Studies of the contraceptive patch and Deep Vein Thrombosis (DVT) have yielded conflicting results. In 2006, two trials found a higher incidence of nonfatal blood clots among women using the patch than among women taking oral contraceptives, while a third study found no significant difference. In 2010, a post-marketing surveillance study found no difference in DVT risk for women under age 40 who used the patch (compared with women on the pill). Even if the true risk of DVT with the contraceptive patch is higher than with oral contraceptives, the absolute risk remains incredibly small.

How can we frame this discussion so that we communicate honestly without alarming patients? Relative risk may exaggerate women’s perception of a method’s danger. We should describe absolute risk instead, as a proportion using a consistent denominator.

For example, instead of saying, “the patch doubles your risk,” we should say, “the risk of clots is 50 per 100,000 users of the pill, 100 per 100,000 users of the patch and 300 per 100,000 women with pregnancy.

Framing risk in this way helps us avoid inadvertently increasing our patients fears.

We appreciate your feedback! Please write us at pearls@reproductiveaccess.org with any questions, comments or additional resources to add to our list.

Helpful Resources

Patch User Guide

Sources

Jick SS., et al.  Postmarketing study of Ortho Evra and levonorgestrel oral contraceptives containing hormonal  contraceptives with 30 mcg of ethinyl estradiol in relation to nonfatal venous thromboembolism.  Contraception.  2010 Jan; 81 (1): 16 – 21.

Pharma-free

The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.