Birth Control Patch (Transdermal Contraceptive)

Medically Reviewed by Traci C. Johnson, MD on May 09, 2023

The birth control patch is a small, sticky square that you wear on your arm, back, lower belly, or other places 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 stop swimming 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 person out of 100 who use the patch might get pregnant in a year. But in real life, people make mistakes, like not changing the patch on the right day. That can drop the effectiveness to about 91%.

You'll need a doctor's prescription for the patch. There are two available in the U.S. One is sold under the name Xulane and used to be sold under the brand name Ortho Evra. The other is newer and called Twirla. Under federal law, all health 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 wear a new patch for 7 days. Replace it on the same day every week.. Some people skip the patch in the fourth week; others don’t. Talk to your doctor about which is right for you. If you don’t wear it in the fourth week, you’ll have a period. If you do, you probably won’t.

You can shower, exercise, and swim with it on. Avoid tight clothes that might rub against it. 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 change it late by more than a day, assume 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.

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
  • More predictable periods; they start promptly about every 28 days (unless you wear the patch during the fourth week)
  • Less anemia (too few red blood cells) due to blood loss
  • Less chance of ovarian cysts, certain cancers, and other illnesses

Patches might not be the best choice if you:

  • Need protection against STDs like HIV and chlamydia. The male condom is the best contraceptive for that.
  • Are over 35 and you smoke.
  • Weigh more than 198 pounds. The patch may be less reliable for heavier people.
  • Are pregnant or think you might be.
  • 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 if you were taking regular birth control pills. 

Not everyone will have problems with the patch, but some common issues include:

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 you’re over 35. Call your doctor right away if you use the patch and you have serious pain in your belly, thigh, or calf or you notice:

Show Sources


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