Dermal and Transdermal Drug Delivery Systems
Tapash K. Ghosh in Dermal Drug Delivery, 2020
Clinical studies involving the Ortho-Evra® contraceptive patch have been reviewed (Creasy et al., 2001). The patch was found to provide ovulation inhibition by suppression of gonadotropins, cycle control similar to that of oral norgestimate and ethinyl estradiol, and decreased mean maximum follicular diameter. Efficacy, safety and compliance of patch use were also demonstrated (Smallwood et al, 2001). The patch was not associated with phototoxicity or photoallergy. By 2006, the contraceptive patch was widely accepted as being an efficacious and safe regimen, with the successful completion of three phase III trials, two of which were randomized comparisons with an oral contraceptive. Although the likelihood of pregnancy was similar between the patch and the pill, compliance with the patch was notably better, particularly in younger women, and the safety and tolerability of the patch was similar to that of oral contraception (Graziottin, 2006). In the same year the increased risk of nonfatal venous thromboembolism, linked to the oral use of the progestin, norgestromate and ethinyl estradiol, was shown to be similar in those subjects using the contraceptive patch (Jick et al., 2006; Jick et al., 2007). However, a later study suggested that the increased risk of venous thromboembolism associated with the use of the contraceptive patch was two-fold greater than that associated with norgestimate-containing oral contraceptives (Dore et al., 2010). These and other studies (Jick et al., 2010) led to a safety update and an FDA requested change to the labeling of Ortho-Evra® in 2011. Nonetheless, an evaluation by Bodner et al. (2011, p. 525) of 80 adolescents and 178 adult users concluded that there was “an overall positive impression of Evra with good compliance…”.
Combined oral contraceptive methods
Sarah Bekaert, Alison White in Integrated Contraceptive and Sexual Healthcare, 2018
The contraceptive patch works by: inhibiting ovulationaltering cerivcal mucus so that it is impenetrable to spermmaking the endometrium unfavourable to implantation.
Understanding Contraceptive Failure: An Analysis of Qualitative Narratives
Published in Women's Reproductive Health, 2023
Lori Frohwirth, Jennifer Mueller, Ragnar Anderson, Patrice Williams, Shivani Kochhar, S. Kate Castle, Megan L. Kavanaugh
Our respondents described using a wide range of contraceptive methods, though all could be categorized as “moderately effective” or “least effective” methods (Centers for Disease Control and Prevention, 2014). Condoms and pills were among the most common methods used, and nearly half of respondents used withdrawal; many of these methods were used in combination. Less frequently mentioned methods were injectables, the contraceptive ring, FABMs, emergency contraception, abstinence, sterilization, suppositories, foam, and diaphragms. No one who described using FABMs in our sample was using any formal method, and none had received any training or instruction; they relied on tracking apps and their own understanding of fertility within their menstrual cycles. No respondent described using the contraceptive patch, an intrauterine device (IUD), or a contraceptive implant.
Delivery of progestins via the subdermal versus the intrauterine route: comparison of the pharmacology and clinical outcomes
Published in Expert Opinion on Drug Delivery, 2018
Norman D. Goldstuck, Hung P. Le
All types of non-hormonal contraceptives act locally in the genital tract. This is true for both short-acting male and female methods, like male and female condoms, and for LARC methods, like plastic or copper carrying intrauterine devices. It is also true for both male and female non-reversible methods, e.g. sterilization. All types of hormonal contraception, whether short-acting like oral contraceptives, the contraceptive patch (Ortho-Evra®) or the vaginal ring (NuvaRing©) or of intermediate action like progestin injectables act both centrally in the brain and peripherally in the genital tract. Logically then, the hormone-based LARC contraceptives behave in the same manner. What is different is the degree to which central rather peripheral action predominates and what effect this has on the advantages and disadvantages of the method.
The influence of hormonal contraception on depression and female sexuality: a narrative review of the literature
Published in Gynecological Endocrinology, 2022
Laura Buggio, Giussy Barbara, Federica Facchin, Laura Ghezzi, Dhouha Dridi, Paolo Vercellini
COCs are the most used type of hormonal contraception. Other birth-control formulations releasing estrogen-progestogens, such as the transdermal patch and the vaginal ring, have become available in the last years. Both vaginal ring and contraceptive patch showed mixed and variable effects regarding sexual function, and no firm conclusions on their sexual effects can be drawn [111]. Some authors reported a decrease in sexual function in women using vaginal rings compared with women using COCs [112,113]. On the other hand, other researchers have shown an improvement in several domains of female sexuality, such as libido, satisfaction with sex, frequency and intensity of orgasm, and sexual fantasies in women using vaginal rings vs. non-users [114]. Regarding the transdermal patch, Gracia et al. [112] reported a slight increase in sexual function scores compared to women using COCs.
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