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The birth control patch is safe for most people, but all medicines have some risks and side effects. Your nurse or doctor will help you figure out if the patch is safe for you.

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Is the birth control patch safe?

There’s a good chance the patch will be totally safe for you — most people can use it with no problems. The hormones in the patch are the same ones in most birth control pills, and millions of people have used these hormones to safely prevent pregnancy for more than 50 years.

Who can’t use the birth control patch?

Like all medicines, the Twirla patch and Xulane patch aren’t right for everyone.

Smoking and the birth control patch don’t always mix.

  • If you smoke 15 cigarettes a day or more, don’t use the patch or any other kind of birth control that has the hormone estrogen (like the pill or ring). 
  • If you smoke fewer than 15 cigarettes a day or vape nicotine at all, talk with your nurse or doctor about whether the birth control patch is safe for you.

Smoking while taking birth control with estrogen (like combination pills, the patch, or the ring), makes you more likely to have problems like a stroke or heart attack.

If you’re a regular smoker, you can safely use any other method without estrogen — like progestin-only pills, the birth control shot, the birth control implant, and IUDs.

Also avoid using the patch if you’ve had or currently have:

  • migraine headaches with aura (seeing flashing, zigzag lines)

  • breast cancer

  • heart attack, stroke, angina, or other serious heart problems

  • very bad diabetes or liver disease

  • uncontrolled high blood pressure

  • blood clots, an inherited blood-clotting disorder, or vein inflammation

Talk with your doctor or nurse about your health history.  They can help you decide if the patch is right for you.

What are the risks of the birth control patch?

Even though the Twirla patch and Xulane patch are very safe, using a form of birth control that has estrogen can slightly increase your risk of certain health problems. These complications aren’t common, but they can be serious. They include heart attack, stroke, blood clots, and liver tumors. In very rare cases, they can lead to death.

When you talk with your nurse or doctor about birth control, tell them about any medicines you’re taking and any health problems you’ve had.

There’s a very small chance that you can get pregnant even if you always use the patch correctly. If you do get pregnant and accidentally use the patch during the early part of your pregnancy, it won’t increase the chances of birth defects.

It’s important to remember that the chance of having any of these problems while using the birth control patch is really, really low for most people. In fact, pregnancy is more likely to cause serious health problems than the patch. Your nurse or doctor can help you figure out which birth control method will be safest for you.

What warning signs should I know about?

Most people on the patch won’t have any problems at all. But just in case, it’s good to know what the signs of a serious issue are.

See a doctor or nurse right away if you have:

  • sudden back/jaw pain along with nausea, sweating, or trouble breathing

  • chest pain or discomfort

  • achy soreness in your leg

  • trouble breathing

  • severe pain in your belly or stomach

  • sudden, very bad headache

  • headaches that are different, worse, or happen more often than usual

  • aura — (seeing flashing, zigzag lines)

  • yellowing of your skin or eyes

You can always call a nurse or doctor, like the ones at your local Planned Parenthood health center if you have any questions or you’re worried about any health issues.

Is it safe to use the patch while breastfeeding?

You can use the patch while breastfeeding. But the estrogen in the patch may lower the amount and quality of your breast milk during the first 3 weeks of breastfeeding. So if you’re nursing, wait at least 3 weeks after giving birth to start using the patch.

Your breast milk will contain traces of the patch's hormones, but it’s unlikely that these hormones will have any effect on your baby. Talk with your nurse or doctor if you have concerns about breastfeeding and birth control.

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The Patch

  • 93% effective

  • Costs up to $150, but can be $0

  • Prescription required

  • Change it once a week

The patch doesn’t protect you from STDs. Use a condom with your patch to help stop pregnancy and STDs.
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