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.