Brief Answer: Difference is not levels of hormones in drugs Detailed Answer: Hi XXXXXXX and thanks for the query, I understand that you are concerned that the levels of estrogen are higher in patch than the tablet. Let me explain things in a bit detail. Ortho evra contains a combination of the hormones estrogen and progesterone preparations designed in such a fashion that they keep on releasing a little amount of hormone in the body. This does not allow the body to make its own hormones as it was used to. All this leads to prevention of ovulation and hence preventing pregnancy. The same principal is used in birth control pills like minastrin. ortho evra contains :Norelgestromin, Ethinyl Estradiol Transdermal Minastrin contains: Norethindrone Acetate and Ethinyl Estradiol/Ferrous Fumarate Capsules Both are estrogen and progesterone combinations. The only difference is that when we take a tablet, it goes into our stomach and intestine for absorption. The rate of absorption depends upon the amount of drug. When the tablet reaches the intestine, the initial concentration of drug is high and more of it gets absorbed quickly so blood levels become high. After some time the concentration in intestine decreases as most of it has been absorbed, so little is available for absorption. So it gets absorbed at slower rate and lesser amount, so blood levels drop. Also body tries to excrete it out via kidney or liver and levels decrease further. So the levels rise rapidly and reach a peak, drop quickly and reach a trough. With ortho evra: the drug is slowly delivered in the body so the issues of rapid absorption and high and low levels is avoided. The peak level reached by orthoevra is less than that by tablet, but its concentration in the body remains higher than the trough levels all the time. Meaning that the higher level is not so much high and the lower level is also not so much low. Having said all this, why must we worry about these sustained moderate levels: Estrogen component of the birth control pills is associated with majority of side effects. So since many years research is going on to decrease the estrogen concentration in pills. The patch delivers higher sustained levels of estrogen that the pill may not deliver. The pill reaches a high but also a low, which the patch does not do. Exact scientific research has yet not proved how harmful that these moderate high levels due to patch may be, but experience says that there is a need to exercise caution. So this is how orthoevra delivers more estrogen. It is not that it contains more estrogen, but it keep estrogen levels higher in the body for longer times than birth control pills. Please excuse me for such a long answer but I thought it was important to explain all the details and clear the concept. Please refer to the link below. There is a chart of ortho evra blood levels there. WWW.WWWW.WW Hope this satisfies your query. Thanks for using HCM. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist

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Brief Answer: I have included some names Detailed Answer: Thanks for the follow up query XXXXXXX I completely understand your problem. It is not uncommon for women to find one preparation better suited for their system than the other, especially with pills. Pills similar to minastrin are Loestrin and Loestrin 24 Fe, gildess fe, Estrostep Fe, Junel etc. The Fe means that they have some pills that are dummy pills providing iron. Some 21 day pills are also available, the only difference is that you do not need to take any pill for 7 days. See if they are covered under your current insurance plan. If yes, you may try them. I have provided a complete list of all types of pills containing the same formulation as in minastrin at the end of the query. There are minor difference in drug concentration or type of drug or iron or vitamins according to different brands. Please check to see if any of these is included in your insurance if the above mentioned are not covered. Hope this helped. Please feel free to ask any doubts in your mind and I am here. Thanks once again. Have a good day. Dr Madhuri Generic Name: ethinyl estradiol and norethindrone (ETH in il ess tra XXXXXXX ole and nor ETH in drone) Brand Name: Alyacen 1/35, Aranelle, Balziva, Brevicon, Briellyn, Cyclafem 1/35, Cyclafem 7/7/7, Dasetta 1/35, Estrostep Fe, Femcon FE, Generess Fe, Gildagia, Gildess, Gildess FE 1.5/30, Junel 1.5/30, Junel 1/20, Junel Fe 1.5/30, Junel Fe 1/20, XXXXXXX Lo Loestrin Fe, Loestrin 21 1.5/30, Loestrin 21 1/20, Loestrin 24 Fe, Loestrin Fe 1.5/30, Loestrin Fe 1/20, Microgestin 1.5/30, Microgestin 1/20, Microgestin FE 1.5/30, Microgestin FE 1/20, Minastrin 24 Fe, Modicon, Necon 0.5/35, Necon 1/35, Necon 10/11, Necon 7/7/7, Norinyl 1+35, Nortrel 0.5/35, Nortrel 1/35, Nortrel 7/7/7, Ortho-Novum 1/35, Ortho-Novum 7/7/7, Ovcon 35, Ovcon 35 Fe, Philith, Tilia Fe, Tri-Legest Fe, Tri-Norinyl, Wera, Wymzya Fe, Zenchent Fe, Zeosa

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Brief Answer: Thank you very much Detailed Answer: Hi XXXXXXX Thank you once again. Please do rate as it also provides me more incentive to work harder for better patient satisfaction as this was my aim when I entered medical school. Thanks once again and have a good day. Dr Madhuri

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