New contraceptive patch for women launched in RP

Call it patch therapy.

Multinational drug firm Janssen Pharmaceutica launched yesterday an alternative to oral contraceptives — an adhesive patch worn for one week that slowly releases two hormones into the bloodstream to prevent ovulation.

"Ever since the birth control pill was developed more than 40 years ago, women have had few alternatives to birth control that are non-invasive," said brand manager Julie Gener.

She said the Evra patch has been available in the United States since 2002 and was approved by the US Food and Drugs Administration in 2001. Janssen said it is still conducting local clinical trials and initial results may be out by May or June this year.

The patch, which is available by prescription, is comparable to oral contraceptives in efficacy and safety, according to Gener. A woman goes through three patches in one menstrual cycle.

Each patch releases measured doses of norelgestromin, a progestin hormone, and ethinyl estradiol, an estrogen hormone, through the skin. The hormones in the patch bypass the liver, which breaks down some of the hormones in oral contraceptives.

She said women can choose four areas on their body on which to apply the patch — abdomen, shoulders, upper arm, or the buttocks — since these areas do not have much hair, are less prone to chafe against clothes, and are discreet.

"The patch is not affected by heat, humidity, exercise, and skin moisture. You can go swimming, to the sauna or to the gym," Gener said.

Obstetrician-gynecologist Dr. Susan Nagtalon said the first patch a woman wears during one menstrual cycle can "achieve plasma levels of the hormones within 48 hours of use." Gener said this means that a woman does not have to worry about pregnancy if she has sex two days after the applying the first patch, which is done on the first day of menstruation.

The patch also "improves (a woman’s) response during the sexual act because she feels safe, (she is) not concerned about getting pregnant," Nagtalon said.

Another advantage of the patch over the birth control pill, Gener said, is that if a woman forgets to change the patch after one week, she has two days to change it without lowering the blood levels of the hormones.

The pill, on the other hand, gives a woman only 12 to 24 hours to remember to take the next dose, she added.

Nagtalon said if a woman wants to get pregnant, she will start ovulating one to three months after she stops wearing the patch.

Gener also said while the side effects of the patch are similar to the pill, a study showed that 87 percent of women who wore the patch for nine months maintained their weight. One side effect of oral contraceptives is weight gain of around five percent.

The patch, however, has certain disadvantages.

Gener warned it "may be less effective" if a woman weighs more than 198 pounds. An overweight woman would "need a greater concentration of steroid hormones to achieve the anti-ovulatory effect," Nagtalon said.

Nagtalon recommended that women who weigh more than 198 pounds either lose weight or consider other forms of contraception, such as a high-dose contraceptive pill or an intra-uterine device.

Women who are hypertensive, diabetic, or have a family history of cancer are discouraged from using the patch or the pill, Nagtalon said.

One box of three patches, good for one menstrual cycle, costs P555 while oral contraceptives range from P100 to P600.

As for the Catholic Church’s stand against artificial methods of contraception, Nagtalon said her patients have a right to know how important birth spacing is to the health of the woman and her family.

"It is their choice, their decision," she said.

Though Nagtalon agrees that responsible couples can space pregnancies through natural methods of contraception, environmental stress as well as emotional and psychosocial factors "can alter hormones in the body."

This can result in an unexpected pregnancy when a couple has sex during what they thought was the woman’s "safe" period, she said.

Another problem is that women who are taking antipsychotics or anticonvulsants cannot wear the patch because "they are not compatible with the patch," Nagtalon said, noting that the drugs and the hormones in patch would be rendered less effective when combined in the body.

In the 2003 National Demographic and Health Survey, pills topped the list of contraceptive methods commonly used by Filipino women, followed by condoms, tubal ligation, vasectomy, intra-uterine devices, and injectables.

The survey also showed that contraceptive use among married Filipino women jumped from 17 percent in 1973 to 49 percent in 2003 and that two in five Filipino women who are not currently using a contraceptive method declared they intend to use one in the near future.