Ortho Evra patch and blood clots?

Originally Published: December 9, 2011 - Last Updated / Reviewed On: June 27, 2012
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Dear Alice,

I am currently using the Ortho Evra patch and have not had any problems so far. However, my friend told me that a lot of women have recently been getting blood clots caused by the patch, and it has resulted in their deaths. Is this true? Is the patch safe to use? If not, what is the safest birth control method to use?

Dear Reader,

Your friend may be referring to the fact that the hormone estrogen has shown to be the active component in increasing blood clots. Estrogen is usually one of the main ingredients in hormonal contraceptives, including the birth control pill and the Ortho Evra patch (i.e., the patch).

It's true that the patch exposes the wearer to a higher level of estrogen than the pill. However, research seems to indicate that other behavioral and medical factors in a woman's life play a more significant role in causing blood clots than the use of the patch alone. Although the patch releases a higher dose of estrogen to the blood than the pill, patch users peak estrogen level usually tops out at a level approximately 25% lower than pill users. Therefore, it has still yet to be determined whether the use of the patch can really be linked to increasing the risk of blood clotting or other cardiovascular diseases.

It's also important to examine other medical conditions and behavioral patterns when choosing a method of birth control. Much like any other medication, Ortho Evra and other forms of hormonal contraception should always be used under the supervision of a health care provider. S/he can periodically evaluate your body's reactions to the ingredients, as well as regularly assess your risks for various health conditions.

Women who are at the highest risk of blood clots or cardiovascular diseases (i.e., stroke, heart attack, or high blood pressure) when using hormonal contraceptives include those who:

  • are over 35 years of age who smoke.
  • have diabetes.
  • have breast and/or reproductive organ cancers, liver disease, or a history of chest pain.

Women with these risk factors should consider using alternate forms of birth control. Women over the age of 40 with any of the above risk factors, and all women over 50, should also use extreme caution when using oral contraceptives because of the risk of adverse effects increasing with age.

For more information on Ortho Evra, visit the U.S. Food and Drug Administration's (FDA) Ortho Evra information page and Go Ask Alice!'s The contraceptive patch: A new birth control option

As far as the safest and most effective form of birth control, abstinence is still the best-known method out there. If that is not a desirable option for you, but you're still concerned about the possible side effects of the patch, you may want to speak with a health care provider or check out some of the Related Q&As below to find out more about other methods of birth control that may be best for you. If you're a student at Columbia, you can make an appointment at Medical Services by calling x4-2284 or logging-in through Open Communicator.

Alice