recommend routine exams once or twice a year or as needed.
What Are The Side Effects Of Birth Control Pills And The Patch
Birth control pills
The most common side effects of the birth control pills include nausea, headache, breast tenderness, weight gain, irregular bleeding, and mood changes. These side effects often subside after a few months’ use. Scanty menstrual periods or breakthrough bleeding may occur but are often temporary, and neither side effect is serious. Women with a history of migraines may notice an increase in migraine frequency. On the other hand, women whose migraines are triggered by fluctuations in their own hormone levels may notice improvement in migraines with oral contraceptive use because of the more uniform hormone levels during oral contraceptive use.
Uncommonly, oral contraceptives may contribute to increased blood pressure, blood clots, heart attack, and stroke. Women who smoke, especially those over 35, and women with certain medical conditions, such as a history of blood clots or breast or endometrial cancer, may be advised against taking oral contraceptives, as these conditions can increase the adverse risks of oral contraceptives.
Ortho Evra
WARNING
Ortho Evra is intended to prevent pregnancy. It does not protect against HIV or other sexually transmitted diseases such as chlamydia, genital herpes, genital warts, gonorrhea, hepatitis B, and syphilis.
The most common side effects of Ortho Evra include:
In addition, change in appetite, nervousness, depression, dizziness, loss of scalp hair, rash, and vaginal infections may occur.
Skin Irritation
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How Do I Change My Patch Change Day
If you wish to move your “patch change day” to a different day of the week, finish your current cycle, removing your 3rd patch on the correct day. During week 4, the “patch-free” week, , you may choose a new “patch change day” by applying a new patch on the day you prefer. You now have a new day 1 and a new “patch change day.” You should never have the patch off for more than 7 days in a row.
Should You Consider A Birth Control Patch
When choosing a method of birth control, most women want what is the most effective and convenient. Women who want hormonal birth control can choose a pill, patch, injection, or vaginal ring. Using hormones for birth control has various benefits and risks. Over the past several years scientists discovered that some forms of birth control have higher risks than others. The Patch was shown to put women at greater risks than birth control pills by exposing women to higher levels of estrogen. How does the Patch work, and why is it more dangerous than other forms of birth control?
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Advantages And Disadvantages Of The Patch
Advantages:
- it’s very easy to use and doesn’t interrupt sex
- unlike the combined oral contraceptive pill, you don’t have to think about it every day you only have to remember to change it once a week
- the hormones from the patch aren’t absorbed by the stomach, so it still works if you’re sick or have diarrhoea
- it can make your periods more regular, lighter and less painful
- it can help with premenstrual symptoms
- it may reduce the risk of ovarian, womb and bowel cancer
Disadvantages:
- it can cause skin irritation, itching and soreness
- it doesn’t protect you against STIs, so you may need to use condoms as well
- some women get mild temporary side effects when they first start using the patch, such as headaches, sickness , breast tenderness and mood changes this usually settles down after a few months
- bleeding between periods and spotting is common in the first few cycles of using the patch this is nothing to worry about if you’re using it properly and you’ll still be protected against pregnancy
- some medicines can make the patch less effective see a GP, nurse or pharmacist for advice
- you need to remember to change it every week, so if it would be easier to use a method that you don’t have to think about you may want to consider the implant or intrauterine device
How Can Pandia Health Help
Choosing the right birth control can be challenging, especially with so many options available. Pandia Health can take a HUGE chunk of your stress away. If you live in AZ, CA, CO, FL, GA, IL, MI, NV, TX, TN, PA, WA, or WY, sign up for an online consultation with one of our expert doctors they can help you find a prescription that best fits your health and lifestyle needs.;
Already have a prescription you love? No problem! for our FREE delivery service to get your pill packs shipped directly to your mailbox. We deliver to all 50 states. With Pandia Health, you can #SkipTheTrip to the pharmacy and feel confident that you will never run out of birth control.;
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What Are The Benefits Of Using The Patch
Regular cyclesThe patch can help regulate the menstrual cycle, and this is especially helpful for people with periods that come too often or too infrequently.
Reduced menstrual crampsThe patch can offer significant relief to people with painful menstrual cramps. It also reduces the amount of blood flow during the period. Less blood loss is helpful in preventing anemia.
AcneWe have known for years that oral contraceptive pills can improve some people’s acne. The patch may or may not have a beneficial effect on acne.
Other important benefitsThe risk of developing benign breast cysts, ovarian cysts, pelvic inflammatory disease, and tubal pregnancy are reduced by taking oral contraceptive pills. The pill is also associated with a markedly decreased risk of uterine cancer and ovarian cancer. Since the patch contains the same hormones as the pill, it is likely to have these same benefits.;
What Is The Birth Control Patch
The transdermal contraceptive patch is a safe and convenient birth control method that works really well if you always use it correctly. You wear the patch on certain parts of your body, and it releases hormones through your skin that prevent pregnancy.;The patch has lots of other health benefits, too.
There are two brands of birth control patches available in the U.S.: the Xulane patch and the Twirla patch.
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Things To Keep In Mind
If you opt for the minipill, it is very important that you take it at the exact same time every day. The Depo-Provera shot must be given every four months. Another thing to consider before starting a progestin-only method is whether you hope to become pregnant in the future. Fertility returns right away after you discontinue some of these methods , while it may take several months with others .