Transdermal Birth Control Patch: What to Know

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 delivers hormones similar to those in birth control pills or the vaginal ring.

The patch works about equally well as the pill or the vaginal ring, and with similar side effects. But some women may find the patch more convenient to use than remembering to take a pill every day and easier than a vaginal ring to put on and take off.

How Does It Work?

The patch blocks conception by delivering the hormones estrogen and progestin through the skin into your bloodstream. The hormones keep your ovaries from releasing an egg, thicken the cervical mucus to deter the swimming sperm, and make it harder for any fertilized egg to implant inside your womb.

How Well Does It Work?

If you follow directions perfectly, the patch is 99% effective. That means one woman out of 100 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%.

How to Get It and Use It

You'll need a doctor's prescription for the patch. It's sold under the brand name Ortho Evra as well as a generic version called Xulane. Under federal law, all health plans must cover most contraceptives without co-pays or deductibles. Depending on your income, you also may get the patch for free from your local public health clinic or a Planned Parenthood health center.

You wear a new patch for 7 days and then replace it weekly on the same day for a total of 3 weeks. You skip the patch on the fourth week, when you have your period.

You can shower, exercise, or swim with it on. It's a good idea to avoid tight clothes that might rub against it and to check it regularly to make sure the patch stays in place.

  • Press the patch on 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 the adhesive peels off, 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, use a condom or another backup contraceptive for a week. If you aren't sure what to do, call your doctor for advice.

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Drawbacks

Transdermal patches can be a convenient option if you want effective and long-term birth control that you can quit easily. But they might not be ideal 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 women.

  • Are pregnant or think you might be.

  • Are prone to blood clots, have had breast or uterine cancer, or take drugs for epilepsy. The patches have a higher concentration of estrogen than typical birth control pills, which may raise your chances of problems.

Side Effects

Not all women have them, but the most common things that could happen include:

Some of these symptoms may go away as you get used to the hormones, but talk to your doctor about anything that makes you feel bad.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on April 11, 2019

Sources

SOURCES:

Xulane: “Patient Information and Instructions for Use,” “Tell me more about the patch.”

MedlinePlus: “Ethinyl Estradiol and Norelgestromin Transdermal Patch.”

KidsHealth: “Birth control patch.”

Mayo Clinic: “Birth control patch.”

National Health Service (UK): "How effective is contraception at preventing pregnancy?”

International Journal of Women’s Health: “Transdermal delivery of combined hormonal contraception: a review of current literature.”

U.S. Department of Health and Human Services: “Birth Control Patch.”

CDC: “Birth Control Methods.”

Office on Women’s Health: “Birth Control Methods.”

UpToDate: “Transdermal contraceptive patch.”

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