Birth Control Patch (Transdermal Contraceptive)

Medically Reviewed by Jabeen Begum, MD on January 11, 2024
7 min read

The birth control patch is a small, sticky square that you wear on your arm, back, lower belly, or elsewhere on your body. Also called a transdermal patch, it sends hormones similar to those in birth control pills or the vaginal ring into your system through your skin. You might also hear it called a transdermal contraceptive.

The patch works about as well as the pill or the vaginal ring, and with similar side effects. You may find the patch easier to use than remembering to take a pill every day and simpler to use than a vaginal ring.

The patch keeps you from getting pregnant by sending the hormones estrogen and progestin through your skin and into your bloodstream. The hormones keep your ovaries from releasing an egg, thicken the cervical mucus to slow down the movement of sperm, and make it harder for any fertilized egg to implant inside your womb.

If you follow directions perfectly, the patch works 99% of the time. That means 1 out of 100 who use the patch might get pregnant in a year. But in real life, people make mistakes, such as not changing the patch on the right day. That can drop the patch birth control effectiveness to about 94%.

You'll need a doctor's prescription for the patch. You can get one from your regular doctor or a health clinic doctor, in person or through an online appointment (telehealth) if available. You may also buy the birth control patch online through a website or app that prescribes birth control after an assessment or virtual visit.

Two patches are available in the U.S. One is sold under the name Xulane (formerly sold under the name Ortho Evra). The other is newer and called Twirla. Under federal law, all health insurance plans must cover most contraceptives without copays or deductibles.

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. Depending on your income, you also may get the patch for free from your local public health clinic or a Planned Parenthood health center.

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, you’ll need to use another type of protection for about a week.

Some doctors suggest using a backup method for the first month, just in case your body releases an egg (you ovulate) before the medicine takes effect.

You should wear a new patch for 7 days. Replace it on the same day every week. Some people skip the patch in the 4th week, while others don’t. Talk to your doctor about which is right for you. If you don’t wear it in the 4th week, you’ll have a period. If you do, you probably won’t.

You can shower, exercise, and swim while wearing it. Avoid tight clothes that might rub against the patch. Check often to make sure the patch stays in place.

  • Press the patch onto clean, dry skin and hold for at least 10 seconds. Pick a different spot when you change it each week. The sticky stuff used to keep it in place is strong and may bother you if your skin is sensitive.
  • If it peels away, try to reapply it. But if the patch won't stick completely, put a new one on. And wear only one patch at a time.
  • If the patch falls off for more than 24 hours or you delay changing it by more than a day, assume that you could get pregnant. Use a condom or another type of backup birth control for a week. If you aren't sure what to do, call your doctor for advice.

Where do you put the birth control patch?

You can place the birth control patch on:

  • Your buttocks
  • The outside of your upper arm
  • Your belly below your belly button
  • Your upper back

Don't put it near your breasts or any area where it might get rubbed with a waistband or bra strap. Avoid areas that are irritated or have sores.

Birth control patch advantages

Patches can be a good option if you want effective and long-term birth control that you can quit easily. Because the patch provides a daily dose of estrogen and progesterone, the patch may have other possible health benefits:

  • Lighter periods; less blood and cramping
  • Fewer PMS symptoms
  • More predictable periods; they start promptly about every 28 days (unless you wear the patch during the 4th week)
  • Because it releases hormones steadily, you won't have spotting between periods like you might with the pill
  • Less anemia (too few red blood cells) due to blood loss
  • Less chance of ovarian cysts, certain cancers, and other illnesses
  • It may improve acne

Other advantages include:

  • It's easy to apply.
  • You don't have to remember to take a daily pill.
  • You don't have to think about it during sex.
  • You don't need to depend on a partner for birth control.
  • You can simply remove it when you're ready to stop using it.

Birth control patch disadvantages

The patch's disadvantages include:

  • It's visible on your body.
  • You must remember to change it every week.
  • You can't get it without a prescription.
  • It may irritate the skin around it.
  • It could fall off.
  • It doesn't protect you from sexually transmitted diseases (STDs).
  • It has side effects for some people.

Not everyone will have problems with the patch. But some common issues include:

  • Headaches
  • Tender breasts
  • Nausea or throwing up
  • Rash or redness where you place the patch
  • Mood changes
  • Menstrual cramps

Some symptoms may go away as you get used to the hormones. Talk to your doctor about anything that makes you feel bad.

There’s a small chance the patch may bother your skin where you place it. If you have a history of sensitive skin or other skin problems, you might want to consider other options.

The patch also could cause more serious but rare problems such as blood clots, stroke, and heart attack. These issues are more common if you smoke or are over 35. Call your doctor right away if you notice the following symptoms after using the patch:

  • Serious pain in your belly, thigh, or calf
  • Chest pain with cough and shortness of breath
  • Headache with dizziness, weakness, or numbness
  • Blurred vision
  • Speech problems

Patches might not be the best choice if you:

  • Are over 35 and smoke
  • Weigh more than 198 pounds. The patch may be less reliable for heavier people.
  • Are pregnant or think you might be
  • Have a history of stroke, heart attack, or seriously high blood pressure 
  • Are prone to blood clots, have had breast or uterine cancer, or take drugs for epilepsy. Because the patches continually deliver estrogen, they may raise your chances of these problems slightly more than regular birth control pills.
  • Have migraines with auras
  • Have liver disease
  • Have diabetes that's not well-controlled
  • Have vaginal bleeding that's unexplained
  • Had previous issues while using hormonal birth control
  • Need protection against STDs such as HIV and chlamydia. In such cases, the male condom is the best contraceptive.

Make sure your doctor knows about your health history and all medications and supplements you take.

The birth control implant is similar to the patch in several ways. The implant is a plastic rod about the size of a matchstick that your doctor places under the skin of your arm. Like the patch, it releases hormones steadily through your skin to prevent pregnancy without a daily pill.

The implant works to prevent pregnancy even better than the patch, with a 99% effectiveness rate. Also, you don't need to remember to replace it every week (it can stay in place for up to 3 years). You can't see it on your body, and it can't fall off.

But it's not as easy to stop using it. You'll need to see a doctor to get the implant removed. Also, it might cause your periods to become irregular, and your acne could get worse.

Talk to your doctor about the pros and cons of different hormonal methods of birth control.


The birth control patch is an effective way to prevent pregnancy. It's easy to use and safe for most people. But it's not right for everyone. You'll need a prescription to get the patch, so talk to your doctor about whether it's a good choice for you.

Is the patch as safe as the pill?

The birth control patch is as effective as the birth control pill (99%) when used as directed. 

The patch has higher levels of estrogen than many types of “combined” pills (those that contain both estrogen and progestin). Your risk for blood clots may be slightly higher with the patch.

Can I put my birth control patch on my thigh?

Doctors recommend that you place it on your arm, belly, upper back, or buttocks. It should be in a location with little hair so that it will adhere well, and where clothing and underwear won't rub against it.