Latest birth control gives the pill a run for its money.

Byline: The Health Files by Tim Christie The Register-Guard

BIRTH CONTROL has come a long way since the Middle Ages, when women were advised to wear amulets of weasel testicles or desiccated cat livers to ward off pregnancy, or to walk three times around the spot where a pregnant wolf had urinated.

Aside from the difficulty of obtaining animal body parts or figuring out where a wolf urinated and whether it was pregnant, those methods, described in a Planned Parenthood history of birth control, had a major drawback: They didn't work.

Since the pill came on the market in the 1960s, women have had a cheap, safe and reliable form of birth control that didn't involve animal body parts. But the pill is only as effective as the memory of the woman taking it.

Now a new wave of hormonal contraceptives is changing the way women take birth control.

The ring and the patch have joined the pill and the shot to give women more hormonal methods for preventing unintended pregnancies. Nearly half - 49 percent - of pregnancies in the United States are unplanned, according to federal health statistics, and half of those occur with women who were using birth control but had trouble following directions.

Local Planned Parenthood clinics began offering the patch and the ring last month, and they had trouble keeping them on the shelves at first, said Diane Duke, associate executive director of Planned Parenthood Health Services of Southwestern Oregon.

"They've just been wildly popular," she said. "They're popular because you don't have to remember to take a pill every day."

The ring, sold under the brand name Nuvaring, is a transparent, 2-inch-diameter ring that a woman inserts after her period and removes three weeks later, and then leaves out for a week.

Ortho Evra is the name of the thin, square patch that a woman wears on any part of the body except the breasts. Three patches are worn, one at a time and each for a week, followed by no patch for a week. Both the patch and the ring use the same types of hormones that are in the pill to prevent pregnancy, but in lower doses.

That means that side effects associated with the patch or ring tend to be less severe than those with the pill, and occur in fewer women, said Dr. Susan Ballagh, an assistant professor at Eastern Virginia Medical Center who was in involved in clinical trials for both devices.

New methods on the rise

While the pill remains dominant, the patch and the ring have grown rapidly in popularity since coming on the market last year. They join other hormonal birth control methods that don't require a daily dose, such as Merina, an intrauterine device that lasts for five years, and Depo Provera, a shot that lasts for three months. Lunelle, a shot that lasts for a month, was taken off the market last year but may be reintroduced.

The patch, in particular, is popular - now the second most-prescribed hormonal contraceptive in the country after the pill, an Ortho Evra company spokeswoman said. The company doesn't disclose sales figures. The patch has been boosted by a major advertising campaign in parenting and women's magazines and on television. While both new methods are growing in popularity at the University of Oregon Health Center, the patch is far outpacing the ring, said administrator Bob Petit. Since last summer, the health center has filled 850 prescriptions for the patch, compared with 153 prescriptions for the ring since last fall, he said.

"My gut reaction is they're (both) going to continue to grow in popularity," he said.

Ballagh said nicotine patches have familiarized people with the idea of delivering medicine through a transdermal patch. But that's not the case with the ring.

"Not just women but physicians aren't as familiar with the vaginal delivery of drugs," she said. "That provides a bit of a hurdle. But once they get past that hurdle, women who try it absolutely love it."

Dr. Melissa Edwards, an ob-gyn at the Women's Care clinic in Eugene, predicts the ring will have more staying power than the patch.

People like the idea of the patch at first, until they get sticky residue on their skin or the patch starts to peel off, she said. With the ring, some women are wary about putting something foreign in their body until they try it, she said.

"Once people take it home and use it they really like the convenience," she said.

Not only is it comfortable, he said, for both the woman and her partner, but it delivers the hormones directly where they're needed and at lower doses than the pill or the patch.

"Women who complain about mood changes or weight gain on the pill like the concept that they may not have side effects to the same degree" with the ring, Edwards said.

Price can be a factor

Brenna May, 27, works at the Planned Parenthood clinic in Medford as a family planning assistant. Married with no children, she had been using the pill but decided to try the ring so she could tell clients what it's like.

She found it to be "surprisingly comfortable" and relatively easy to use. She wants to try the patch as well, but said she would consider sticking with the ring.

For some women, the cost of the new products can be an issue. At local Planned Parenthood clinics, the patch sells for $28 a month and the ring for $21 a month, while the pill costs $18 to $20 a month.

But even that's too steep for some low-income women and public health clinics, said Diana Bruce, senior policy analyst at the National Family Planning and Reproductive Health Association, which represents publicly funded family planning clinics.

"In the private market, they're selling really well. In the public market, it's harder," Bruce said. "The pill is a much more affordable method for clinics to purchase."

For women younger than 30, the pill has long been the most popular method of birth control. A 1995 federal health survey found the pill was used by 35 percent of women age 15 to 19, 48 percent of women age 20 to 24 and 37 percent of women age 25 to 29.

It seems unlikely either new method will dethrone the pill, doctors said. "The pill has just ingrained itself into American culture," Edwards said. "People are really comfortable with it."

Tim Christie covers health and medical issues. Call 338-2572 or e-mail [e-mail].

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