In November 2005, a strongly worded warning was added to the patch label, advising that women using the patch would be exposed to approximately 60 percent more estrogen than those using typical birth control pills. Estrogen use is linked to blood clots in the legs and lungs and other clotting problems such as strokes and heart attacks. This warning came four months after reports surfaced that patch users die and suffer blood clots at a rate three times higher than women taking the pill.

In addition, according to The Associated Press, an internal Ortho McNeil memo shows that the company refused, in 2003, to fund a study comparing its Ortho Evra patch to its Ortho-Cyclen pill because of concerns there was "too high a chance that study may not produce a positive result for Evra" and there was a "risk that Ortho Evra may be the same or worse than Ortho-Cyclen."

While it is true that most birth control pills contain the same amount of estrogen as the patch, hormones from patches go directly into the bloodstream while pills must first be swallowed and digested. The result is that women using the patch have much higher levels of estrogen in their bodies. Users have suffered blood clots, pulmonary emboli and deep vein thrombosis, which have caused death, strokes, heart attacks and extensive surgical and medical intervention, including prolonged anti-coagulant therapy.

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