Contraceptive Patch

The contraceptive patch is a combined form of hormonal contraception. It contains estrogen and progestin, similar to the oral contraceptive pill. The contraceptive patch sticks to the skin. If used correctly, is a very effective contraceptive.

On this page

  • What is the contraceptive patch?
  • How does the birth control patch?
  • How effective is the contraceptive patch?
  • What are the advantages of the contraceptive patch?
  • What are the disadvantages of the contraceptive patch?
  • Are there side effects of the contraceptive patch?
  • Who can not use the contraceptive patch?
  • Are there any risks in using the contraceptive patch?
  • How I can use the contraceptive patch?
  • What if my birth control patch falls off?
  • What if I forget to change the contraceptive patch?
  • No other drugs interfere with the contraceptive patch?
  • What if you vomit or have diarrhea?
  • What happens if I have a withdrawal bleed (like a period) between the patches?
  • Bleeding during use of the contraceptive patch (breakthrough bleeding)
  • References

The patch is a combination hormonal contraceptive containing estrogen and progestin. It is essentially the same type of contraception as the combined oral contraceptive pill (COCP – often referred to as "the pill"), but as a patch instead of pills. The contraceptive patch is attached to the skin so that the two hormones are continuously delivered to the body, providing contraceptive coverage. See separate leaflet called 'combined oral contraceptive pill.

There is a combined contraceptive patch available in the UK, called Evra ®. The contraceptive patch is available from your doctor, family planning clinic or sexual health clinic.

The contraceptive patch does not protect against sexually transmitted infections and condoms must be used to protect against these.

The contraceptive patch works mainly by changing the hormonal balance of the body to not produce an egg each month (ovulation). It also makes the cervical mucus thick, forming a plug in the cervix. This makes it difficult for sperm to move to the womb (uterus) to fertilize an egg. The contraceptive patch also makes the lining of the womb thinner, making it less likely that a fertilized egg can attach to the uterus.

If used correctly, less than 1 in 300 women will get pregnant each year. When using any method of contraception, more than 80 of every 100 sexually active women become pregnant in a year.

  • It is very effective and easy to use.
  • Does not interfere with sex.
  • Your periods are often lighter, less painful and more regular when using the contraceptive patch.
  • You do not have to remember to take the pill every day, but you only have to remember to change the patch once a week.
  • The patch is small and discreet so that people will not realize that it is easily used. Skin is colored and is approximately 5 cm x 5 cm in size.
  • The patch adheres well to the skin and can be used continuously, even while bathing, showering, exercising and swimming.

The other advantages of the contraceptive patch are believed to be similar to the COCP. However, because it is a new form of contraception, there have been many research studies as with the contraceptive patch as it has been with the pill. For example, the contraceptive patch may relieve premenstrual tension. It can also reduce the risk of pelvic infection (such as the mucous plug can prevent bacteria and sperm from entering the uterus). You can help protect against some breast disease benign (not cancerous). You can reduce the risk of developing certain types of ovarian cyst. You can reduce the risk of developing ovarian cancer, colon and uterus.

Some women have skin irritation when using the contraceptive patch. This is usually itching, redness or pain. About 2 in every 100 women have to stop using the patch for skin irritation. Although the patch adheres well most of the time, there is a possibility that it may detach from the skin, either totally or partially. This is not common, but may mean that its effectiveness as a contraceptive to be missed. Despite its discreet design, some women still feel that the contraceptive patch can be seen.

Some women have mild side effects, when they start using the contraceptive patch. If side effects occur, they tend to settle within the first few months. Possible side effects may include:

  • Breast discomfort and tenderness.
  • Small changes in body weight (these are small and are similar to those which can occur with the pill).
  • Headaches.
  • Feeling sick (nausea).
  • Mood swings.
  • Bleeding between periods and spotting (light bleeding, irregular).

Most women can use the contraceptive patch. Your doctor or family planning nurse to discuss any current and previous illness I had. You can also ask about any health problems in your family. It may be prescribed for some women with a history of certain diseases or who are at increased risk of developing certain diseases – for example, some women with an increased risk of having a blood clot (thrombosis) may be advised not to use the contraceptive patch (see below).

If you are breast-feeding should not use the contraceptive patch, as it can reduce the amount of milk you produce. Other forms of contraception are available if you are breastfeeding. You should not use the contraceptive patch if you, or you think you may be pregnant.

The contraceptive patch is less effective in women weighing more than 90 kg and generally advised not to use for these women. Women with liver or gallbladder or women with unexplained vaginal bleeding (eg, after sex or between periods) may not be able to use the contraceptive patch.

The risks in the use of the contraceptive patch are believed to be similar to those when using the COCP because it contains similar hormones. For most women, the benefits far outweigh the risks, because the risks are small. However, a small number of women using the contraceptive patch may develop serious problems. Since you ask about current or past disease has had and any family history of health problems, women who have a higher risk of serious side effects are usually prevented from using the contraceptive patch. Serious side effects that may occur in some women include:

Thrombosis

This means a clot in a blood vessel and can be very serious. A blood clot in an artery can cause a stroke or a heart attack. A blood clot in a vein can cause deep vein thrombosis (DVT), which may travel to the lungs and cause a pulmonary embolism. The following situations increase the risk of thrombosis and may recommend not using the contraceptive patch in these circumstances:

  • If you have had a deep vein thrombosis or pulmonary embolism before.
  • If you are overweight.
  • Immobility (eg wheelchair).
  • Severe varicose veins.
  • Poorly controlled diabetes.
  • High blood pressure is not adequately controlled.
  • If you have a close relative who has had a thrombosis, myocardial infarction or stroke before the age of 45.
  • Severe migraine.
  • If you have any complications of diabetes or had diabetes for over 20 years.
  • Smoking – especially if you are older than 35 years.
  • If you have had a heart attack, stroke, mini-stroke or suffer with angina.
  • Some rare diseases.

Consult a doctor immediately if you have any of the following circumstances while using the patch: severe headache, severe pain in the chest or legs, leg swelling, shortness of breath, cough up blood, sudden problems with vision or speech, vision problems, weakness or numbness in an arm or leg, collapse.

Cancer

There is a small increased risk of developing breast cancer in women using combined hormonal contraception such as the contraceptive patch. You should not use the contraceptive patch if you currently have breast cancer or have had breast cancer in the past five years. If you have a strong family history of breast cancer or have had breast cancer treated over five years, you should talk to your doctor about the pros and cons of starting the contraceptive patch.

When to start the patch

Ideally start using the patch on the first day of your period. This means that the patch will begin working immediately as a contraceptive. You can have sex right away and you will be protected. If you start the patch on any other day of your menstrual cycle, you should be sure you are not pregnant. Then you must also use an additional contraceptive method (such as condoms) for the first seven days.

Apply the patch

The contraceptive patch should be applied to clean, dry, hairless skin. Do not use lotions, makeup, creams, powders or anything else in the area of skin before applying the patch. Do not use on areas of the skin that is irritated or broken. Right places to apply the patch are the upper outer arm, chest / upper back area (do not apply the patch on the breasts), buttocks or lower abdomen. You should use a different site to change the patch, as this will help to prevent skin irritation. You should check every day to make sure the patch has not fallen.

You should follow the manufacturer's instructions on the package does not operate the patch after use, as it still contains some active hormones.

When changing the patch

You wear a patch every day for three weeks. The patch should be removed and changed every week. During the fourth week, when you're not wearing a patch, you should have your period.

Imagine your menstrual cycle as 28 days. Day 1 of your cycle is the first day of your period. Follow these instructions:

  • Apply the first patch on the first day of your period (day 1).
  • Wear the patch for seven days (week 1).
  • Day 8, remove the old patch and apply a new patch immediately. You are now in week 2.
  • Use the new patch for seven days. On day 15, remove the old patch and apply a new patch immediately. You are now in week 3.
  • Use the new patch for seven days. On day 22, remove the patch.
  • Do not use a patch between 22 and day 28 (week 4). You must have a bleeding as during this time period. Still protected against pregnancy provided that the following patch is applied on time.
  • Start your next cycle of 4 weeks the day after 28 days. Apply a new patch today. You must ask for this review no matter when your period begins or ends.

Will change the patch on the same day each week.

It is unlikely that the contraceptive patch will fall, as it has been carefully designed to minimize this.

If the patch has been off for less than 48 hours:

  • Reapply as quickly as possible (if still sticky).
  • If it is still sticky, replace it with a new patch. Do not use anything (such as tape) to try to carry out a review in place that is no longer sticky.
  • You are still protected and do not need to use any birth control method.
  • Keep using the patch as normal and change in your normal day.

If the patch has been off for 48 hours or more, or if the time that has spread is uncertain:

  • Start a new patch cycle by applying a new patch as soon as possible. This is now week cycle patch 1. It may also mean that you have another day of the week to change his spots and initiate new cycles.
  • If you have sex within the next seven days, you must use an additional method of contraception such as condoms.
  • You may need to take additional emergency contraception if you have had sex in the last five days. If this is the case, you should discuss this with your doctor, nurse, family planning or sexual health clinic.

If you miss your patch at the end of the week 1 to 2 weeks

If the delay in the patch change is less than 48 hours:

  • Replace the old patch with a new patch as soon as possible.
  • Continue to use the patch of normal shape, the change in the usual day.
  • No need to use any additional contraceptive precautions.

If the delay in the change of the patch is more than 48 hours:

  • Replace the old patch with a new patch as soon as possible.
  • This is now week cycle patch 1. It may also mean that you have another day of the week to change his spots and initiate new cycles.
  • If you have sex within the next seven days, you must use an additional method of contraception such as condoms.
  • You may need to take additional emergency contraception if you have had sex in the last five days. If this is the case, you should discuss this with your doctor, nurse, family planning or sexual health clinic.

If you forget to remove the patch at the end of week 3

  • Remove the patch as soon as possible.
  • Apply the following patch at the usual start day next patch cycle. This may mean that you do not have a 7-day patch-free break.

If you forget to apply a new patch as the end of the week off

If the delay in the patch change is less than 48 hours:

  • Put a new patch as soon as possible.
  • This is now the week 1 new patch cycle. It may also mean that you have another day of the week to change his spots and initiate new cycles.
  • No need to use any additional contraceptive precautions.

If the delay in the change of the patch is more than 48 hours:

  • Apply a new patch as soon as possible.
  • This is now the week 1 new patch cycle. It may also mean that you have another day of the week to change his spots and initiate new cycles.
  • If you have sex within the next seven days, you must use an additional method of contraception such as condoms.
  • You may need to take additional emergency contraception if you have had sex in the last five days. If this is the case, you should discuss this with your doctor, nurse, family planning or sexual health clinic.

Some medicines may interact with it and make it less effective. You should always talk about all other medicines you are taking with the person prescribing the patch. This includes prescription medicines (such as St. John's wort) may also interfere with the contraceptive patch. If you are starting a new medication, be sure to tell the person prescribing what you are using the contraceptive patch. You may need to take additional contraceptive precautions (such as condoms) during treatment with the other drug and for a period of time after it is over.

Some commonly encountered drugs that can interfere with the contraceptive patch include certain antibiotics (eg, rifampin or rifabutin), certain anticonvulsants (medications used to treat epilepsy), some drugs used for HIV infection, some medications used to treat and fungal infections, as mentioned earlier, the St. John's wort (a herbal remedy used to treat low mood).

Note: the commonly used antibiotics (for example, to treat a chest infection or urinary infections) do not interfere with the effectiveness of the contraceptive patch.

If you have vomiting or diarrhea, the contraceptive patch remains effective (unlike when you are on the pill). This is because the hormones are absorbed into the bloodstream through the skin, rather than through the gastrointestinal tract (stomach and intestines). No need to use extra contraceptive precautions.

Sometimes not all women have bleeding during the patch-free week. If you have used the contraceptive patch properly, if it has not fallen and if you have not taken any drugs that may interfere with the patch, it is unlikely that you are pregnant. If you are concerned, you can do a pregnancy test or visit your doctor, nurse, family planning clinic or sexual health clinic for advice. If you miss two, you should seek medical advice.

During the early months while your body is adjusting to the birth control patch, you may have some vaginal bleeding, besides the normal bleeding during their week off. This is not serious, but more of a nuisance. May vary from spot to a heavier loss as a light period. Do not stop using the patch. This usually settles after the first 2-3 months. If the problem persists, consult your doctor or nurse.