Birth control patch
Medically reviewed on December 30, 2017
The birth control patch for women is a type of contraception that contains the hormones estrogen and progestin. You place the small patch on your skin once a week for three weeks, so that you wear a patch for a total of 21 days. During the fourth week, you don't wear a patch — which allows menstrual bleeding to occur.
The birth control patch works similarly to combination birth control pills. The birth control patch prevents pregnancy by releasing hormones into your bloodstream that keep your ovaries from releasing an egg (ovulation). The birth control patch also thickens cervical mucus to keep sperm from reaching an egg.
Ortho Evra, once marketed as a birth control patch, is no longer available in the U.S. The manufacturer discontinued Ortho Evra after the U.S. Food and Drug Administration approved Xulane, a generic birth control patch, in 2014. The Evra patch is still available in Europe and Canada.
You'll need a prescription from your health care provider to use the birth control patch. The patch doesn't protect against sexually transmitted infections (STIs).
Why it's done
The birth control patch is used to prevent pregnancy. The birth control patch has some advantages over other types of birth control:
- It eliminates the need to interrupt sex for contraception
- You don't need your partner's cooperation to use it
- It doesn't require daily attention or having to remember to take a pill every day
- It provides a steady dose of hormones
- It's easier to use for women who have trouble swallowing pills
- It can be removed at any time, allowing for a quick return to fertility
The birth control patch isn't appropriate for everyone, however. Your health care provider may advise against the patch if you:
- Are age 35 or older and smoke
- Have chest pain or a history of heart attack, stroke or severe high blood pressure
- Have a history of blood clots
- Have a history of breast, uterine or liver cancer
- Weigh more than 198 pounds (90 kilograms)
- Have liver disease or migraines with aura
- Have diabetes-related complications of the kidneys, eyes, nerves or blood vessels
- Have unexplained vaginal bleeding
- Developed yellowing of the whites of the eyes or of the skin (jaundice) during pregnancy or when previously taking hormonal contraceptives
- Are about to have major surgery and will be unable to move around as usual
- Are taking any medications or herbal supplements
- Are sensitive to any part of the birth control patch
In addition, tell your health care provider if you:
- Are breast-feeding or recently gave birth, had a miscarriage or an abortion
- Have concerns about a new breast lump or change in your breast self-exam
- Take epilepsy medications
- Have diabetes, or gallbladder, liver, heart or kidney disease
- Have high cholesterol or triglycerides
- Have irregular periods
- Have depression
- Have skin conditions, such as psoriasis or eczema
Compared to oral contraceptives, less than one out of 100 women will get pregnant during the first year of typical use of the birth control patch.
The birth control patch doesn't protect against sexually transmitted infections (STIs).
Side effects of the birth control patch may include:
- An increased risk of blood-clotting problems, heart attack, stroke, liver cancer, gallbladder disease and high blood pressure
- Breakthrough bleeding or spotting
- Skin irritation
- Breast tenderness or pain
- Menstrual pain
- Nausea or vomiting
- Abdominal pain
- Mood swings
- Weight gain
- Muscle spasms
- Vaginal infections and discharge
- Fluid retention
Research shows that the birth control patch may increase estrogen levels in the body compared to combination birth control pills that are taken by mouth. You may have a slightly higher risk of estrogen-related adverse events, such as blood clots, while using the patch than if you took combination birth control pills.
How you prepare
You'll need to request a prescription for the birth control patch from your health care provider. Your health care provider will review your medical history and check your blood pressure. Talk to your health care provider about any medications you're taking, including nonprescription and herbal products.
What you can expect
To use the birth control patch:
- Talk to your health care provider about a start date. If you're using the birth control patch for the first time, wait until the day your period starts. If you use the first-day start, you'll apply your first patch on the first day of your next period. No backup method of contraception is needed. If you use the Sunday start, you'll apply your first patch on the first Sunday after your period starts. Use a backup method of contraception for the first week.
- Choose where to apply the patch. You can place the patch on your buttocks, upper outer arm, lower abdomen or upper body. Don't put it on your breasts or in a place where it will be rubbed, such as under a bra strap. Apply to skin that's clean and dry. Avoid areas of the skin that are red, irritated or cut. Don't apply lotions, creams, powders or makeup to the skin area where the patch will be. If skin irritation develops, remove the patch and apply a new patch to a different area.
- Apply the patch. Carefully open the foil pouch. Use your fingernail to lift one corner of the contraceptive patch. Peel the patch and the plastic liner away from the pouch, then peel away half of the protective clear lining. Be careful not to cut, alter or damage the patch. Apply the sticky surface of the patch to your skin and remove the rest of the liner. Press down firmly on top of the skin patch with the palm of your hand for about 10 seconds. Smooth it out, making sure that the edges stick well. Leave the patch on for seven days. Don't remove it to bathe, shower, swim or exercise.
- Change your patch once a week for three weeks. Apply a new contraceptive patch to your body each week — on the same day of the week — for three consecutive weeks. Apply each new patch to a different area of skin to avoid irritation. After you remove a patch, fold it in half with the sticky sides together, place it in a sturdy container and throw it in the trash. Don't flush it down the toilet. Remove any adhesive that remains on your skin with baby oil or lotion.
- Check the patch regularly to make sure it's still in place. If the patch becomes partially or completely detached and can't be reapplied, replace it with a new patch immediately. Don't reapply a patch if it's no longer sticky, it becomes stuck to itself or another surface or it has other material stuck to it. Don't use other adhesives or wraps to hold the patch in place. If your patch becomes partially or completely detached for more than 24 hours, apply a new patch and use a backup method of contraception for one week.
- Skip the patch on the fourth week. Don't apply a new patch during the fourth week, when you'll have your period. After the fourth week ends, use a new patch and apply it on the same day of the week that you applied the patch in the prior weeks.
- If you're late applying a new patch, use backup contraception. If you're late applying the birth control patch in your first week or more than two days late in your second or third week, apply a new patch immediately and use a backup method of contraception for one week.
Consult your health care provider as soon as possible if you have:
- Sharp chest pain, sudden shortness of breath or coughing up blood, which can be signs of a blood clot
- Persistent pain in your calf or other signs of a blood clot in your leg
- Sudden partial or complete blindness or other signs of a blood clot in your eye
- Crushing chest pain or other signs of a heart attack
- Sudden severe headache, problems with vision or speech, numbness in an arm or leg, or other signs of stroke
- Yellowing of the skin or whites of the eyes, possibly accompanied by fever, fatigue, loss of appetite, dark urine or light-colored bowel movements
- Severe trouble sleeping, fatigue or feeling sad
- Severe abdominal pain or tenderness
- A breast lump that persists through 1-2 menstrual cycles or increases in size
- Two missed periods or other signs of pregnancy