Hi, Thanks for posting in HCM. I understand your concern. Ortho Evra is a contraceptive patch that contains the hormones estrogen and progestin. To use Ortho Evra, you apply the small patch to your skin once a week for three weeks. On the fourth week, you don t use a patch — which allows menstruation to occur. It prevents pregnancy by releasing hormones into your bloodstream similar to birth control pills, that suppress ovulation, keeping your ovaries from releasing an egg. Ortho Evra also thickens cervical mucus and prevents sperm from reaching the egg. To use Ortho Evra, you ll need a prescription from a doctor or health care provider. An estimated 9 out of 1,000 women will get pregnant during the first year of typical use of Ortho Evra. The patch doesn t offer protection from sexually transmitted infections (STIs). Usual side effects associated with its use include: An increased risk of blood-clotting problems, Breakthrough bleeding or spotting, Breast tenderness or pain, Headaches, Nausea or vomiting, Abdominal pain, Mood swings, Weight gain, Dizziness, Acne, Muscle spasms, Vaginal infections and discharge, Fatigue and Fluid retention. If you re using Ortho Evra for the first time, wait until the day your period starts. If you use the first-day start, you ll apply your first contraceptive patch on the first day of your next period. No backup method of contraception is needed. If you use the Sunday start, you ll apply your first patch on the first Sunday after your period starts. You need to use a backup method of contraception for the first week like condoms and/or spermicidal agents. Hope the information provided would be helpful. All the best.