Birth Control Medications (Contraceptives) (cont.)
Topical Contraceptive Patch
Norelgestromin/ethinyl estradiol (Ortho Evra)
The topical patch may be applied to clean, dry skin on the shoulders, upper arms, buttocks, or abdomen. It should not be applied to red or inflamed areas of the skin or in areas where tight clothing may rub. The patch may be less effective in women weighing more than 198 pounds (90 kg).
- Use: A new patch is applied on the same day of the week, each week for 3 weeks in a row. The first patch is applied either on the first day of the menstrual period or on the Sunday following the onset of menses. On the fourth week, no patch is applied. Menstruation should begin during this time. This 4-week period is considered 1 cycle. Another 4-week cycle is started by applying a new patch following the 7-day patch-free period.
- Side effects: Side effects are similar to other birth control agents containing both estrogen and progesterone. Effects include menstrual irregularities, weight gain, and mood changes. Other specific side effects include a skin reaction at the site of application and problems with contact use.
Long-Acting, Injectable, Progesterone-Only Contraceptives
Medroxyprogesterone acetate (Depo-Provera)
- Use: Administration of the injection requires a visit to a doctor’s office. The first injection is given within 5 days following the onset of menstruation. After that, an injection is needed every 11-13 weeks. Unlike pills, the injection works right away; therefore, additional contraception is not needed when beginning the shots.
- Side effects: Since progesterone is the only hormonal ingredient, estrogen-related side effects are avoided. A side effect unique to this method of birth control is that most women eventually stop having their periods. Because the drug is maintained in the body for a long time (at least 3 months), periods may take longer to resume after stopping injections, compared with birth control pills. Depo-Provera may last in the body for several months in women who have used it on a long-term basis and can actually delay the return to fertility after stopping the drug. Approximately 70% of former users desiring pregnancy conceive within 12 months, and 90% of former users conceive within 24 months. Other side effects include weight gain and depression.
Progesterone-only pills (POPs), also known as mini-pills, are not used widely in the United States. Less than 1% of users of oral contraceptives use them as their only method of birth control. Those who use them include women who are breastfeeding and women who cannot take estrogen.
- Use: POPs are ingested once daily, every day. POPs may be started on any day, and there are no pill-free days or different-colored pills to track. Since progesterone is the only hormonal ingredient, estrogen-related side effects are avoided. However, since POPs do not include estrogen, they have a higher failure rate. Users must take this pill at the same time daily for greatest effectiveness.
Medically Reviewed by a Doctor on 1/4/2016
Francisco Talavera, PharmD, PhD
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