The birth control pill and patch are prescription birth control methods that contain hormones to keep you from getting pregnant. They work well at preventing pregnancy more than 99% of the time if you use them correctly.
Hormonal birth control methods share similar side effects and risks. But there’s more to consider before you choose any birth control method. You’ll want to use one that’s best for your health and also easy to stick with.
Birth Control Pills
Birth control pills are medications you take by mouth. Since the FDA approved the first birth control pill in 1960, birth control pills have been the most commonly prescribed and preferred birth control method for women.
How Do Birth Control Pills Work?
Birth control pills contain the hormones progestin and estrogen, or only progestin. The pills that contain progestin and estrogen work to prevent pregnancy by:
- Stopping the ovaries from releasing a mature egg (ovulation) so that the sperm has nothing to fertilize
- Thickening the cervical mucus so that even if the ovaries release an egg, the sperm can’t get through to fertilize it
- Thinning the uterus lining so that if the sperm does fertilize an egg, it can’t attach itself to the uterus, which is the beginning of pregnancy
Progestin-only pills work against pregnancy based on their formulations. Some work primarily by thickening the cervical mucus, and others stop pregnancy by preventing ovaries from releasing an egg.
How Do You Use Birth Control Pills?
You can start taking the birth control pill on any day during your cycle.
If you start to take it on the first day of your period, you can have sex without using another form of birth control as a backup. If you start on any other day, you’ll need to use another birth control method like a condom for the first 7 days for combination pills, and the first 2 days for progestin-only pills, after starting the pack.
You’ll need to take the pill around the same time every day to avoid the risk of pregnancy.
How Effective Are Birth Control Pills?
How well any birth control works depends on whether you use it correctly every time you use it. If you use it correctly at all times, experts call this perfect use. If you don’t use it correctly or miss a dose as regular people do, it’s called typical use.
The birth control pill is more than 99% effective at protecting against pregnancy with perfect use. In other words, less than one out of 100 women will get pregnant in the first year of using the pills if they follow usage instructions strictly.
Typical use of birth control pills is 91% effective at preventing pregnancy. This means that only about nine out of 100 women get pregnant in the first year with typical use.
What Are the Side Effects of Birth Control Pills?
When you start using the birth control pill, you might have side effects that typically go away within 2 to 3 months as you stay on it.
Common side effects of birth control pills are:
- Breast tenderness
- Mood changes
- Belly cramping
- More vaginal discharge
- Low sex drive
Birth control pills aren't recommended for certain groups of people because the pills can increase their risk of health problems. A doctor might only prescribe it to some people if the benefits of using the pills are bigger than the risks. This method of birth control may not be right for you if you:
- Are 35 or older and smoke cigarettes.
- Are pregnant or might become pregnant
- Have had weight loss surgery (You use the birth control patch if this is the case.)
Your doctor may also not prescribe birth control pills for you if you have the following conditions:
- Blood clots or stroke
- Abnormal menstruation
- Migraines with aura (flashes of light, vision changes, or tingling in the body)
- Liver disease
- Diabetes for more than 20 years
- High blood pressure
The birth control pill can slightly raise your risk of high blood pressure, stroke, and blood clots.
Certain medications can make birth control less effective. Some of them are:
- Seizure medications
Talk to your doctor about any preexisting conditions or medications you’re on before starting the pill.
Does the Birth Control Pill Have Other Uses?
About 14% of women use them for reasons other than preventing pregnancy, like:
- Regulating periods
- Managing period pain
- Treating period migraine
- Easing heavy periods
- Managing acne
- Managing endometriosis pain
- Treating fibroids
Research shows that birth control pills can reduce the risk of uterine cancer by 50%, ovarian cancer by 27%, and colon cancer by 18%.
What Are the Drawbacks of the Birth Control Pill?
But for birth control pills to work best, you have to use them at the same time every day. Birth control pills cannot protect against sexually transmitted diseases (STDs). If that’s a concern, you can lower your risk of STDs by using a condom when you have sex.
The Birth Control Patch
The birth control patch is a small square that contains estrogen and progestin, which it releases into the body through your skin.
The FDA approved the first birth control patch in 2001. Today, birth control patches are available under the names Twirla and Xulane.
How Does the Birth Control Patch Work?
The patch contains progestin and estrogen and releases a dose into the bloodstream every day. Patches work just like the combination birth control pills by:
- Preventing the ovaries from releasing an egg
- Thickening the cervical mucus so that the sperm cannot meet the released egg to fertilize it
- Making the uterus lining thinner so that a fertilized egg cannot attach to it and begin pregnancy
You only have to take off the old patch and put on a new patch once a week. You can stop using the patch any time if you want to become pregnant.
How Do You Use the Birth Control Patch?
You can wear the patch on your upper back, lower abdomen, shoulder, or buttock. You wear one for 7 days, and then remove it and put on a new one.
This pattern continues until the fourth week, when you might have your period. You don’t wear the patch during this time. But you’ll start again the week after. You can also use the patch every week, including the fourth week. Your doctor will help you decide which is best.
Don’t wear the patch on irritated or injured skin. Try to change the patch location every time you put it on to reduce your risk of skin irritation. Use another birth control method when you have sex if your patch doesn’t stick properly to your skin or you lose it.
How Effective Is the Birth Control Patch?
The patch works just as well as the birth control pill. You’re more than 99% protected against pregnancy if you use it perfectly. With typical use, its effectiveness falls to 91%.
What Are the Side Effects of the Birth Control Patch?
Safety concerns and side effects of the patch are similar to those of birth control pills. But unlike the pill, you might have skin irritation with the patch, especially if you always wear it on the same skin area.
The patch releases 60% more estrogen into the body than the pills, and some experts say this increased estrogen exposure is tied to a slightly higher risk of blood clots.
Does the Birth Control Patch Have Other Uses?
Like the birth control pills, the patch can treat:
- Irregular periods
- Heavy periods
- Period pain
- Low iron levels that cause low blood count (iron-deficiency anemia)
Using the patch can also lower your uterine, ovarian, and colon cancer risk.
What Are the Drawbacks of the Birth Control Patch?
As with birth control pills, you’ll still need to use a condom during sex to protect yourself from STDs.
The patch doesn’t work as well in reducing the risk of pregnancy in people with bigger bodies with a body mass index (BMI) of 30 or higher. The patch is also visible on your skin, which some might be uncomfortable with. And according to some studies, the patch comes with about double the risk of blood clots, compared with birth control pills.
Choosing Between the Birth Control Pill and the Patch
Both the birth control pill and patch can protect you from pregnancy when you’re not ready. Choosing the right one for you depends on various things that you and your doctor will look into. Some things you and your doctor might consider are:
- Your general health
- Potential side effects
- Any health conditions that might put you at a higher risk of other health problems
- Which method is more convenient for you
- The more affordable choice
Both the birth control pill and patch are simple to use, although you might find one more convenient than the other. For example, if taking a pill around the same time every day sounds easier than remembering to change the patch every week, the pill would be the better choice.
The Affordable Care Act requires many insurance plans to cover FDA-approved prescription birth control like pills and patches. If you have insurance, your provider might cover any birth control costs. You can get them at a lower price from a family planning clinic if you don't have insurance.