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: