Patch

THE BASICS

What is it?


The birth control patch is a thin piece of plastic that looks like a square bandage. Like combined birth control pills, it contains the hormones estrogen and progesterone.

Once a week for 3 weeks, you stick a new patch on your upper outer arm, lower belly, buttocks, or upper chest (but not on the breasts). In the fourth week, you do not use a patch and you get your period.

How well does it prevent pregnancy?


An effective method of birth control, but not as reliable as the implant, hormonal IUD, copper IUD, or sterilization for men or women.

About 9 out of 100 women using the patch get pregnant in a year of use.

HOW DOES IT WORK?

Prevents the monthly release of an egg from the ovaries (ovulation) in most women. Progesterone also thickens the mucus in your cervix. This stops sperm from entering the uterus. The lining of the uterus also becomes thinner.

WHAT ARE SOME PRODUCT NAMES?

Xulane, a generic, is the only brand available in the United States.

PROS

  • Effective birth control.
  • Sex can be spontaneous.
  • No need to remember to take a pill every day.
  • Reversible. Stop using the patch if you want to try to get pregnant.
  • You can bathe, swim, exercise, and do other normal activities while wearing the patch.

CONS

  • You need to remember to replace the patch on the same day of the week for 3 weeks in a row. If you don’t, you could become pregnant.
  • If privacy is a concern, you may prefer another method.
  • The patch can come off partly or all the way. You’ll need to check it daily to make sure all the edges are attached.
  • Because birth control containing estrogen may lessen breastmilk supply, many experts recommend using other methods of birth control while breastfeeding, particularly during the first six months. Talk to your doctor about what is best for you, your milk supply, and your baby.
  • May be less effective for women who weigh more than 198 pounds.
  • Not safe if you are a smoker over age 35.
  • No-go with some health issues and medicines:
    • History of blood clots
    • Breast or endometrial cancer
    • Stroke
    • Coronary artery disease
    • High blood pressure
    • Serious liver disease
    • Migraine with aura
    • Advanced diabetes or certain types of lupus
    • Certain seizure medicines

POSSIBLE CONCERNS

Side effects (mostly short-term) may include:

  • Breast tenderness
  • Headache
  • Nausea
  • Depression

Risks include:

  • Blood clots
  • High blood pressure

EXTRA BENEFITS

  • Can reduce heavy menstrual bleeding, painful periods, and anemia.
  • Probably similar to combined pills, may lower risk for colon, ovarian, and endometrial cancers
  • May improve:
    • Acne
    • Endometriosis
    • Menstrual migraine without aura
    • Irregular periods
Back to my options
Consider keeping emergency birth control (“morning-after pill”) at home to use as backup. It works best to prevent pregnancy if taken as soon as possible after unprotected sex or birth control mishaps, but may work if taken up to 5 days afterward. Brands include Plan B, ella, and others.
Use with condom to avoid getting or spreading sexually transmitted diseases or infections, including HIV.
You can get pregnant if you change your patch more than 2 days late or go without wearing a patch for more than 9 days. In either case, you’ll need to apply a new patch and use a backup method for 7 days. If you stop having periods, you’ll need to call your doctor if you think you might be pregnant. Signs of pregnancy include breast tenderness and nausea (“morning sickness”).