What Is the Birth Control Patch?
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Medically reviewed by Dr. Andrea L. Braden
The birth control patch is a form of hormonal contraception you stick onto your skin. As you wear the small patch, hormones are continuously released through the skin and into the bloodstream to prevent pregnancy.
Like other types of hormonal birth control, such as the pill, shot, and vaginal ring, you must keep to a schedule when using the patch to prevent pregnancy.
Different brands of birth control patches have been approved by the U.S. Food and Drug Administration (FDA) and are available: Xulane, Zafemy, and Twirla. All work similarly to prevent pregnancy.
While the birth control patch is a safe and reliable way to prevent pregnancy, like any medication, it may have side effects and risks.
How Does the Birth Control Patch Work?
The birth control patch is a thin, beige-colored bandage-like patch that is usually 1.75 inches in size at most. One side of the patch is covered in an adhesive film, which allows it to stick to the skin. The patch is usually applied to the stomach, buttocks, upper arm, or upper torso.
The birth control patch works by slowly releasing a combination of hormones throughout the time you are wearing the patch. The hormones are absorbed by your skin and enter the bloodstream. Because the hormones enter through your skin, the birth control patch is also referred to as a transdermal contraceptive patch.
The two hormones the patch releases are estrogen and progestin, often called combined hormonal birth control. Many hormonal birth control pills, as well as the vaginal birth control ring, are also types of combined hormonal birth control that have the same combination of hormones.
Estrogen and progestin work together to prevent pregnancy in three ways:
They prevent ovulation, the release of an egg from the ovaries.
They thicken the cervical mucus, preventing sperm from reaching an egg.
They thin the lining of the uterus, preventing the implantation of an egg.
All brands of the birth control patch contain a combination of estrogen and progestin. The specific type of progestin hormone differs, though. While Xulane and Zafemy contain ethinyl estradiol and norelgestromin, Twirla contains ethinyl estradiol and levonorgestrel.
Like the pill, shot, and vaginal ring, the birth control patch is a short-acting hormonal method. That means you have to remember to regularly replace the patch so that you can continue to receive the necessary amount of hormones to prevent pregnancy.
Birth Control Patch Effectiveness
If used perfectly, the patch is 99% effective in preventing pregnancy. Of course, in reality, people aren’t perfect. With typical use—meaning you might not always use the patch consistently or correctly—the patch is about 93% effective. That means fewer than 1 in 100 people will get pregnant during their first year of using the birth control patch. The patch might be less effective for people who weigh more than 198 pounds (lbs).
Compared to other forms of short-acting hormonal birth control, the birth control patch has the same effectiveness if used perfectly. With typical use, the patch is slightly more effective than the pill (91% effective) and about as effective as the vaginal ring (93% effective).
The birth control patch is considered less effective than long-acting, reversible contraceptives like intrauterine devices (IUDs) and implants, which a healthcare provider has to place.
Compared to non-hormonal and barrier contraception methods like condoms or a sponge, the patch is considered more effective. While condoms have an 85% effectiveness rate, sponges have a 76% effectiveness rate.
When you use the patch, follow both the manufacturer’s and your healthcare provider’s instructions closely to lower the risk of unintended pregnancy.
How To Use It
Once prescribed, you can start using the patch immediately at any time during your menstrual cycle. However, if you start the patch after the first five days of your period and plan on having sex, you will need to use a backup method of birth control (such as condoms or a diaphragm) for the first seven days.
You wear the patch for one calendar week (seven days). There are only enough hormones in the patch for the week, so you should not wear one for multiple weeks. Instead, replace your patch with a new one after a week. This is done for three weeks in a row.
You will not apply a new patch for the fourth week when you will get your period. The following week, you should apply a new patch again and follow the same pattern.
Below are step-by-step instructions to apply a birth control patch:
Check the expiration date before putting on a new patch. Do not use an expired patch, as that may affect the patch’s effectiveness
Select which part of the skin you will apply the patch. Generally, the buttocks, belly, or back are considered good spots. If you are using the Xulane brand patch, you can apply it to your upper arm. Avoid applying the patch anywhere it will come into contact with repeated friction, such as under the waistband of your pants or on your breasts.
Make sure your skin is clean and dry. Avoid applying lotions, creams, or oils to the spot where you place the patch.
Following the manufacturer’s instructions, peel part of the plastic layer off the adhesive backing of the patch. Avoid touching the sticky side with your fingers.
Carefully place the patch flat on the chosen part of your skin, peel the remaining plastic film off the back of the patch, and press firmly for 10 seconds.
Once you have the patch on, continue to avoid lotions and creams. You don’t have to worry about coming into contact with water or sweating while wearing the patch, but if you frequently swim, check your patch daily to ensure it is still firmly affixed to your skin.
When you change your patch, don’t use the same spot each time. Instead, rotate the patch's location. Change your patch on the same day every week. For instance, if you placed your patch on Monday, change the patch the following Monday.
Benefits
Some of the main benefits of the patch are its convenience and ease of use. Applying a patch is almost as easy as applying a Band-Aid. You also don’t have to worry about remembering to take a daily pill or to use a condom, diaphragm, or spermicide every time you have sex. It is also easy to stop using the patch, unlike a long-acting reversible contraceptive like an IUD, which a healthcare provider has to remove.
As with other hormonal contraceptives, there are other benefits you might get from using the patch. It may help with acne, heavy periods, and painful menstrual cramps. When using the patch, your periods may become shorter and lighter. You can also use the Xulane patch to skip your period safely. In this scenario, you would use a new patch during the fourth week. To clarify, you take the medication continuously, without skipping weeks
Downsides
The patch is a safe and effective method of birth control. However, there are some disadvantages.
One downside is that this method of birth control requires a prescription, so you will have to get approval from your healthcare provider before you can use the patch. You will also need to keep up with filling your prescription and requesting refills from your provider.
You will also have to remember to replace the patch each week. While this is less often than trying to remember daily, you may want to set a weekly reminder so you don’t forget to put on a new patch.
Another downside is that, unlike barrier methods of contraceptives like condoms that can reduce the risk of acquiring or spreading a sexually transmitted infection (STI), birth control patches cannot protect against STIs. If you want to use the patch and protect against STIs, you will have to use a second method of contraception.
While the patch is small and often worn under clothes, it may be visible when wearing certain clothes or when you are intimate. Some people might prefer contraceptive methods that you can’t ever see, as is the case with an IUD.
Birth Control Patch Side Effects
The birth control patch may cause several side effects, many of which are common in other methods of hormonal contraception as well. When using the patch, you may experience:
Skin irritation where you wear the patch
Sore breasts
Headaches
Spotting or breakthrough bleeding (bleeding between your periods)
Changes in your menstrual cycle
Mood changes
Weight gain
These side effects are often mild and only last a few months as your body adjusts to the hormones.
Contact your healthcare provider if you experience ongoing side effects or any of the following changes in your health:
Swelling or pain in your legs
Chest pains
Irregular vaginal bleeding
Vision problems
Like any other combination of birth control, the birth control patch can increase the risk of blood clots and high blood pressure (hypertension), both of which can lead to heart attack or stroke. However, severe side effects are rare.
Because of the potential for these side effects, you should avoid birth control patches if you:
Smoke (especially those over the age of 35)
Have a history of blood clots, heart attacks, or strokes
Take certain medications.
Always discuss your complete medical history with your healthcare provider before trying a new medication.
A Quick Review
The birth control patch is a safe, effective, and easy-to-use contraceptive option available via prescription from your healthcare provider. It prevents pregnancy by releasing a combination of two hormones into your body while you wear the patch on your skin. Most people stick the patch on their buttocks, chest (except the breasts), upper back, upper arm, or abdomen.
As with all medications, the birth control patch comes with risks and side effects. However, the side effects are often mild and short-lasting, and the severe risks are rare. If you experience any concerning symptoms as you use the patch, reach out to your healthcare provider.
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