Document Detail

Adolescents' experience with the combined estrogen and progestin transdermal contraceptive method Ortho Evra.
MedLine Citation:
PMID:  15897103     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The new combined estrogen & progestin contraceptive patch Ortho Evra was approved by the FDA in December 2001. To date, there is a paucity of data regarding its use in the adolescent age group. We examined adolescents' experience with this new contraceptive method. METHODS: Using a questionnaire designed by the authors, care providers in a hospital based adolescent clinic interviewed and reviewed the charts of adolescent girls who had initiated Ortho Evra in 2002-2003. RESULTS: Twenty-eight adolescent girls (age 18 +/- 1 years, gyn age 6 +/- 1 years, onset of sexual intercourse at 14 +/- 1 years, body mass index (BMI) 27.6 +/- 1.2, 57% Hispanic, 21% Caucasian, 11% African American, 7% biracial, 4% Indian American) who had used Ortho Evra for 7 +/- 1 months were enrolled. Half (50%) were adolescent mothers, and 57% had a history of irregular menstrual periods. All (100%) girls reported regular menstrual periods while using Ortho Evra, with only 14% experiencing occasional breakthrough bleeding. Half reported a shorter duration and 36% reported a lighter flow of their periods. About a third (39%) reported a decrease and 11% reported an increase in dysmenorrhea symptoms. About a third (29%) of those with a history of recurrent headaches at initiation reported decrease in headaches, and about a third (33%) of those with acne at initiation reported decrease in facial acne while on Ortho Evra. There were no significant BMI changes during Ortho Evra use. Although condom use while on Ortho Evra was poor (only 15% reporting consistent condom use), there were no pregnancies reported. A majority (93%) reported that they remembered to apply the patches on time, and 40% stated that Ortho Evra was easier than previous contraceptive methods. Two thirds (68%) were very satisfied and 29% were somewhat satisfied with the method, and 93% stated that they would recommend the method to a friend/relative. The preferred application site was the buttock (40%) followed by the lower abdomen (32%). About a fifth (21%) experienced at least one episode of complete patch detachment and 32% reported partial peeling of the patch corners. About a third (32%) would prefer another patch color, and 25% would like a fourth week placebo patch. The most common side effects were mild temporary application site reactions (64%), some discomfort on patch removal (32%), nausea (18%), and breast tenderness (18%). Eleven girls (39%) discontinued Ortho Evra (three lost health insurance, three because of application site reactions, two found patch application schedule difficult to remember, two desired pregnancy, two because of nausea, one because of perceived weight gain). CONCLUSIONS: Ortho Evra provides excellent cycle control in adolescents. Most adolescents are satisfied with this method. Intensive efforts should be made to increase condom use by adolescents on Ortho Evra.
Zeev Harel; Suzanne Riggs; Rosalind Vaz; Patricia Flanagan; Kimberly Dunn; Dalia Harel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric and adolescent gynecology     Volume:  18     ISSN:  1083-3188     ISO Abbreviation:  J Pediatr Adolesc Gynecol     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-05-17     Completed Date:  2005-09-27     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  9610774     Medline TA:  J Pediatr Adolesc Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  85-90     Citation Subset:  IM    
Division of Adolescent Medicine, Hasbro Children's Hospital, Brown University, Providence, Rhode Island 02903, USA.
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MeSH Terms
Acne Vulgaris / prevention & control
Administration, Cutaneous
Attitude to Health
Breast / drug effects
Contraceptives, Oral, Combined / administration & dosage*,  adverse effects
Drug Carriers
Dysmenorrhea / prevention & control
Ethisterone / analogs & derivatives
Headache / prevention & control
Menstrual Cycle / drug effects
Menstruation / drug effects
Nausea / chemically induced
Norgestrel / analogs & derivatives
Patient Dropouts
Patient Satisfaction
Reg. No./Substance:
0/Contraceptives, Oral, Combined; 0/Drug Carriers; 0/Oximes; 0/norelgestromin; 434-03-7/Ethisterone; 6533-00-2/Norgestrel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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