A Contraceptive Patch looks like a square bandage. It is applied to the abdomen, buttocks, upper arm, or upper torso. The Patch is used on a four-week rotation: it’s changed each week for three weeks and is absent for the fourth week. The Contraceptive Patch works by slowly releasing a combination of estrogen and progestin hormones through the skin. These hormones prevent ovulation (release of an egg from the ovary) and thicken the cervical mucus, creating a barrier to prevent sperm from entering the uterus. When used correctly, it is about 99% percent effective as birth control; for women weighing 198 pounds or more, it’s about 92% effective. The Patch does not protect against sexually transmitted infections or HIV/AIDS.
You can start using the Contraceptive Patch immediately or you can wait until the Sunday after the start of your period. The day of the week you pick to apply the Patch will be the same day you change the Patch a week later. If you’re breastfeeding, consult your health care provider.
After filling your prescription from a clinic, apply the Contraceptive Patch yourself. Choose a part of your skin that is clean and dry. The Patch should be placed on a slightly different spot every time to avoid skin irritation, but should never be placed on the breasts. Try to place it where it will not be rubbed by tight clothing.
When you apply the Patch, peel away the packaging without touching the sticky surface. Press the sticky medicated part against your skin for ten seconds. Run your finger along the edge to make sure the Patch is sticking.
Use one Patch per week for three weeks in a row. On the fourth week, no Patch should be worn. Your menstrual period should start sometime while the Patch is off. Then, a new Patch is applied seven days after you removed the old one, on the same day you normally change your Patch. The Patch should not be worn continuously; it’s important to have a break from the Patch hormones.
When removing the used Patch, fold it in half with the sticky hormonal side in and dispose of it in the garbage. Don’t flush it down the toilet, as this releases the remaining hormones into the environment. If there is a leftover adhesive or a sticky spot on your skin, you can remove this with mineral oil.
Check the placement of your Contraceptive Patch daily. It may become loose or fall off. If it has been off the skin for less than a day, reapply it or put on a new Patch as soon as possible. Your Patch change schedule will not be affected, nor will the effectiveness of the method.
If your Patch has been off the skin for over 24 hours or if you’re not sure how long it has been, you can start your four-week Patch cycle over. Use a new Patch as soon as possible and record the day of the week. This will be your new Patch change day. For the first seven days of this new cycle, you may not be protected from pregnancy. Use back-up methods of birth control for seven days.
Approximately two percent of the time, the Patch will fall off and need to be replaced. Do not attempt to reapply Patches with tape or other measures. Do not reapply Patches that have any materials stuck to them. Use a new one to ensure the method remains effective.
Missed Patch Changes
If you forget to change your Patch at the beginning of a monthly cycle, you can apply one as soon as you remember. Record this day of the week as your new Patch change day and use a back-up method of birth control for the next seven days.
If you forget to change your Patch for one or two days in the middle of a monthly cycle, change your Patch as soon as you remember. Keep the same Patch change day. A back-up method is not required.
If you forget to change your Patch for more than two days in the middle of a cycle, put on a new Patch as soon as possible. You will be beginning a new four-week Patch cycle with this Patch. Record the day of the week and use a back-up method of birth control for the next seven days.
If you forget to remove the third Patch in the cycle, remove it as soon as you remember. You will not need to change your regular Patch change day or use back-up contraception.
Missing a period does not necessarily mean you are pregnant. However, if you miss a period, you may want to consider the likelihood of pregnancy and take a pregnancy test. Pregnancy is more likely if a Patch fell off for longer than 24 hours or if you missed a Patch change during the cycle. If you are pregnant, discontinue use of the Contraceptive Patch.
Some women may not be able to use Contraceptive Patches because of the risk of serious health problems. Women over 35 who smoke or have any of the following conditions should not use the Patch:
- History of heart attack or stroke
- Chest pain
- Blood clots
- Unexplained vaginal bleeding
- Severe high blood pressure
- Diabetes with kidney, eye, nerve or blood vessel complications
- Known or suspected cancer
- Known or suspected pregnancy
- Liver tumors or liver disease
- Headaches with neurological symptoms
- Hepatitis or jaundice
- Disease of the heart valves with complications
- Post-surgical conditions requiring long bed rest
- Allergic reaction to the Patch
Women who have a family history of breast cancer, diabetes, high blood pressure, high cholesterol, headaches or epilepsy, depression, gallbladder disease, kidney disease, heart disease, irregular periods, or are breastfeeding may not be able to use the Patch. Women over 198 pounds may not receive a large enough hormone dose for the Patch to be effective.
A woman gets more estrogen in her body from the Patch than she would get from low-dose birth control pills or the Ring. More research needs to be done to learn if this increases her risk for blood clots, heart attack and stroke.
Using the Patch lowers a woman’s risk of ovarian cancer, endometrial cancer, and pelvic inflammatory disease.
As the body adjusts to hormonal changes, women may experience some minor side effects, including:
- Skin irritation or rashes at site of Patch
- Irregular bleeding
- Problems wearing contact lenses
- Fluid retention or raised blood pressure
- Breast tenderness
- Mood changes
- Menstrual cramps
- Abdominal pain
The effectiveness of the Contraceptive Patch is lowered when taken with certain medications, including certain antibiotics, anti-seizure, tuberculosis, and migraine medications. Some drugs used to treat HIV or AIDS may also interfere with the Patch. If you are taking any medications, tell your clinician. When taking medications that may interfere with hormonal birth control, consider adding a backup method, like male condom, female condom or spermicide. As with all drugs, it is useful to inform all your medical providers if you are using the Contraceptive Patch.
Women who experience any of the following “ACHES” symptoms while using the Contraceptive Patch should call the a doctor immediately:
- Abdominal pains (severe)
- Chest pain or shortness of breath
- Headaches (severe)
- Eye problems, such as blurred vision
- Severe leg or arm pain or numbness
- Easy to use.
- Can be worn for three weeks.
- Effects fertility one month at a time.
- Does not interrupt sex play.
- May regulate or lighten periods.
- Does not protect against sexually transmitted infections, including HIV/AIDS.
- Raises woman’s risk of heart attack and stroke.
- Requires a prescription.
- OrthoEvra (the manufacturer’s website)
- Ortho Evra Birth Control Patch Users Twice as Likely To Develop Blood Clots as Women Taking Oral Pills, Manufacturer-Funded Study Says from Our Bodies Ourselves Health
- Coalition for Positive Sexuality
- Scarleteen sex ed for the real world