Birth control patch (Ortho Evra)

[dreamintwilight]

Any ladies used the birth control patch as your form of birth control? I just visited my new gyno's office yesterday to discuss my Crohn's and get suggestions on what would be best for me for birth control.

She suggested the patch which I have never tried before. I picked it up from the pharmacy yesterday and am starting to wonder about the extra estrogen I'd be exposed to. Wondering if increase in hormones could exacerbate any flare symptoms I might have. Also, there is controversy whether the patch actually increases your chance of blood clotting more than the pill. Some studies confirm this, other studies don't.

I just called and left a message for a nurse at my GI doc's office to call me back, but wanted to know if anyone had any success with it or otherwise.

I tend to be a worrier, so any advice would help.

 

[katiesue1506]

Personally I wouldn't play with the blood clot risk because IBD sufferers are already at a higher risk for clots.

I'm on the nuvaring and I like it because Crohn's can't affect its absorption (like with the oral pill) and its a very low steady dose of hormones.

Thats all I know

 

[dreamintwilight]

Yeah...well my gyno said there are studies out recently that doesn't confirm the patch increases the chance of blood clots. But I was kinda worried about it too, so I called my GI's office and left a message. The nurse called me back and told me it was alright to take it. But now I'm paranoid about blood clots. Argh.

 

[teeny5]

I was taking the pill, but honestly I never even thought about how it interacted with Crohn's. Wish I could be of more help.

 

[InkyStinky]

Hi Marisa!

I tend to be a worrier, too...! From my perspective I'd try to avoid anything that could increase your risk of clots - in Dec I found out I had clots in my legs and lungs (dvt and pe) and being on blood thinners is turning out to be a really big deal (trying to keep my blood "thin" enough to prevent more clots without starting up my Crohn's bleeding).

Before they found the clots I was on the pill, but my docs don't really know if that contributed to me developing the clots or not, as I (1) was getting over a Crohn's flare, (2) most likely have a clotting disorder (still waiting on the repeat test for it!), and (3) I seem to have developed a new superficial clot since stopping the pill back in early Dec.

Do you know if your GI is aware of the link between IBD and clots? (My GI, who seems really good and on top of the research, surprisingly hadn't). If you doc isn't aware of this then you might not be getting the most accurate advice about using contraceptives with hormones.

Anyway, I really hope that I'm not sounding like an alarmist or anything, but since I found out I had blood clots I'm also finding out that they are scary stuff.

 

[dreamintwilight]

Katie - I forgot to mention I have tried the NuvaRing and for some darned reason I couldn't get it to stay put. I tried and tried and it kept slipping out causing me pain, so I switched to a BCP and used that until I went into the hospital and found out I had Crohn's.

Sabrina - Thanks for sharing your experience. That kind of confirms my reasons for not wanting to take the patch, I think. Whether the studies are right or wrong about the patch being more likely than pills to cause clotting, I'm thinking maybe it wouldn't be smart of me to chance something like that ESPECIALLY since Crohnies are already at risk for blood clots.

Yeah, I'm not sure if my GI knows about the association with blood clotting, IBD, estrogen, etc. I am assuming he does, but as you said, even the smartest doctors don't know everything. I even mentioned to the nurse, when she clalled me back and said "Yeah, the patch is fine," that I was making sure because I know I'm exposed to more estrogen with the patch and didn't know if it would cause me more flare-ups or anything and all she said was "Yeah, it's fine." So, perhaps that could be something I talk to him about at my next visit (which isn't until April).

If you don't mind me asking, what are you using now as birth control instead of pills? I would assume since you have a history of blood clots that you won't be able to have anything with estrogen in it. After talking with a couple if my friends and my husband I'm thinking we might try the non-hormone option with condoms. I do not have any experience using them, so we'll see how that goes. I do like the idea of not adding extra chemicals and things in my body that don't need to be there.

Maybe we can at least use them until I talk to more of my doctors in detail about my concerns. I have an appointment with my PCP next week. Maybe he'll have some insight on the whole matter.

 

[InkyStinky]

Hey Marisa! I used to be pretty embarrassed to talk about contraception stuff, but after talking with so many docs lately I think I've almost stopped feeling any embarrassment about this topic :ylol2:

Right now my husband and I are using the condom/spermicide combo. None of my docs want me using anything with hormones because of the clots so this is pretty much our only option. (We don't want to do anything permanent because we're still hoping one day if my health gets under control we could have a baby). My gyno told me that condoms are very effective when used correctly and every time (my husband is a great guy who'd do anything for me, and he's really careful to use them correctly. I think that the Mayo Clinic website had some good instructions on condom use if you were looking for some reliable info. And I think they have info on how to "fit" them if your husband needs some help with that). I'm using a spermicide in addition because the blood thinner I'm taking causes some really horrible birth defects so I'm being as careful as I can be not to get pregnant.

I'm glad you have an appt with your pcp next week - I've found that it's a lot better to talk to docs directly so nothing gets "lost in translation". If there's anything I can help you out with, just ask!

 

[dreamintwilight]

Thanks, Sabrina I think I feel more comfortable about using condoms hearing your story and experience. Most women I know just use the pill, so not knowing much about the condom made me uneasy about using it as an effective option. Thanks for sharing!

 

[soupdragon69]

Hey Marisa,

Certainly worth looking at all the options isnt it?

I did alot of reading/research and ended up with the implanon implant in my inner left upper arm.

It took 6-12mths for my cycle to eventually stop. If I do bleed its very light now and only 2/3 days every 3/4 months. It was a good benefit from it as my cycle is really heavy and painful.

Main thing for me was as has been already mentioned the absorption aspect in relation to crohns.

It is due changed this coming september and lasts 3ys. Had it done by my GP under local anaesthetic and it took all of 15mins to insert. Lovely bruise after it!

Never had any problems though and certainly will have it renewed.

I didnt want to take any chances with being on remicade and methotrexate at the same time and was really twitched about it all.

If that hadnt been an option - cant use patches as I have hypersensitive skin like you wouldnt believe! - then we would have opted for condoms/spermicide like Sabrina has mentioned.

 

[s.a.m.]

Any ladies used the birth control patch as your form of birth control? I just visited my new gyno's office yesterday to discuss my Crohn's and get suggestions on what would be best for me for birth control.

Great question. I have a prescription for the patch which I never filled. This is the method my doctor suggested as well. My GI referred me back to my GP for any questions. I would like to know if anyone with Crohn's had any issues iwth flaring after starting Birth Control.

 

[Mouse]

I have been using the patch for over four years now with no problems, much easier for me as I'm quite forgetful with pills (even though I should be used to taking them by now!) and obviously can't rely on absorbing them properly. Haven't noticed a bad reaction crohn's-wise and my docs are always on top of my bloods anyway so I'm not too concerned about clots. Definately the easiest thing for me but it does depend on cirumstance I'm sure.

 

[dreamintwilight]

Thanks, Mouse How often do you get blood work? I'm scheduled every 3 months so far.

 

[Mouse]

At the moment it's every month, depends what meds I'm on but it has been as little as three months since I've used the patch. I never really thought about clots before but I think if they tried to leave my bloods for too long I'd bring it up with them. It's surprising how my gastro has never asked if I'm on birth control, it's up to me to bring it up!

 

[dreamintwilight]

Yeah, well after my gyno prescribed the patch I called my GI to run it by them and the nurse said it would be fine as well. There didn't seem to be any concern. So, perhaps the GI docs aren't too concerned especially if we are getting regular blood tests while on our meds. I think I'm maybe a little more concerned though because right now I'm jobless and out of school, so I spend most of my days sitting around the house not doing anything too active.

 

[Lydia]

I found it gave me migraines and I got a lot more girlie infections while on it. My husband and I now use condoms or vaginal contraceptive film. The VCF is great for the times you want to ditch the condoms. I used the progestin only pill for awhile after my DD was born but I did not have any active disease at the time. I found that those did not give me migraines. It must be the estrogen that causes me problems.

 

[dreamintwilight]

Hmm...thanks I haven't heard about VCF. Reading about it now!

 

[Meltric]

I'm glad I stumbled upon this as I'm on the pill and never once thought about whether my crohns would affect it!!
Still kinda new to crohns so I definitely need clarification. i'm reading about absorption... does this mean that there's a chance I am taking the pill in vain? Are the contraceptive effects not working as they should? scary!!!!
Should I look into other forms of contraceptives? I asked my GP recently about the clotting (from the pill, not the crohns) and she said the chances were so low that I had no reason to worry.

every day I learn something new about crohns, good grief!

 

[dreamintwilight]

Yeah, well if you think about how the docs tell you that you may not be getting the proper nutrition from your food due to your Crohn's (that's why some people get B12 deficient anemia), the same could be said for your absorption of the pill. Something to definitely keep in mind if you don't want to get pregnant Though I've read many people say they've been taking the pill with Crohn's and their gynos never said anything about it. It might be opinion. Also, I'm not sure if indeed it does affect absorption of the pill, by what percentage it decreases in effectiveness. It's all so confusing to me, haha. Just one more thing to think about along with all this Crohn's business, huh?

 

[Meltric]

Exactly! I feel like I've recently been inundated with so many things to worry about and now BAM! one more! haha. Crohn's is SO complicated, I had no idea.

 

[dreamintwilight]

Just thought I'd update on this thread. Finally able to talk in person to my GI about blood clotting, hormonal contraceptives, and Crohn's and he said it wasn't a significant percentage of risk that he felt the need to be concerned about it. So, I think I'm going to give the patch a try starting my next cycle. We'll see how it goes. The nurse practitioner I talked to about the patch said when she tried it herself she had terrible headaches too. It would be nice if I didn't have any symptoms, though I remember getting headaches when I first started taking Seasonique.

 

[kello82]

hey sorry i cant be of too much help with that one specifically....i almost started on depro provera a couple years back to try to help my symptoms, and they DID sternly warn me about clotting. i remember the main thing being air travel? the told me i would have to get up and move at least every 20 mins?

thats all i remember about that.

BUT as far as patch drugs in general? maybe be totally different things, but i do believe the delivery method for all transdermal systems is the same....SO do you know if you have to be careful about exposing the patch to heat?
for the fent patch i was on i could not expose the area to sun, hot tub, really hot shower, etc etc. it can make the gel in which the droplets of drug are suspended dissolve quicker, thus leading to quicker absorbtion thru your system.
took me a long while to understand how that crap worked....

plus, if you have high fevers at any point (crohns, not uncommon) that can release the drug faster too. i do not know what the risks of rapid absorbtion of ortho evra are, i would think they arent as bad as OD on narcotics....but would be good to check yeah? make sure that its not something that is deemed safe for normal systems but not considered for a system such as yours

 

[dreamintwilight]

Yah, well it says the patch can be taken during showers and such and even swimming. So, perhaps the heat aspect doesn't aply. I would imagine if it does it would just increase he likelihood of experiencing side effects. So, I'll give it a try. The worst thing that could happen would be I have annoying side effects and take it off. I'm kinda looking forward to being on something hormonal because it helps me with my acne-prone skin. Since being of of hormonal birth control I can tell my skin is starting to suck again. Boo.

 

[coachvee]

Hey Soupdragon, thanks a lot for the post! I had considered the implant some time ago but was told that for "overweight" people it may not be so effective. I immediately forgot about it.

Did some more reading today and supposedly thats for people with BMI 35 and over, and I'm under that. And that's at my heaviest weight - am losing weight (deliberately, I might add - I get all the side-effects of Crohns except the losing weight part!).

So I'm going to ask the doctor about this tomorrow. Brilliant!! Another bit of good news for me this year

 

[hindyg]

I thought the patch had been discontinued because of the clots - or maybe it was temporarily when I last inquired. I was on the patch after my first child. I wasn't happy with it. It messed up my cycle. Lutera was a good, effective pill for me. It didn't mess with my crohns. My doctor also recommended Mirena as a better option for something that wouldn't be affected by all the crohns meds I was on.

 

[dreamintwilight]

I've been on the patch with much success. No problems experienced while taking it. Just maybe a bit of irritation around the site where the patch is applied, but that soon goes away after switching to a different place the next week. It's regulated my cycle perfectly. I always start 2 days after removing the 3rd patch. Prior to birth control, I never had a clue when my cycle would start. IT was always so sporadic. So, knowing the exact day (and time!) is awesome.

So, for anyone considering the patch I would say at least give it a try because it's been working GREAT for me and I was nervous about using it.