Birth Control Patch Problems

If you are currently using the birth control patch you are probably familiar with how this contraceptive works and the common side effects associated with it. However, you may not be familiar with the new FDA warning that now appears on the packaging for the birth control patch. Due to recent concerns over the safety of the patch, this type of contraception is now sold with an important warning informing women that the patch could increase their risk of developing dangerous blood clots. Though rare, these blood clots can cause serious tissue damage and may even result in a heart attack or stroke.

What is the Birth Control Patch?
The birth control patch, sold under the brand name Ortho Evra, is a relatively new form of contraception. Unlike the birth control pill, which is taken orally every day, the birth control patch is a transdermal adhesive worn on the skin for about a week. This patch releases hormones through the skin and directly into the bloodstream, where it controls ovulation and prevents pregnancy. The birth control patch is currently used by more than five million American women.

What is the Warning on the Birth Control Patch?
Since September 2006, a warning has appeared on the Ortho Evra birth control patch. This warning was issued by the FDA and states that “high levels of estrogen may put some women at increased risk for getting blood clots.” This warning was placed on the Ortho Evra packaging after the Associated Press retrieved information illustrating that the risks of blood clots and other serious side effects were elevated for patch users. The FDA announced that all Ortho Evra patch users should be informed of these risks before using the patch. More recently, the results of a 2007 study demonstrating an increased risk of blood clots for patch users compared to pill users, has also been put on the packaging.

What Are Your Risks of Having a Blood Clot?
Any hormonal method of birth control is associated with a slight risk of blood clots. The traditional birth control pill carries a risk of about 3 in 10,000 for non-fatal blood clots and a risk of about 1 in 200,000 for fatal blood clots. These risks are clearly stated on all birth control pill packages. It was initially believed that the birth control patch carried similar risks for fatal and non-fatal blood clots. However, this has since been called into question.

In June of 2005, the Associated Press generated studies on the Ortho Evra patch and its risk for dangerous blood clots. According to the Associated Press, a woman’s risk for experiencing a non-fatal blood clot while using Ortho Evra was 12 in 10,000. Meanwhile, her risk for experiencing a fatal blood clot while using the patch appeared to be close to 3 in 200,000. This is almost three times the risk level associated with the traditional birth control pill. The Associated Press also noted that at least a dozen women, mostly in their late teens and early twenties, had died in 2004, apparently due to complications associated with the birth control patch. A 2007 study indicates that in women aged 15-44, there is a higher risk of blood clots in those using the patch than those using the pill.

Why Does the Patch Cause Blood Clots?
All hormonal methods of birth control pose a threat to normal blood flow. This is because hormonal methods of birth control contain estrogen, which causes blood to coagulate in the veins. But why does the patch appear to cause more blood clots than the pill?

Well, the birth control patch actually delivers higher amounts of estrogen directly to your bloodstream. The traditional pill is broken down in your intestinal tract before any hormones reach the bloodstream. By the time it is broken down, about 50% of the estrogen contained in the pill has been lost. However, because the patch delivers estrogen straight through the skin and into the bloodstream, users are actually receiving about 60% more estrogen with this form of birth control. As a result, their risks for blood clots increases.

Are Blood Clots Dangerous?
Blood clots have the potential to be extremely dangerous. They occur when blood in the veins becomes coagulated, forming a blockage in the vessel. As a result, blood and oxygen cannot travel to all areas of the body, leading to tissue death. Additionally, some blood clots can travel to sensitive areas of the body, including the heart, brain, and lungs. When this happens, you can suffer a stroke or heart attack, which may result in death. Women over the age of 35 appear to be at greater risk for suffering a dangerous blood clot while using birth control. Women who smoke are also at increased risk for blood clots, whether they are using the traditional birth control pill or the patch.

Is the Patch Safe For Use?
As of January 2008, it has been shown that the birth control patch poses a higher risk of blood clots than other homonal birth control methods, including the pill. While the FDA believes the patch is a safe and effective method of contraception, it recommends that women with concerns or risk factors for serious blood clots talk with their health care provider about contraceptive options.

Ortho-McNeil, the manufacturer of the Ortho Evra birth control patch, maintains that the patch is safe for use. When used according to instructions, Ortho-McNeil claims that there are no serious risks associated with the patch. Ortho-McNeil does confirm that hormonal methods of birth control (such as the Ortho Evra patch) are not suitable for all women. The company recommends that all women to consult with their health care providers prior to starting the birth control patch, or any other method of birth control. Ortho-McNeil also advises smokers and women over 35 that they face an increased risk of blood clots and other serious side effects when using any hormonal contraceptive, including the patch.

What Should You Do?
If you are currently using the Ortho Evra birth control patch, you should talk with your health care provider to find out more about your risk for possible blood clots. Should you decide to discontinue use of the patch, be sure to use a backup method of birth control, such as a condom, in order to prevent an unplanned pregnancy.

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