Adolescents' Experiences Using the Contraceptive Patch versus Pills

Study Objective: To compare use of the weekly transdermal contraceptive patch (patch) with daily combined hormonal contraceptive pills (pills) in adolescents. Design: Prospective longitudinal study of adolescents' self-selected (non-randomized) use of the patch or pills. Setting: Urban, university hospital-affiliated, adolescent outpatient clinic. Participants: 13-22-year-old female adolescents seeking hormonal contraception, 40 who chose the patch and 40 who chose pills. Interventions: Data were collected via self-report on paper questionnaires at three-cycle intervals for a total of up to nine cycles. Main Outcome Measures: Method continuation, perfect use, method satisfaction, quality of life, and side effects, including menstrual changes and perceived mood changes. Results: After nine cycles, 38% of patch users and 60% of pill users were still using the method they had chosen at enrollment. There were no significant differences between the groups in self-reported perfect use. No differences were found in quality of life or side effects. Both patch and pill users noted menses became lighter and more predictable and reported decreased depression prior to their menses; only the pill group reported improvement in premenstrual anger. Method satisfaction was similar in both groups except patch users were more likely to report that their contraceptive method improved normal daily activities. Conclusions: Despite apparent advantages of the patch over the pill, adolescents using both methods continue to face challenges achieving perfect and sustained contraceptive use.