1. Birth Control Slideshow Pictures

What should I discuss with my healthcare provider before using ethinyl estradiol and norelgestromin (Ortho Evra)?

This medication can cause birth defects. Do not use if you are pregnant. Tell your doctor right away if you become pregnant, or if you miss two menstrual periods in a row. If you have recently had a baby, wait at least 4 weeks before using this medication (6 weeks if you are breast-feeding).

Do not use this medication if you have:

• a history of a stroke, blood clot, or coronary artery disease;
• circulation problems (especially if caused by diabetes);
• a hormone-related cancer such as breast or uterine cancer;
• abnormal vaginal bleeding;
• liver disease or liver cancer;
• severe high blood pressure;
• severe migraine headaches;
• a heart valve disorder;
• a history of jaundice caused by birth control pills; or
• if you are 35 or older and you smoke.

To make sure you can safely take birth control pills, tell your doctor if you have any of these other conditions:

• high blood pressure, heart disease, congestive heart failure, angina (chest pain), or a history of heart attack;
• diabetes;
• high cholesterol or if you are overweight;
• kidney disease;
• a history of depression;
• gallbladder disease;
• seizures or epilepsy; or
• a history of fibrocystic breast disease, lumps, nodules, or an abnormal mammogram.

The hormones in this medication can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

Your risk of serious blood clot may be higher with the use of birth control skin patches than with the use of birth control pills.

How should I use ethinyl estradiol and norelgestromin (Ortho Evra)?

Use exactly as prescribed by your doctor. Do not use more skin patches or wear them for longer than recommended by your doctor. You will apply your first patch on the first day of your period or on the first Sunday after your period begins (follow your doctor's instructions).

Place the patch on your skin and press it into place firmly for 10 seconds. Make sure the edges stick well. You will wear the patch for a full week.

Apply the patch to clean, dry skin on any of these areas: the outside of your upper arm, your stomach, your buttocks, or your upper back. Do not apply the patch to skin that is broken or irritated, or to a skin area that may be rubbed by tight clothing (such as a waistband).

Remove the patch and apply a new one on the same day each week for three weeks in a row. At the end of the third week, remove the patch and do not apply a new one for 7 full days. Your period should start during this time Do not allow more than 7 days to pass before starting your next 3-week patch cycle..

You may have breakthrough bleeding, especially during the first 3 months. Tell your doctor if this bleeding continues or is very heavy.

Check your patch every day to make sure it is sticking well. If a patch comes loose or falls off, throw it away and apply a new one. You may need to use back-up birth control, such as condoms or a spermicide, if a patch has been off for more than 24 hours. Follow your doctor's instructions.

After removing a skin patch fold it in half, sticky side in, and throw it away in a place where children and pets cannot get to it. Do not flush a used patch down the toilet.

If you need to have any type of medical tests or surgery, or if you will be on bed rest, tell the doctor or surgeon ahead of time that you are using this medication. You may need to stop wearing the patches for a short time.

Your doctor will need to see you on a regular basis while you are using this medication. Do not miss any appointments.

Store the skin patches at room temperature away from moisture and heat. Do not freeze or refrigerate. Keep each patch in its foil pouch until you are ready to apply it.

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