Is the Birth Control Patch Right for Me?

All of us who need birth control want to find the method that is best for us. And every woman has different needs when choosing a method. Whether you’re thinking about starting the birth control patch, you’re using the patch, you’re a concerned partner, or you’re just someone who’s curious about it, you may have many questions. Here are some of the most common questions we hear women ask about the birth control patch. We hope the answers help you decide if it is right for you.

Highlights

• What Is the Birth Control Patch?
• How Does the Birth Control Patch Work?
• How Effective Is the Birth Control Patch?
• How Safe Is the Birth Control Patch?
• What Are the Benefits of the Birth Control Patch?
• What Are the Disadvantages of the Birth Control Patch?
• How Do I Get the Birth Control Patch? How Much Does the Birth Control Patch Cost?
• How Do I Use 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.

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 work by keeping a woman’s ovaries from releasing eggs — ovulation. Pregnancy cannot happen if there is no egg to join with sperm. The hormones in the Ortho Evra patch also prevent pregnancy by thickening a woman’s cervical mucus. The mucus blocks sperm and keeps it from joining with an egg.

Some people say that the birth control patch works by keeping a fertilized egg from attaching to the lining of the uterus. But there is no proof that this actually happens.

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 8 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
• certain medicines that are taken by mouth for yeast infections
• 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.

Most women can use Ortho Evra safely. But all medications have some risks, so safety is a concern when choosing a birth control method. Certain conditions increase the risk of serious side effects. Talk with your health care provider about your health and whether the patch is likely to be safe for you.

There are many other methods of birth control that may be safe for you if you cannot use the patch. Read about other methods to find one that may be right for you.

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
• breast growths that are not cancer
• ectopic pregnancy
• endometrial and ovarian cancers — protection increases with each year of use
• iron deficiency anemia
• ovarian cysts
• pelvic inflammatory disease, which often leads to infertility when left untreated
• premenstrual symptoms, including headaches and depression
• vaginal dryness and painful intercourse related to menopause

Many of us like to weigh the benefits against the risks of taking a medicine. Now that you’re familiar with the benefits, let’s look at the possible disadvantages. 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
• aura — seeing arching, bright, flashing zigzag lines that develop slowly and don't last long
• headaches that are different, worse, or happen more often than usual
• no period after having a period every month
• pain in your abdomen or chest
• severe depression
• severe headaches
• shortness of breath or coughing up blood
• unusual swelling or pain in your leg or arm
• unusually heavy bleeding from your vagina
• yellowing of the skin or eyes

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.

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

First, you’ll need to get a prescription. Visit a Planned Parenthood health center, a clinic, 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–$50.

Medicaid and private health insurance may cover the patch. Family planning clinics usually charge less than private health care providers.

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 upper torso 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.
  
  
• Talk with your health care provider about what day is best to start using the patch. Consider the first day you apply the patch as "patch change day." So if you first apply the patch on a Thursday, you will always apply, change, or remove it on a Thursday.
  
  
• 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 upper torso. 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. But many women forget from time to time. The key to protecting yourself from an unplanned pregnancy is knowing what to do if you make a mistake or if the patch falls off. A missed period does not always mean you are pregnant, especially if you have used Ortho Evra correctly. But see your health care provider if you miss a second period. 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.