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Twirla is a combination hormonal contraceptive (CHC) transdermal patch containing the estrogen ethinyl estradiol and the progestin levonorgestrel. Developed by Agile Therapeutics and marketed by Exeltis USA, it utilizes the proprietary Skinfusion technology to deliver 30 mcg of ethinyl estradiol and 120 mcg of levonorgestrel daily over a seven-day wear period. The primary mechanism of action is the suppression of ovulation via the inhibition of gonadotropin secretion (luteinizing hormone and follicle-stimulating hormone) from the pituitary gland. Secondary mechanisms include thickening of cervical mucus to inhibit sperm transport and alterations to the endometrium to prevent implantation. It is FDA-approved for the prevention of pregnancy in women with a body mass index (BMI) less than 30 kg/m².
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