The Patch: For Women Who Won't Take the Pill Every Day (and Know the Extra Risk)

Ortho Evra, approved by the FDA in 2001, is a beige patch about the size of a matchbook that you attach to the skin of your outer arm, upper torso (but not on your breasts), abdomen, or buttock, and forget about for a week. You apply a new patch every week for three weeks, and then take a week off to have your period.

Some women say it's easier to remember something weekly than daily (the Pill) or three weeks on and one week off (the ring). But the patch can get dirty after a few days of wear. And although it's designed to endure sports and showers, it occasionally falls off. Some users with insurance that covers the patch have found that if it falls off twice in one month, their policies don't cover a replacement.

More estrogen makes it riskier
A more significant risk is the increased level of estrogen that the patch delivers—60% more than the typical low-dose birth control pill. Estrogen is linked to side effects and, in early 2008, the FDA issued a new warning label for the patch after a study showed that patch users had a higher risk of dangerous blood clots than those using the Pill. Talk to your doctor about potential risks before using the patch.

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