Birth Control Patch (Ortho Evra)

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  What Is the Birth Control Patch?

  The birth control patch is a thin, beige, plastic patch that sticks to the skin. It is used to prevent pregnancy. A new patch is placed on the skin once a week for three weeks in a row, followed by a patch-free week.

  The birth control patch is commonly called Ortho Evra, its brand name.

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  How Does the Birth Control Patch Work?

  Like other methods of birth control, the birth control patch releases hormones. Hormones are chemicals made in our bodies. They control how different parts of our bodies work.

  The hormones in the patch are the same hormones as in the birth control pill — estrogen and progestin.

  The hormones in the birth control patch work by

  • Keeping eggs from leaving the ovaries. Pregnancy cannot happen if there is no egg to join with the sperm.
  • Making cervical mucus thicker. This keeps sperm from getting to the eggs.

   

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  How Effective Is the Birth Control Patch?

  Effectiveness is an important and common concern when choosing a birth control method. The birth control patch is very effective. It works best when it is always placed on the skin on time. That keeps the correct level of hormone in a woman’s body.

  • Less than 1 out of 100 women will get pregnant each year if they always use Ortho Evra as directed.
  • About 9 out of 100 women will get pregnant each year if they don’t always use Ortho Evra as directed.

  The patch may be less effective for women who weigh more than 198 pounds.  But it may still be a good option for women of all sizes. Talk with your health care provider if you are concerned about how well Ortho Evra may work for you. 
  
  Certain medicines and supplements may make the birth control patch less effective. These include

  • the antibiotic rifampin — other antibiotics do not make the patch less effective
  • the antifungal griseofulvin — other antifungals do not make the pill less effective
  • certain HIV medicines
  • certain anti-seizure medicines
  • St. John's wort

  Keep in mind the patch doesn’t protect against sexually transmitted infections. Use a latex or female condom to reduce the risk of infection.

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  How Safe is the Patch?

  Most women can use Ortho Evra safely. But all medications have some risks, so safety is a concern when choosing a birth control method. Serious side effects of the birth control patch, though rare, may be more likely if you have certain conditions. Some of these conditions may even rule out using the patch. Talk with your health care provider to find out if the patch is likely to be safe for you.
  
  You should not use the patch during prolonged bed rest or if you

  • are pregnant
  • get migraine headaches with aura
  • have certain inherited blood-clotting disorders
  • have had blood clots or vein inflammation
  • have had breast or liver cancer
  • have had a heart attack, stroke, or angina 
  • have had serious heart valve problems
  • have lupus with certain conditions
  • have serious liver disease
  • have uncontrolled high blood pressure
  • have very bad diabetes
  • smoke and are 35 or older
  • smoke and have high blood pressure

  If you have a condition that makes it unsafe to use the patch, don’t worry. There are many other methods of birth control that may be safe for you if you cannot use it. Read about other methods to find one that is right for you.

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  What Are the Benefits of the Birth Control Patch?

  Using Ortho Evra is safe, simple, and convenient. There is nothing to do right before having sex. Some women say it improves their sex lives because it helps them feel more spontaneous.

  Many women who use the patch have more regular, lighter, and shorter periods. And a woman’s ability to become pregnant returns quickly when use of the patch is stopped.

  Because the patch works like the pill, it probably offers the same benefits. These health benefits may include some protection against

  • acne
  • bad menstrual cramps
  • bone thinning 
  • breast growths that are not cancer
  • ectopic pregnancy
  • endometrial and ovarian cancers
  • serious infection in the ovaries, tubes, and uterus
  • iron deficiency anemia
  • cysts in the breasts and ovaries
  • pelvic inflammatory disease, which often leads to infertility when left untreated
  • premenstrual symptoms, including headaches and depression
  • heavy and/or irregular periods

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  What Are the Disadvantages of the Birth Control Patch?

  Because the birth control patch works like the pill, it probably carries the same possible disadvantages.

  Possible Side Effects of the Birth Control Patch

  Some women may have undesirable side effects while using Ortho Evra. But many women adjust to it with few or no problems. 
  
  Some of the most common side effects usually clear up after two or three months. They include

  • bleeding between periods
  • breast tenderness
  • nausea and vomiting

  Ortho Evra may also cause more long-lasting side effects.  The hormones in the patch may change a woman’s sexual desire. A woman may also have a reaction or irritation where she puts the patch on her skin.

  It’s important that you find a method that won’t make you feel sick or uncomfortable. If you continue to experience side effects after using the birth control patch for three months, talk with your health care provider.

  After a woman stops using the patch, it usually takes one or two months for her periods to return to the cycle she had before using it. Once in a while, a woman may have irregular or absent periods. This may go on for as long as six months after stopping. This is more likely if her periods were irregular before using the patch.

  Serious Side Effects of the Birth Control Patch

  Many women have concerns about the possible risks of taking hormones in birth control. Serious problems do not occur often.

  Women who use birth control with estrogen — like Ortho Evra — have a slightly greater chance of certain rare, but serious, problems than nonusers. The most serious — in very rare cases — may be fatal. These include heart attack, stroke, having a blood clot in the legs, lungs, heart, or brain. Studies have found that women using the patch may have a higher risk of getting blood clots than women taking most kinds of birth control pills. But a woman’s overall risk of any major problem while using the patch is low.

  Other rare risks include developing high blood pressure, liver tumors, gallstones, or yellowing of the skin or eyes (jaundice).
  The risk for these problems increases if you

  • are age 35 or older
  • are very overweight
  • have certain inherited blood-clotting disorders
  • have diabetes
  • have high blood pressure
  • have high cholesterol
  • need prolonged bed rest
  • smoke

  Serious problems usually have warning signs. Report any of these signs to your health care provider as soon as possible:

  • a new lump in your breast
  • a sudden very bad headache
  • achy soreness in the leg
  • aura — seeing bright, flashing zigzag lines, usually before a very bad headache
  • bad pain in your abdomen or chest
  • headaches that are different, worse, or happen more often than usual
  • no period after having a period every month
  • trouble breathing
  • yellowing of the skin or eyes

  See the insert from your Ortho Evra package for more information about possible side effects.

  The Birth Control Patch and Breast Cancer
  
  You may have heard claims linking the hormones in the patch to breast cancer. The most recent literature suggests that the use of these hormones in birth control has little, if any, effect on the risk of developing breast cancer.

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  How Do I Start the Patch?

  To find out what day is best for you to start using the patch, talk with your health care provider. Most often, women start using the patch within the first five days after the start of their periods. That way, they are protected against pregnancy right away. That means that if your period starts on a Wednesday morning, you can apply the patch as late as the following Monday morning to be protected right away.
  
  If you start the patch later than five days after the start of your period, protection will begin after seven days. Use another method of birth control — like a condom, female condom, diaphragm, or sponge — if you have vaginal intercourse during the first week of use.

  Starting the Patch After Pregnancy

  It’s possible to get pregnant again shortly after being pregnant. Starting birth control after pregnancy is an important concern for many women.

  You can start using the patch after waiting at least three weeks after giving birth vaginally.

  You can start using the patch after waiting at least six weeks if you are nursing — it may reduce the amount and quality of milk in the first six weeks of breastfeeding. Also, the milk will contain traces of the patch's hormones. It is unlikely that these hormones will have any effect on your child. But talk with a health care provider about what birth control methods might be right for you after giving birth.

  You should wait at least six weeks after birth if you have an increased risk of blood clots. Women have a higher risk of blood clots if they
  • are obese
  • are over age 35
  • had a cesarean section (C-section)
  • had heavy bleeding after delivery
  • had preeclampsia
  • have certain inherited blood clotting disorders
  • have had blood clots in the past
  • have a close family member who has had blood clots
  • need prolonged bed rest
  • received a blood transfusion at delivery
  • smoke

   You can start using the patch right after an abortion or miscarriage.
  

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  How Do I Use the Birth Control Patch?

  Most women find that the patch is easy to use. You’ll stick one new patch on the skin of your buttocks, stomach, upper outer arm, or back once a week for three weeks in a row. You won’t put on a patch for the fourth week.

  

  Here are some more specific details about using the patch:

  • Store your unused, sealed patches at room temperature and out of direct sunlight. 
  • Consider the first day you apply the patch as "patch change day." So if you first apply the patch on a Tuesday, you will always apply, change, or remove it on a Tuesday.
  • Gently tear the package along the top and side edges. 
  • Peel the foil pouch apart and open it flat. Then peel the patch and plastic layer off the foil liner. 
  • Next, peel half of the clear plastic away from the patch itself — do not touch the sticky part. 
  • Apply the sticky half of the patch to a clean and dry area of skin on your buttocks, stomach, upper outer arm, or back. Never put it on your breasts. Do not use body lotion, oil, powder, or makeup on skin where you are going to put the patch. They could keep the patch from sticking.
  • Remove the other half of the plastic and press the full patch to the skin with your palm for 10 seconds. 
  • Check your patch every day to make sure it is sticking in place. Avoid using body lotion, oil, powder, or makeup on the skin around the patch so it doesn’t become loose. 
  • Remove it after one week. Reapply a new patch once a week on "patch change day" of the second and third weeks. 
  • After removal, fold the patch in half so that it sticks to itself, seal it in plastic bag, and throw it out in the trash.  Do not flush. Used patches still contain some hormones. Folding the patch in half reduces the chance that hormones will get into the soil and water supply.

  During the one-week break, you will usually have your period.  You may still be bleeding when it is time to put on another patch. This is normal, too. But the patch must be applied on the same day of the week as it was applied in the last cycle, or pregnancy may occur.

  
  

  Helpful Tips About Using the Birth Control Patch The patch will work best if you always remember to apply or remove it at the right time. A missed period does not always mean you are pregnant, especially if you have used Ortho Evra correctly. Even though the chance of pregnancy is low, you may want to take a pregnancy test if you miss two periods in a row. Talk with your health care provider if you have any questions or concerns while using the patch. There is a very slight chance that you will become pregnant even if you use the patch correctly. It is unlikely that using the patch during early pregnancy will increase the risk of birth defects. If you decide you want to become pregnant, stop using the patch. It’s possible to get pregnant right after stopping. It usually takes about one or two months for your period to return to the cycle you had before using the patch.

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  What Happens if the Patch Falls Off or I Make a Mistake?

  It’s pretty common for women to make a mistake at some time when using the birth control patch.

  If you use the patch, you may forget to change the patch on time. You may forget to put the patch on after your patch-free week. Or you may make no mistakes, and the patch may become loose or fall off. The key to protecting yourself from an unplanned pregnancy is knowing what to do if any of these things happen to you.

  Here are some general instructions. Talk with your health care provider for more information.

  If You Forget to Change or Apply the Patch on Time

  If You Apply the Patch Late During	What to Do
  Week one	Apply a new patch as soon as you remember. This will become your new “patch change day” — the day of the week you normally change your patch. Wear the late patch for one week. Use a backup method — like a condom, female condom, diaphragm, or sponge —  for seven days after you apply the new patch. If you have had vaginal intercourse without using a backup method, take emergency contraception (morning after pill). You can take it up to five days after unprotected intercourse to prevent pregnancy. But the sooner you take it, the better it works.
  Week two or three	If you are one or two days late changing your patch Change it as soon as you remember. Change to your next patch on your regular patch change day.   If you are more than two days late changing your patch Change it as soon as you remember. Wear it for one week. Change to your next patch on this day of the week — this becomes your new patch change day. That means that if it’s a Tuesday when you remember to change your patch, you will continue to apply, change, or remove your patches on Tuesdays from then on — even if you had been changing your patches on a different day. Use a backup method for seven days after you apply the new patch. If you have had vaginal intercourse without using a backup method, use emergency contraception — up to five days after you have unprotected intercourse.

  If you forget to remove the patch on time during the fourth week, simply remove the patch when you remember. Apply a new patch on your regular patch change day.

  If a patch becomes loose or falls off

  • for less than one day, reapply the patch. If the patch will not stick well, apply a new patch. Change the patch on your regular patch change day.
  • for more than one day or if you are unsure how long it has been loose or off, apply a new patch. This day of the week will become your new patch change day.

  Use a backup method for seven days after you apply the new patch. Wear the replacement patch for one week. If you have had vaginal intercourse without using a backup method, use emergency contraception — up to five days after you have unprotected intercourse.

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  How Do I Get the Birth Control Patch? How Much Does the Birth Control Patch Cost?

  First, you’ll need to get a prescription. Visit a Planned Parenthood health center, another health center, or a private health care provider for a prescription. Your health care provider will discuss your medical history with you, check your blood pressure, and give you any other medical exam that you may need. If you need an exam, it may cost about $35–$250.

  Ortho Evra may be purchased with a prescription at a drugstore or clinic. A one-month supply costs about $15–$80.

  Planned Parenthood works to make health care accessible and affordable. Some health centers are able to charge according to income. Most accept health insurance. If you qualify, Medicaid or other state programs may lower your health care costs. 
  
  Call your local Planned Parenthood health center to get specific information on costs.

  • Want the patch?Find a health center