While the preceding list of features and benefits is impressive, the patch does have several weaknesses:

• Not a true low-dose hormone based on EE serum concentration levels
• Side effects: breast tenderness (19%), abdominal pain (8%), nausea (20%), site rash (20%), headache (22%)
• Significant breakthrough bleeding in first and second cycles
• Failure rate of five of the 15 pregnancies in clinical trials occured in women > 198 lbs.
• Adhesion issues - patches sometimes fall off (4.6% per patch)
• Local site irritation
• Lack of cleanliness; may smell
• Not discreet; can't match skin tones
• Replacement costs
• Topical products may interfere with absorption
• Perceived negatively by clinicians