Women looking for an alternative to oral birth control may soon be able to use a skin patch to avoid pregnancy.

A new study finds the hormone-secreting patch is 99 percent effective, the same as the pill at preventing conception. Yet a patch is far easier to use faithfully and that likely will lead to fewer accidental pregnancies, experts say.

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Although the birth-control patch is not yet available in South Africa or even the United States, the RW Johnson Pharmaceutical Research Institute in America is seeking approval for its patch, called Ortho Evra. The institute funded the study.

Less hassle, same results
The birth-control patch is a potent mimic of the hormone replacement patches already available to postmenopausal women. Affixed by adhesive, the 3.2-square-inch pad can be worn on the arm, buttocks or torso, though not on the breast.

The patches release a steady stream of oestrogen and progestin for a week, blocking ovulation, creating an unfriendly atmosphere for sperm and discouraging implantation of a fertilised egg. Women must replace the pad only three times a month, whereas oral contraception requires 28 pills during each menstrual cycle.

Compliance rate of pill lower
The study, reported in the May 9 issue of the Journal of the American Medical Association, compared failure and compliance rates of the patch and the pill in 1 417 American and Canadian women, ages 18 to 45. The women were followed for either six or 13 menstrual cycles.

Women had perfect compliance with the pill in 77 percent of their monthly cycles, compared with 88 percent for the patch. Fewer than 5 percent of patches detached partly (2.8 percent) or completely (1.8 percent) before needing replacement.

Side effects from the patch were more common than from the pill, and included site reactions, breast pain and tenderness, and discomfort around the time of menstruation. These were generally mild and well-tolerated, the researchers say.

While oral contraceptives are in theory extremely effective, they're quite sensitive to proper use. A 1995 survey found that compliance failure rates in the first year for women on the pill ranged between 7.3 percent and 8.5 percent, Koltun says. "I think [compliance] is a bigger issue than we talk about, and this particular product is going to" improve it, he says of the patch.

"Women are busy today, and having to worry about taking a daily pill has been taken for granted. This is a first attempt at making inroads in giving women some freedom," Koltun says. Larger studies of the patch may show that it is even more effective than the pill because of its improved compliance, he says.

Read more:
The pill is safe - study
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