What’s the Pill?
A less common, less effective form of the pill, sometimes called the “mini-pill,” uses only synthetic progesterone.
What’s the Patch?
Just like the name sounds, the patch is 2 inches square and has a sticky backing. You attach the sticky side to your skin, usually your rear end, upper arm, shoulder blade, or lower belly just below your underwear line. Talk to your doctor about other options if these places don’t work for you.
Like the pill, it uses a combination of synthetic estrogen and progesterone to prevent pregnancy. And both depend on you to remember to use them -- daily for the pill, and weekly for the patch.
The patch lasts a week, and then you switch it for a new one, which goes in a different place. Clean and dry your skin before you put it on. Press on it for about 10 seconds, and check the edges to make sure it’s firmly stuck.
It’s waterproof, so you should be able to bathe, shower, swim, and sweat with no problem. Some people skip the patch on the fourth week; others don’t. Talk to your doctor about which is right for you. If you don’t wear it, you’ll have a period. If you do, you probably won’t.
How Do They Work?
The combination of hormones in both the methods slows your pituitary gland, which helps stop your ovaries from releasing eggs. The hormones also change the surface of your uterus and cervix and thicken the mucus so that it’s harder for sperm to make their way to the egg.
How Fast Do They Work?
The patch starts to work almost right away if you apply it in the first 5 days of your period. If you and your doctor decide to start it in the middle of your cycle, then you’ll need to use another type of protection for about a week.
Some doctors suggest using a backup method for the first month of either method in case your body releases an egg (the doctor will call this ovulation) before the medicine takes effect.
How Well Do They Work?
When used exactly as directed, the pill and the patch are very effective. But what does that mean?
For the pill, it means you take it at the same time every day. This is sometimes called “perfect use.” For the patch, perfect use means you replace it on exactly the same day every week, except for the fourth week, which you typically (though not always) skip.
Perfect use of either method results in less than a 1 in 100 chance of getting pregnant in the next year. But most people aren’t perfect. For example, you could lose your pills for a day or two, or take them at different times of day. Your patch might come loose or fall off, or you might forget to apply the new one for a day or two.
With this kind of use, about 9 in 100 women will get pregnant over the course of the year on either method.
If your patch falls off, stick it right back on. It isn’t sticky anymore, put on a new one. If you think it could have been off for more than a day, assume you could get pregnant. Even if you replace it right away, it’s best to skip sex or use backup protection, like condoms, over the following 7 days. Call your doctor if you’re unsure.
Finally, the patch seems to be less effective for some women who weigh 198 pounds or more. Talk to your doctor if this is a concern.
Are There Other Health Benefits?
Because both methods provide a daily dose of estrogen and progesterone, the pill and the patch have similar possible benefits, too:
- Lighter periods; less blood and cramping
- More predictable periods; they start promptly about every 28 days
- Less anemia (too few red blood cells) due to blood loss
- Less change of ovarian cysts, certain cancers, other illnesses
How Much Do They Cost?
The patch: Your insurance typically covers prescription birth control of some sort, but check the details of your plan to see if it includes the patch. It shouldn’t be more than about $85 a month if you pay out of pocket.
The pill: Almost all insurance plans cover the pill. You typically pay little or nothing at all.
Are There Side Effects?
Most birth control methods have side effects, though they differ for each woman. Both the pill and the patch might cause:
- Mood changes
- Breast tenderness
- Upset stomach
- Changes in your period: heavier, lighter, longer, or shorter
- No period, which is not usually a sign of problems on the pill or patch
There’s a small chance the patch will bother your skin where you stick it on. So you might want to consider other options if you have a history of sensitive skin or other skin problems.
- Chest pain with cough and shortness of breath
- Headache with dizziness, weakness, or numbness
- Blurred vision
- Speech problems
Are They Safe?
Yes, but the pill or patch might not be the best choice in if you have:
- Heart disease or you’ve ever had a stroke
- Blood that clots too easily or genes that put you at risk for blood clots
- Migraine headaches with aura, numbness, or other problems
- High blood pressure not controlled by medication
- Breast cancer
- Long-term diabetes
- Liver problems
- Problems moving around due to surgery or some other issue
How Do You Stop Taking Them?
Whether you want to switch to another method or stop taking birth control to get pregnant, talk to your doctor about when it’s OK to stop and what type of backup to use.
If you stop, you could get pregnant right away. But there’s no danger to you or the baby if you get pregnant soon after stopping the pill or the patch.