Warning Issued for Birth-Control Patch

Kathleen Thoren sits in bed at Sweetwater County Hospital in Rock Springs, Wyo., in this handout photo from Sept. 4, 2004, with her new baby, Brandy, in the arms of her daughter, Kelsey, almost 2 years old, with husband, Tom, and son, Mikey, 7. The new mother died just before Thanksgiving that fall after days of agonizing headaches brought on by hormones released into her body from a birth control patch. (AP Photo/Courtesy Erika Klein-File) (Erika Klein - AP)

New published studies show that women using the patch absorb about 50 percent more estrogen than with the pill, said Dr. Leslie Miller, an associate professor of obstetrics and gynecology at the University of Washington.

When women take the pill, the medication is absorbed into the bloodstream through the digestive tract. In the process, about half of the estrogen dose is lost.

Hormone levels in women on the pill are highest one or two hours after taking it, Miller said. Twelve hours later, estrogen levels are quite low, meaning the body is not exposed to high levels of estrogen 24 hours a day.

But the patch causes higher estrogen levels since delivery of medication continues all day. Those elevated levels may be high enough to increase some women's risk of blood clots, Miller said.

"If the patch is delivering too much estrogen, then it may need to be redesigned," Miller said. "Women should not just take off their patch; they risk pregnancy. If they are worried and want to change off the patch, they can wait to get something else."

Even before the warning, some advocacy groups and medical providers were raising questions about the patch.

In September, Public Citizen's Health Research Group, a consumer advocacy organization, added Ortho Evra to its ongoing list of dangerous medicines, warning that there is "no medical reason for women to use the more dangerous Ortho Evra rather than one of the older, better understood, and equally effective oral contraceptives."

And last month, Dr. Miguel Cano, an obstetrician and gynecologist in Reedley, Calif., sent a note to several thousand women patients recommending that they stop using the patch and that they come in for appointments to get a new form of birth control.

Erika Klein's sister Kathleen Thoren died a year ago from blood clots in her brain that the coroner said were brought on by Ortho Evra. She said women deserve to be informed when making birth-control decisions.

"Women have a right to know the true risks and make their decisions based on that information," she said. "No one should have to go through what my sister went through."