Advantages and Disadvantages of the Contraceptive Patch

The oral contraceptive pill was used widely because of its high efficacy. However, poor patient compliance inevitably led to higher-than-ideal pregnancy rates, as users often forgot to take the pill at the right time, to take it every day, or had gastrointestinal conditions which interfered with its digestion and absorption.

The contraceptive patch was one of the alternatives designed to address this issue.

Advantages of the patch

It is simple to use
Can be used by just one partner
Highly effective if used properly, with almost 100 percent protection
Needs to be applied only once a week and not in relation to intercourse, improving patient compliance
Its presence can be verified by sight
Does not detach with exposure to water or sweat
May improve menorrhagia and dysmenorrhea not due to organic conditions
May improve acne in many cases
May improve bone strength due to the estrogen content
May reduce the risk of benign breast disease, as well as uterine endometrial and ovarian cancers

Disadvantages

The patch is not a perfect means of contraception, because of some drawbacks listed below:

It does not provide protection against sexually transmitted infections (STIs), including HIV
Must be prescribed by a health care provider
The estrogen levels are higher with the patch than with other hormonal methods
Interacts with some medications such as rifampin (an anti-tuberculosis antibiotic), corticosteroids, anticonvulsants, and herbal supplements such as St. John's Wort. These induce greater activity of the liver enzymes which metabolize the hormones, and may therefore lead to a shorter term of activity than expected.
The return of fertility may be delayed by up to two months after stopping the use of the patch
Skin irritation may occur in some women
It can be seen by the partner
It is sometimes felt inside the vagina by the partner

Minor side effects

Minor side effects may occur for the first few months, such as:

Headaches
Hypertension
Nausea
Breast tenderness
Depressive mood changes
Intermenstrual spotting or bleeding
Breast tenderness
Vaginal pruritus or discharge

Serious side effects

Estrogen and progesterone may produce some life-threatening complications, such as:

Thromboembolic episodes including events such as pulmonary embolism, myocardial infarction, calf venous thrombosis, or cerebrovascular accidents
A somewhat increased risk of breast cancer and cervical cancer with long-term use

Contraindications

Women with the following conditions should not use the patch for fear of thromboembolism:

Severe obesity
Smoking, current or quit within the last year
Age over 35 years
Family or personal history of thromboembolic events, especially if the relative was under 45 years at the time
Immobilization following surgery, trauma, or other conditions
Severe varicose veins
Hepatitis or benign liver tumors
Gallbladder disease
Diabetes with complications or of more than 20 years duration
Migraines with aura on a regular basis

The patch is also not suitable for women who are exclusively breastfeeding their infants and are less than six months postpartum.

References

http://www.nhs.uk/Conditions/contraception-guide/Pages/contraceptive-patch.aspx
https://medlineplus.gov/druginfo/meds/a602006.html
https://www.hhs.gov/opa/pregnancy-prevention/hormonal-methods/patch/index.html