The birth control patch is a safe and effective way to prevent pregnancy. All you have to do is replace your patch weekly and the hormones in the patch do the rest. Like any medication, it comes with some side effects that make it not right for everyone, but overall, it’s a great bet if you’re looking for something less involved than the Pill.
IN THIS ARTICLE
- What’s the birth control patch?
- How does the birth control patch work?
- How do I use the birth control patch?
- How effective is the patch?
- What are the pros and cons of the patch?
- What side effects does the patch have?
- Is the birth control patch safe if I’m breastfeeding?
- What happens if my birth control patch falls off?
- When should I call my provider about my birth control patch?
What’s the birth control patch?
The birth control patch (brand names Xulane or Twirla) is a thin, beige square that sticks to your skin like an adhesive bandage. Once applied to the skin, the patch releases a continuous dose of contraceptive hormones that are absorbed into your bloodstream through your skin.
Because the patch contains both estrogen and progestin (synthetic progesterone), it’s considered a type of combined hormonal contraception. These are the same two hormones you’d get from taking the combination pill (the Pill) or using a birth control ring, the other two combined hormonal contraceptive methods.
You apply one patch to your skin each week for three consecutive weeks. Then you go without a patch for one week before starting the cycle again. During your patch-free week, you’ll get your period.
How does the birth control patch work?
The hormones released by the patch – estrogen and progestin – prevent pregnancy by stopping your ovaries from releasing eggs. The lack of mature eggs means that any sperm that enters your vagina has nothing to fertilize.
These hormones have other contraceptive effects, as well. They thicken your cervical mucus, making it more difficult for sperm to get into your uterus and fallopian tubes where one might fertilize an egg, if an egg were released. They also thin the lining of your uterus, making it less likely that an egg could implant if it did get fertilized.
If you’re an appropriate candidate for the patch, your practitioner can write you a prescription. Thanks to the Affordable Care Act, insurance plans must cover FDA-approved prescription contraceptive methods completely – with no cost to you. Some religiously affiliated employers (like a church or a non-profit religious hospital) are exempt from this requirement, but in some cases, there are still ways to get third-party coverage for contraception.
If you’re paying out of pocket, you can expect to spend up to $150 a month, plus the cost of your initial doctor’s visit. The patch may be available at some family planning clinics for less – or possibly free, thanks to certain government programs.
In most cases, you can start to use the patch right away – either on the day your period starts or whenever you pick up your patches. If you start mid cycle instead of with your period, you’ll want to use a backup method for the first week after you start, like many other combination birth control methods. But it should be fully effective after your first week.
However, if you’ve just given birth, you’ll need to wait at least three to five weeks after delivery before using the patch due to the increased risk of blood clots in the immediate postpartum period. Because new mothers who aren’t breastfeeding exclusively may ovulate within a month after delivery, you’ll need to abstain from sex or use another method of contraception during this time, such as the progestin-only mini-pill or condoms. Most women abstain from intercourse during this time, anyway, as their body needs time to recover from giving birth. If you’re breastfeeding, the estrogen in the patch could decrease your milk supply, just like the combination pills and the contraceptive ring.
How do I use the birth control patch?
You can wear the patch on your belly, butt cheeks, or back. Xulane can also be worn on your upper arm.
Once you’ve decided on where you want to wear your patch, make sure that the area of skin you choose is clean, dry, and free of any skin products such as makeup, lotion, cream, or powder. Make sure your hands are clean, too. And before applying your patch, check the expiration date on the package to ensure it’s not expired.
Then, open the package and remove the patch. Peel away half of the plastic liner, but avoid touching the sticky side of the patch with your fingers. Apply the sticky side of the patch to the area of skin where you’ve chosen to wear it. Peel the rest of the plastic liner away as you do. Press down firmly on the patch with the palm of your hand for ten seconds, making sure that the edges stick well. (If in doubt, check the manufacturer directions for your specific patch to ensure you’re wearing it correctly.)
Once a patch is in place, leave it there for seven days straight. Check the patch every day to make sure that all the edges are still sticking. You can shower, bathe, swim, or exercise as usual. Many women find it helpful to set an calendar reminder in their phone for each week’s patch change.
When you remove your patch exactly seven days later – your designated “patch change day” – peel it off, fold it in half so it sticks to itself, and discard it in the trash. Don’t flush the patch down the toilet, as the hormones from the patch can get into the water supply. To avoid irritation, don’t apply a new patch to the same exact place on your skin. You can apply the new patch to a different part of the body if you wish, as long as it’s one of the recommended areas.
As mentioned earlier, you’ll wear one patch every week for three weeks, then go without for a fourth week in order to have your period. Then you resume wearing your patch at the beginning of the next week. Be super consistent about what day you reapply your patch to ensure there’s not a lapse in hormones that would put you at risk of pregnancy.
If you want to skip your periods altogether, you can apply a new patch on the same day every week, without skipping a week. Talk to your provider about this as you will need more patches with each prescription.
How effective is the patch?
When used correctly and consistently, the patch is about 99 percent effective. This means that only about one woman out of 100 who use the patch exactly as prescribed will get pregnant during the first year of use
If you don’t use the patch exactly as prescribed – for example, you don’t use them continuously for three weeks or change your patch inconsistently – the likelihood that you’ll get pregnant is higher. With normal human error, the patch is estimated to be 91 to 93 percent effective at preventing pregnancy.
Some medications can also affect how well the patch works, including certain types of antibiotics, antifungals, and anti-seizure meds – so be sure to talk through your options with your provider. Also, the patch may be less effective for women who weigh over 198 pounds or who have a BMI of 30 or above. If this applies to you, talk to your doctor or provider about other birth control options.
Keep in mind, too, that, although the patch is an excellent contraceptive method, it doesn’t offer any protection against HIV, gonorrhea, chlamydia, or any other sexually transmitted infections (STIs). The same is true for other hormonal contraceptives. So, if you or your partner is having sex with anyone else, you’ll need to make sure your partner uses a latex condom (or a polyurethane one if either of you is allergic to latex) as well every time you have sex.
What are the pros and cons of the patch?
The birth control patch is a very effective form of hormonal contraception. But as with any medication, it has its pros and cons that might not make it right for every person.
There are certainly a lot of pros: The birth control patch can:
- help make your periods lighter and less crampy
- improve hormonal acne
- alleviate PMS-related issues
- help manage fibroids and endometriosis
You might also find it easier to change a patch once a week than remembering to take a pill every single day or inserting and removing a vaginal ring monthly or using a diaphragm each time you have sex.
That said, some people still might have trouble remembering to change their patch on time every week – and that’s crucial, since lapses affect the efficacy of the hormones. It’s less of a hands-off method than other types of birth control, like the IUD or arm implant.
As mentioned earlier, it’s also not recommended for people over a certain weight. In addition, if you have sensitive skin, or have had rashes in the past when using adhesives in band-aids for example, this may not work for you. And like all medications, the patch has some potential side effects that might make it less appealing to certain women.
What side effects does the patch have?
The most common side effects are most likely to show up during the first two to three months of use and may gradually disappear. These include:
- Spotting or bleeding between periods
- Breast tenderness or swelling
- Headaches
- Nausea or vomiting
- Bloating and abdominal discomfort
- Mood changes or depression
It’s also important to note that combined hormonal birth control of any kind is also associated with a small increase in your risk of blood clots, deep vein thrombosis (DVT), heart attack, and stroke, although the risk of clotting may be slightly higher on the patch. This risk is greater for women older than 35 who smoke or women who have other risk factors for heart disease. The risk of blood clots with any estrogen-containing birth control method is still less than the risk of blood clots with a pregnancy.
Is the birth control patch safe if I’m breastfeeding?
Using combined hormonal birth control like the patch is not recommended in the first three weeks after birth, because the risk of DVT is higher after delivery. Additionally, the estrogen in these drugs might decrease your milk supply.
If breastfeeding is going well after the first five weeks, it’s okay for you to use the patch. If you’re not producing as much milk as you’d like, or if your baby is having any trouble nursing, though, the patch may not be a good choice for you. If your supply drops after you start this method, you may want to consider a method without estrogen until you are ready to wean.
What happens if my birth control patch falls off?
Your patch needs to stick completely to your skin in order to work effectively. If it comes loose or falls off, read the instructions that come in the package for your specific patch or call your healthcare provider for guidance.
If your patch has fallen off completely or partially for less than a day, you might be told to put on a new patch immediately, and stick with the same “patch change day” as before. If it’s been off for more than one day, you’ll need to put on a new patch and start a new four-week cycle. In this case, you will need to use a backup method like condoms for the first week to protect yourself from pregnancy.
You should be able to go to your pharmacy to pick up a replacement patch if yours falls of. If this happens frequently, you should consider alternative methods of contraception. If the patch has been off your skin for more than 24 hours and you’ve had unprotected intercourse during this time, consider using emergency contraception to decrease your odds of becoming pregnant. (See our complete article on emergency contraception).
When should I call my provider about my birth control patch?
Call your healthcare practitioner immediately if you notice any of these symptoms, as they could be signs of more serious complications with the patch:
- Sharp pain in your chest
- Shortness of breath
- Coughing up blood
- Severe abdominal pain, tenderness, or swelling
- Swelling in one leg, or severe calf or thigh pain
- Migraine headaches, sudden severe headaches of any kind, persistent headaches, or headaches that are more intense than they were before you started using the patch
- Any neurological symptoms, including visual disturbances (such as blurred or double vision, temporary loss of vision, flashing lights or spots before your eyes), slurred speech, and tingling or weakness on one side of the body
Call without delay if you develop a severe skin rash, become jaundiced (yellowing of your skin or eyes), feel itchy all over, notice a lump in your breast, feel depressed, or have severe mood swings. And, of course, contact your caregiver if you think you might be pregnant.
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