Transdermal contraceptive patches: current status and future potential

Transdermal contraceptive patches were first introduced in the USA in the spring of 2002. Approval in Canada and the EU followed soon thereafter. In the USA, sales of the patch were so robust that during the first months the manufacturer could not keep up with demand; by fall of 2002, the patch was the second highest selling combined hormonal contraceptive in the USA. This initial success reflected the strong demand that US women had for a more convenient delivery system that required less frequent dosing. Adolescent women in particular seemed to be more able to successfully use patches than they did pills. However, following a typical US pattern of boom-and-bust cycling and the initiation of litigation that claimed that there was a greater risk of venous thromboembolism (VTE) with the patch, sales in the USA dropped significantly. This article describes the hormonal properties of the contraceptive patches that are currently available, the clinical experience with the patch, and the results of postmarketing surveillance for VTE. We also discuss the potential for future contraceptive products using this route of administration.