Birth Control Pill vs. the Patch

What’s the Pill?

It’s a regular dose of man-made hormones that you take by mouth every day to prevent pregnancy. These hormones mimic the action of your body’s natural estrogen and progesterone.

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?

It takes about 7 days for the pill to take full effect, so use another method of protection, like condoms, for the first week.

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.

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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

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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.

There are even options if you don’t have insurance. Family planning clinics will usually provide the pill, the patch, or some other form of safe birth control at little or no cost to you.

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:

  • Headaches
  • 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.

Both methods also could cause more serious, but rare problems like blood clots, stroke, and heart attack. These issues are more common if you smoke or you’re over 35.

Call your doctor right way if you use the pill or the patch and you have serious pain in your belly, thigh, or calf or you notice:

Are They Safe?

Yes, but the pill or patch might not be the best choice in if you have:

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.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on November 28, 2019

Sources

SOURCES:

American Family Physician: “How to Switch Birth Control Methods.”

Bedsider.org: “Birth control and infertility: Does using birth control hurt my chances of getting pregnant later?”

Boston Children’s Hospital Center for Young Women’s Health: “Birth Control Pills: General Information,” “I have very painful periods. Should I go on the pill? Will that help?” “How long does it take the pill to kick in? Say I start the pill on Monday. Can I have unprotected sex on Friday?”

Cleveland Clinic: “6 Things That Can Happen When You Stop Taking The Pill,” “Birth Control: The Pill,” “Ethinyl Estradiol; Norelgestromin skin patches,” “Should You Wait to Get Pregnant After Stopping the Pill?”

FDA: “Birth Control.”

Mayo Clinic: “Birth control patch.”

National Women’s Health Network: “How much do different kinds of birth control cost without insurance?”

Nemours Foundation: “Birth Control Patch,” “About the Birth Control Pill.”

Reproductive Health Access Project: “Fact Sheet: The Patch.” 

University of Michigan Health Service: “Contraception Cost, Insurance and Payment.”

UpToDate: “Combined estrogen-progestin oral contraceptives: Patient selection, counseling, and use,” “Transdermal contraceptive patch.”

WomensHealth.gov: “Birth control methods,” “Frequently Asked Questions: Ovarian Cysts.”

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