Women's Health Research Newsletter
March 2006

Mythbusters -
The Truth About the Contraceptive Patch

The contraceptive patch, despite a history of comprehensive research and proved efficacy in the prevention of pregnancy, has recently come under fire in the press. Since many of you might be confused by what you’ve heard, we felt it was timely to update you on the facts and myiths about this important method of contraception, and to clarify some misconceptions.

Most of the stories written about hormonal contraception have focused on the negative. Concerns about breast cancer (to be discussed in a future newsletter) and venous thromboembolism (blood clots) are but two associations made which can deter women from using hormonal contraception, often unnecessarily. Soon after the introduction of birth control pills in the 1960s, blood clotting problems emerged as an important complication in some users. Research revealed that this side effect is directly related to the dose of estrogen in the product. To put the risk in perspective, for most women using the pill increases the risk of a blood clot by a factor of 4. This sounds large unless one considers that pregnancy increases this risk by more than a factor of 6. For most healthy women, the benefits of hormonal contraception far outweigh the risks. Knowledge of the estrogen-thrombosis connection led to the development of newer methods of contraception with lower doses of estrogen which greatly reduced the clotting problem. By the 1980s most pills contain 30 mcg or less of estrogen.

The contraceptive patch (Ortho Evra) was approved by the FDA in 2002 and marketed by the R. W. Johnson company. The idea behind the patch was a straightforward one:  was there another way for ensuring the same contraceptive outcome with a hormonal method that didn’t require daily pill consumption?  The Ortho Evra Patch, after extensive clinical trials, proved that this could be the case, and provided an excellent alternative to the pill for many women who found taking a pill everyday difficult.

Recently, news reports have begun to surface questioning the safety of this method; as is frequently true, the headlines don’t match up to the facts. Two recent headlines in the Oregonian and the Vancouver Columbian recently presented slightly skewed headlines regarding the safety of this product. In actuality, while some side effects have been more pronounced with the use of the patch, this has not resulted in a significant number of women discontinuing the method. Although average blood estrogen levels are higher in users of the patch than in users of oral contraceptives, the peak levels are lower. Large epidemiologic studies have not suggested that women using the patch are at a greater risk of blood clots than pill users. In fact, since some studies have suggested that the failure rate with the patch might be lower than the pill (particularly for poor pill takers), the overall chance of a clot might be lower due to a greater number of pregnancy-related clots due to pill failures.

In short, the Ortho Evra patch remains a safe and reliable method of contraception. It should always be noted that hormones in general are not for everyone; increased risk categories include, but are not limited to, smokers over the age of 35 and those women with a history of venous thrombosis.

If you are a woman between the ages of 18 and 35 and have never used the Ortho Evra Patch before, the Women’s Health Research Unit (WHRU) current offers a study opportunity that would enable qualified individuals to receive either this method, or the contraceptive ring (Nuva Ring) at no cost. The WHRU is currently studying women’s acceptance of these two methods to determine whether one is more appealing to women, and why. For more information on this study, please call our confidential recruitment line at 503 494-3666.

The Women’s Health Research Unit is continually conducting studies in areas ranging from contraception and abortion to dysfunctional uterine bleeding and breast pain. To learn about these, or other study opportunities, please call OHSU’s Women’s Health Research Unit at 503 494-3666.

Heidi Printz Milliken, Ph.D.
Manager, Women’s Health Research Unit
Oregon Health & Sciences University