Rough Patch

This contraceptice device sickened thousands of women. I was one of them.

by Nicole Ankowski

October 6, 2008

"Those fucking bastards," I whispered to my boyfriend and cat when I read the article. "They're getting away with it!"

In April, The New York Times brought us a nasty update to the 2005 news that pharmaceutical giant Johnson & Johnson had been lying to the public about their Ortho Evra birth-control patch. Marketed as a lower-estrogen birth-control option (meaning fewer and milder side effects than the pill), the patch actually delivered much higher doses of estrogen than the pill, and that Johnson & Johnson failed to reveal this to the public for six years. At least fifty deaths have been attributed to the patch because of this, with thousands more women reporting alarming symptoms. And now, Johnson & Johnson is arguing that women hurt by the patch cannot sue, because the FDA approved the patch in the first place.

I was one of the women whose body was ransacked by the patch. And as I read the article, I flashed back to 2004 in wavy slow-dissolve: I was living in California , chasing after my man — the cat still a mere twinkle in his eye — with a brand-new Ortho Evra patch affixed firmly to my ass. It was like Erin Brockovich, only in this lurid real-life chick flick, there would be no legal retribution for the estrogen-roofied woman. At least, not yet.

I'd never been the type of girl who wanted to be locked down in any way — by a cat, a job, a man, a tattoo. But then I met The Boy, who changed me from an aloof Leo to a helpless kitten batting at a string. I left my job, my home, my friends, and moved across the country for a guy I'd been dating less than four months. I'd like to say I was boldly throwing caution to the wind, but the fact is, I simply wasn't thinking. I was in that place where I just wanted to meld my body totally into his. I wanted to lick him with my little cat tongue and scratch him with my claws and devour him like so many Tender Vittles.

Even a condom was too much space between us. So I did yet another thing I'd always vowed I would never do: I went on the pill.

My distaste for the pill might be rooted in my mother. She called my periods my "power time," and when I got sick made me swallow a vitamin-C pill the size of a Baoding ball. In my family, we only went to the doctor when we fractured a leg bone or had a heart attack (and even then, he better not get all patriarchal 'n' shit.) So the pill was an amalgamation of everything I'd grown up resisting: man-made chemicals recklessly messing with a woman's natural bodily rhythms.

But everyone else was doing it, I told myself. And it's safer than when it was when it was first introduced (isn't it?). Most importantly, it would offer me freedom. I'd just have to get annual pap smears in order to buy monthly packets of small orange dots which I'd need to remember to swallow at the exact same time every day. But we'd be able to have impromptu sex in the kitchen, so hot damn.

Unlike many friends, I didn't experience side effects from the pill: no weight gain (I already had extra), no wild mood swings (no comment), and disappointingly, no breast augmentation.

Amazingly, The Boy and I didn't break up, although the stress of a major move, looking for work and that laid-back Northern California vibe got to me. (My hair was always too clean at parties, and why did I need a pea coat in August?) I got sick. A lot. Womanly issues. UTIs. Too much sex and not enough health insurance. Things in life and between my legs eventually calmed down, but I was still spotting between periods, which I told my doctor during my yearly exam.

"Are you taking the pill at the same time every day?" she asked.

"Yeah, between seven a.m. and noon ," I replied. You know, the exact period of time I wake up in the morning.

She told me it would be best if I took it at precisely the same time every day. Or, as an alternative, she held up the blue gummy bracelet I'd worn on my wrist during the '80s, and told me I should stick it up my vagina. I eyed the ring suspiciously. Why do all birth control devices have one-word names with "the" attached as a prefix? Frodo wouldn't go near this bad boy.

Sensing my reiticence, she opened a drawer, removed a small, pink square and, with a flourish, thrust it aloft: The Patch.

The Patch is a hormone-delivery system that looks like an oversized BandAid. It comes in one shade, "flesh," though it certainly didn't match my whale-bone skin. A woman affixes the patch on one of four areas: the upper torso (back or front, but not the boobies), the upper arm, the lower back, or the buttocks. Hormones are absorbed through the skin. After seven days it sloughs itself off like a snake's skin, and a small alien bursts through your intestinal lining, hopefully while you're sleeping.

No, of course not. If the FDA had tested an alien patch, they would have sold it to the military, not women. At any rate, you apply one per week for three weeks, and on the fourth week you bleed but you don't have a baby.

The doctor promised me exactly what Johnson & Johnson reps had promised hundreds of thousands of women: that the patch offered lower estrogen than the pill, therefore I'd have fewer side effects and health risks. Unfortunately for me, the 3,000 women who are suing Johnson & Johnson and the fifty who died, they were wrong.

I got off easy. We're conditioned to ignore possible side effects (bloodclotsstrokeheartattacks… lionsandtigersandbearsohmy!) just like we're conditioned to ignore that when we board a passenger plane, we're thirty thousand feet and one small mechanical malfunction away from certain death.

Luckily, my own patch story spans only twenty-four hours.

I applied the patch at my boyfriend's apartment on a sunny Oakland Sunday. Ever afraid of commitment, I took a while to place it. The upper arm would be visible when I wore tank tops, the abdomen might chafe against a belt. I settled on the upper butt cheek. I figured it would be a turnoff during doggy-style sex, but lights could be turned off, too.

"How's it feel?" The Boy asked.

"It kind of burns," I said, realizing it did sting around the application area, like someone had lit a match and then blown it out, holding the heated head next to my skin.

The rest of the day, I napped fitfully. During sluggish waking moments, I demanded The Boy bring me pizza or the remote control. I said things like, "I really wanna tear this thing off me right now." Then I'd sprawl out and sleep again. At the time, I didn't notice anything unusual in this behavior. It was, after all, a Sunday.

The next morning I dragged myself out of bed before sunrise to begin my hour-long bus commute to Berkeley . I blamed my uneasy nausea on last night's pizza. I must have looked bad — in a glamorous, Britney Spears post-rehab sort of way, of course — because The Boy insisted I take his car to work. But at the office, I wasn't feeling any better. And then suddenly I knew I was going to throw up right now.

Remember those pre-vomit moments in cartoons, where an animated pig's cheeks bulge out like balloons, and he puts his finger against his pursed lips to try and hold back the imminent flood? That's exactly what I felt like. I ran — I mean, I hauled patched ass — to the restroom and upchucked.

A little watery-eyed and weak, I went back to my cubicle pod feeling much better. Then, twenty minutes later, I was running back to the toilet. It went on like this all morning. By the fifth or sixth twenty-meter dash, I was only puking white foam. And my coworkers had noticed. "Why don't you go home?" they said. And, "Why don't you take off the patch?"

Practical suggestions. Except that a new side effect had begun to reveal itself. The best kind of medical side effect one could hope for: my breasts were growing. The night before, I'd felt a new springiness, and demanded The Boy feel me up, to see if he noticed too. (Then I'd slapped his hand away, since damn they were sore.) This was the one side effect the pill had always promised, and now, finally, it was here. I wasn't giving up on the patch that easily.

But I did concede that I'd drive home — even though I felt fine, post-puke — since what with all the vomiting, I wasn't getting any work done (and was frightening my podmates). Giddy, I drove away from Berkeley . The sun was glinting off the waves. My breasts were plumping. I cranked up NPR. It was a good day in the East Bay !

Now, as anyone who's driven from Berkeley into San Francisco knows, highway planners made an interesting choice when they decided to merge three freeways into one narrow junction at the edge of the bay. I-80, 580 and a dash of 880 traffic all converge in one wildly frenetic half-mile of freeway. Half the flow of cars from the left side of the highway is forced to merge mercilessly to the right as they jockey for the bridge, while people on the right thrust maniacally left to try to stay on 580. Throw in the IKEA exit that shoots off to the right, and you have a Beijing-grade traffic clusterfuck.

It was just as I was gunning the engine and beginning my journey across five lanes of traffic that I felt it: the cheek bulge. The stomach roil. The acidic white foam in the throat.

There was no time and nowhere to stop. I couldn't open the car door or window. If I took my eyes off the road for one second I would hit someone, or be flattened by the multiple big rigs roaring behind me. So I did the two things my body dictated: I stayed alive by continuing to drive, and I locked my knees together and puked in my lap.

I was wearing fern-green corduroy pants (why not? It's Oakland ). I pushed my legs together tightly to create a leak-free pooling area. And right before it began, I smiled. Because as awful as it was about to get, this shit was pretty funny. And then I opened my mouth, pushed my neck forward like a baby bird, and puked my guts out.

And cried just a little.

There was a small amount of splatter on the wheel, but other than that The Boy's car was miraculously unharmed. My cords were not: the large crotch stain caused quite a few double-takes as I walked into my building. When I finally got a call back from my doctor's office, the nurse said, "Are you sure you don't have the flu? It sounds like you have a stomach flu." Bitch, no, I wanted to say. Instead, I hung up and ripped off the patch.

That was 2004. Just this year, I was telling a new doctor here on the East Coast that I'd tried the patch once, but it had made me so sick I could only use it for one day. "Well, that's your problem," he said, leaning back behind his big, wooden desk. "You didn't give it enough of a chance."

I'm pretty sure I said, Bitch, please, as I walked out of his office.

The Ortho Evra website now lists all of these symptoms, including "nausea and/or vomiting, application site reaction, breast symptoms, headache, and emotional lability," as well as blood clots, strokes, heart attacks, and "the risk of venous thromboembolic events." It also offers a confusingly worded warning about the extra estrogen in the patch: "You will be exposed to about 60% more estrogen if you use ORTHO EVRA® than if you use a typical birth control pill containing 35 micrograms of estrogen."

I'm embarrassed that, despite all my misgivings about hormonal birth control (not to mention its effects on fish!), I went back on the pill, ignoring the warnings until my face began changing color. Welcome to the wonderful world of melasma. For me, it meant waxing my peach-fuzz mustache, then discovering skin discoloration underneath in the exact shape and shade of a Hitler 'stache.

So, with vanity winning out over puke, chemicals and feminism, I went off the pill three weeks ago. It hasn't been smooth sailing — my lady parts are sore, I've gained five pounds and I'm moodier than Meredith Grey. But it feels great to share the burden of reproductive choice in my relationship.

Who knows if my upper lip will ever return to its normal color. I'm unsure as to which long-term contraceptive option I'll choose, where the best place to snag free condoms is, or what the hell is the attraction of "ribbed for her pleasure." But I am certain of one thing, both for Johnson & Johnson and society as a whole: when it comes to the messy task of pregnancy prevention, it's time for some shared responsibility.  

©2008 Nicole Ankowski and


This information is not intended as medical advice. I encourage everyone to make their own health care decisions, with advice from qualified professionals.


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