About the Birth Control Patch

The birth control patch is a thin, beige, 1¾-inch (4½-centimeter) square patch that sticks to the skin. It releases hormones through the skin into the bloodstream to prevent pregnancy.

How Does the Patch Work?

The combination of the hormones progesterone and estrogen in the patch prevents ovulation (the release of an egg from the ovaries during a girl's monthly cycle). If an egg isn't released, a woman can't get pregnant because there's nothing for the male's sperm to fertilize.

The hormones in the patch also thicken the cervical mucus (the mucus produced by cells in the cervix). The cervix is the part of the uterus that sits within the vagina and acts as the opening to the uterus. The thickening of cervical mucus makes it difficult for sperm to enter the uterus and reach any eggs that may have been released. The hormones in the patch can also sometimes affect the lining of the uterus so that if the egg is fertilized it will have a hard time attaching to the wall of the uterus.

Like other birth control methods that use hormones, such as the birth control pill or birth control ring, the birth control patch is used based on a young woman's monthly menstrual cycle. She applies the patch on the first day of her menstrual cycle or the first Sunday after her menstrual cycle begins. She will change the patch on her skin once a week for 3 weeks in a row. (The patch should be applied to one of these four areas: the abdomen, buttocks, upper outer arm, or upper torso — except for the breasts.) On the fourth week, no patch is worn, and the menstrual period should start during this time. It's important to use an additional form of contraception during the first 7 days on the patch to prevent pregnancy.

A new patch should be applied on the same day every week to make sure that it keeps working effectively. For example, if the first patch is applied on a Monday, patches should always be applied on a Monday. When it's time to change the patch, the old one should be pulled off first, before applying a new patch. The new patch should be placed on a different area from the old patch (but still on one of the four recommended areas) to avoid skin irritation. And any skin that is red, irritated, or cut should be avoided.

If a patch becomes loose and falls off or if a woman forgets to apply a new patch on the right day, she should consult the labeling information or a doctor about what to do. A backup method of birth control may be necessary for a while, such as condoms, or she might need to stop having sex for a while to protect against pregnancy. Also, if a young woman stops using the patch for any reason, she will need to begin using another method of birth control, usually 24 hours after removing the last patch.

It's OK to participate in regular activities like swimming and exercise while wearing the patch. It can also get wet in the shower or in the bath. However, the patch should not be moved or removed until the week is over (pulling the patch off to reposition or move it may cause it to lose some of its stickiness and it might fall off easily). If the patch does not stick well, a replacement patch should be applied. A girl wearing a patch shouldn't try to change its size by trimming it or try to attach it with tape.

The patch should not be applied over makeup, creams, lotions, powder, or other skin products as these may prevent it from sticking well. (Skin products may also affect how hormones are absorbed by the skin.)

A removed patch should be folded in half with the sticky sides facing each other (to prevent the chemicals from getting into other items in the trash and going to the soil) and thrown away (not flushed down the toilet).

How Well Does the Patch Work?

Ongoing studies suggest the birth control patch is as effective as the birth control pill. That means that about 9 out of 100 couples will have an unintended pregnancy during the first year of use. Of course, a woman's chance of getting pregnant depends on whether she uses the patch correctly. Delaying or missing a weekly application or removing a patch too early reduces its effectiveness and increases the chance of pregnancy.

For young women who weigh more than 198 pounds (90 kilograms), the contraceptive patch may be less effective in preventing pregnancy. If a young woman has any health conditions or is taking any medications, that might interfere with the patch. How effective the patch is at preventing pregnancy also depends on whether the girl finds it convenient to use, and whether she remembers to wear it correctly all the time.

Protection Against STDs

The birth control patch does not protect against sexually transmitted diseases (STDs). Couples having sex must always use condoms along with the birth control patch to protect against STDs.

Abstinence (not having sex or any type of intimate genital contact) is the only method that always prevents pregnancy and STDs.

Possible Side Effects

The birth control patch is a safe and effective method of birth control. Most young women who use the patch have no side effects. Smoking cigarettes while using the patch can increase a girl's risk of certain side effects, which is why health professionals advise those who use the patch not to smoke.

The side effects that some women have while using the patch are similar to those experienced with the birth control pill. These may include:

• irregular menstrual bleeding
• nausea, headaches, dizziness, and breast tenderness
• mood changes
• blood clots (rare in women under 35 who do not smoke, but there may be a higher risk with the patch than with the Pill)

Other possible side effects seen in patch users include:

• skin reactions at the site of application of the patch
• problems with contact lens use, such as a change in vision or inability to wear the lenses
• menstrual cramps

Many of these side effects are mild and tend to disappear after 2 or 3 months.

Who Uses the Patch?

The birth control patch may be a good choice for sexually active young women who weigh less than 198 pounds (90 kilograms) and find it difficult to remember to take a pill every day or who have difficulty swallowing pills.

Not all women can — or should — use the birth control patch. In some cases, medical or other conditions make the use of the patch less effective or more risky. For example, it is not recommended for women who have had blood clots, severe high blood pressure, some cancers, certain types of migraine headaches, or diabetes with certain complications. Girls who have had unexplained vaginal bleeding (bleeding that's not during their periods) or who think they may be pregnant should talk to their doctors, discontinue using the patch, and use another form of birth control in the meantime.

Girls who are interested in learning more about the possible health benefits and risks of different birth control methods, including the patch, should talk to a doctor or other health professional.

Where Is the Patch Available?

A doctor or a nurse practitioner must prescribe the patch. He or she will ask about a girl's health and family medical history, and may also do a complete physical exam, including a blood pressure measurement and a pelvic exam.

If the patch is prescribed, the doctor or nurse will also provide instructions on how to use it. Girls who use the patch may be asked to return within a few months for a blood pressure measurement and to ensure that there are no problems. After that, a doctor may recommend routine exams once or twice a year or as needed.

How Much Does the Patch Cost?

The patch usually costs between $30–$85 a month, although health and family planning clinics (such as Planned Parenthood) might sell them for less. In addition, the birth control patch and doctor's visits are covered by many health insurance plans.