Transdermal contraceptive patch placement

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The patch supplies norelgestromin and ethinyl estradiol to the bloodstream through the skin.
The patch supplies norelgestromin and ethinyl estradiol to the bloodstream through the skin.

After using the Ortho Evra patch (norelgestromin, ethinyl estradiol), a patient experienced painful swelling of the clitoris, vulva, and introitus that subsequently resolved after patch removal. Has any evidence of genital swelling been documented with the use of the patch when placed inappropriately on the pubic area?—BARBARA J. CAPEZIO, RNC, CRNP, Philadelphia

As many as half of patients experience local reactions with the Ortho Evra patch, even when placed appropriately on intact skin of the upper arm, upper chest, abdomen, or buttocks. A local reaction would be just as likely—or even more so—from an inappropriately placed patch. Absorption of the patch's component hormones may also be higher if placed on more delicate tissue, which could also lead to uncomfortable engorgement of the genitals.—Lisa Stern, APRN (139-11)

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