Contraceptive patch

Contraceptive patch
Ortho Evra brand of contraceptive patch
Background
Type	Hormonal (combined estrogen + progestin)
First use	2002
Failure rates (first year)
Perfect use	0.3%
Typical use	9%
Usage
User reminders	Weekly application for 3 weeks
Advantages and disadvantages
STI protection	No
Weight	No proven effect
Period advantages	Regulated, may be lighter and less painful
Benefits	Compared to oral pills, may be less affected by antibiotics
Risks	DVTs rates similar to oral combined pills

A contraceptive patch, also known as "the patch", is a transdermal patch applied to the skin that releases synthetic estrogen and progestin hormones to prevent pregnancy. They have been shown to be as effective as the combined oral contraceptive pill with perfect use, and the patch may be more effective in typical use.

The only currently available contraceptive patches are Xulane in the United States (after Ortho Evra, marketed by Ortho-McNeil was discontinued), and Evra, marketed in Canada by Janssen-Ortho and in the United Kingdom and other countries by Janssen-Cilag. The patches are packaged in boxes of three and are only available by prescription.

A woman applies her first patch onto her upper outer arm, buttocks, abdomen or thigh on either the first day of her menstrual cycle (day 1) or on the first Sunday following that day, whichever she prefers. The day of application is known from that point as patch change day. Seven days later, when patch change day comes again, the woman removes the patch and applies another to one of the approved locations on the body. This process is repeated again on the next patch change day. On the following patch change day, the patch is removed and not replaced. The woman waits 7 days without a patch in place, and on the next patch change day she applies a new patch. Extended use regimens, where patches are used for several weeks before a patch-free week, have been studied.

The patch should be applied to skin that is clean, dry, and intact. This means, if skin is red, irritated, or cut, the patch should not be placed in that area. Additionally, avoid using lotions, powder, or makeup around the area where the patch is, or will be placed.

Like all combined hormonal contraceptives, Ortho Evra / Evra works primarily by preventing ovulation. A secondary mechanism of action is inhibition of sperm penetration by changes in the cervical mucus. Hormonal contraceptives also have effects on the endometrium that theoretically could affect implantation; however, no scientific evidence indicates that prevention of implantation actually results from their use.