Women who are considered to be high risk of pregnancy appear more like to continue with use of oral contraceptive pills than with a transdermal contraceptive patch, doctors have observed, according to Reuters. In their study, despite apparent ease of use and simplicity, the patch was considerably less effective than the pill. "What we found," Dr. Arvind Bakhru told Reuters Health, "is that those using the contraceptive patch were more likely to become pregnant and more likely to discontinue usage." In the journal Obstetrics and Gynecology, Bakhru of the University of Maryland School of Medicine in Baltimore, and Dr. Nancy Stanwood of the University of Rochester, New York note that half of all unintended pregnancies in the US occur in the 10 percent of fertile women who use no contraception. However, about half of these women report that the conceived while practicing contraception. This led Bakhru and Stanwood to determine if a contraceptive patch might do better than an oral contraceptive in reducing such consequences. They studied information on 1,230 women that underwent contraceptive counseling at Planned Parenthood centers. The women had never before used hormonal contraception. Most were considered at high risk of unintended pregnancy. In all, 579 started on oral contraceptives and the remaining 651 began with the contraceptive patch. A total of 468 women (38 percent) had no further contact with the clinic after their initial visit. Initial loss to follow-up was higher in patch (45.2 percent) than in pill users (29.5 percent). Continued use of contraception beyond the first three cycles was significantly higher in the pill users (89 percent) than was the case in patch users. Moreover, only 3.3 percent of patch users found skin irritation to be a treatment-limiting factor. The researchers also found that the pregnancy rate was markedly lower for pill users than for patch users. "Further research," the investigators conclude, "should investigate factors contributing to poorer real-world performance by the patch." However, Dr. Bakhru added that "the patch users in this study were more likely to have been pregnant or to have had pregnancy terminations in the past and may therefore be more likely to fail any hormonal contraceptive therapy. This may explain the lower continuation and effectiveness of the patch in this population."
