A Complete Guide to Birth Control Patch Side Effects

    From its 91 percent to 99 percent effectiveness rate, to the fact that you only need to change it once per week, the birth control patch offers a variety of unique advantages.

    Available as Xulane, the modern birth control patch is a safe, convenient and effective form of contraception. However, like other hormonal contraceptives, it can occasionally cause certain side effects. 

    For the most part, the side effects of the birth control patch are mild. They usually occur during the first few months after you start using the patch. However, in some cases, it’s possible to get lasting, persistent side effects after you start using the patch for birth control. 

    Below, we’ve listed all of the side effects associated with the birth control patch, as well as how frequently they occur. In addition to the common side effects of the patch, we’ve also looked at the less common side effects and interactions that affect a small percentage of patch users.

    Finally, we’ve covered what you can do to manage and treat any side effects you experience if you use the patch as your preferred form of birth control.

    Common Side Effects of the Birth Control Patch

    The birth control patch contains two hormones — a synthetic, estrogen-based hormone called ethinyl estradiol and a synthetic progestin called norelgestromin.

    These hormones are very similar to the hormones used in the birth control pill. As a result of this, the most common side effects of the patch are almost identical to the side effects of the birth control pill.

    If you’ve used the pill before, the side effects listed below might seem familiar. Like the pill, the common side effects of the patch are usually temporary, with most disappearing as your body gets used to the effects of the medication.

    Breast Tenderness, Discomfort and Pain

    Pain, discomfort and tenderness of the breasts is one of the most common side effects of the birth control patch. 

    According to data from the FDA for Ortho Evra (an older brand of the birth control patch that uses the same formula as Xulane), 22.4 percent of women who used the patch reported pain in the breasts.

    This occurs due to the estrogen and progestin hormones in the patch, which can cause your breast ducts and milk glands to swell. 

    Breast pain from the patch is usually a temporary side effect, with your body adjusting to the medication over several months. In the meantime, it’s okay to use over the counter pain relief drugs like Tylenol (acetaminophen) or Advil (ibuprofen) to manage any breast-related pain. 

    Headache 

    According to FDA data, headaches are the second-most common side effect of the birth control patch, affecting 21 percent of women. 

    Headaches are a common side of most forms of hormonal birth control. For example, the birth control pills Yaz and Estrostep both include headache as a potential adverse effect in their FDA drug labels. 

    Like other side effects of the patch, headaches usually occur as a reaction to the hormones in the birth control patch. Most headaches from the birth control patch are mild, although a small percentage of women experience migraines after starting the patch. 

    Headaches from the patch, whether mild or severe, usually improve over time. If you notice an increase in mild headaches after using the patch, you can manage them using over the counter drugs like Tylenol (acetaminophen) or Advil (ibuprofen).

    It can also help to use some general headache prevention techniques, such as making sure you get enough sleep, avoiding common sources of stress, staying hydrated and limiting the amount of alcohol you consume. 

    If you frequently get migraines after starting the patch, contact your doctor. Frequent migraines from birth control could indicate that you have a higher risk of experiencing cardiovascular side effects. Based on your symptoms, your doctor might recommend another form of birth control. 

    Application Site Issues (Skin Irritation)

    Because the birth control patch needs to be applied to your skin to prevent pregnancy, you may feel irritation and discomfort at the application site.

    According to FDA data, 17.1 percent of women who use the birth control patch report “application site disorder.” If you frequently apply the birth control patch to the same area of skin, it could lead to mild skin irritation, itchiness and other symptoms. 

    To avoid this, it’s best to rotate between several different areas of your body when you replace your patch every week. The patch can be used on your upper torso, upper outer arm, buttocks or abdomen, giving you a variety of locations to switch between for each new patch. 

    Our Birth Control Patch 101 guide goes into more detail on how you can apply the patch to make sure it’s effective while avoiding common side effects. 

    Nausea

    Nausea is a common side effect of the birth control patch, affecting 16.6 percent of women, according to the FDA data linked above. 

    Like headaches, nausea is a common side effect of most forms of hormonal birth control. After you start using the patch, it’s far from uncommon to occasionally feel as if you need to vomit or use the toilet.  

    Nausea is caused by the hormones in the birth control patch, particularly ethinyl estradiol. Just like with other side effects, it usually fades away over the course of a few months as your body adjusts to the higher levels of ethinyl estradiol and norelgestromin in your bloodstream.

    Since the patch is on your body all day, every day, tactics like taking your birth control pill at night to reduce nausea don’t work. However, you can talk to your doctor about using anti-nausea medication if you frequently feel sick after you start using the patch. 

    Although nausea is reported by more than 16 percent of women who use the patch, vomiting is less common. According to the FDA, only 5.1 percent of women who use the patch report vomiting after starting this form of birth control.

    Luckily, unlike with the pill, if you do vomit while you’re using the patch, it won’t make it any less effective as a form of contraception. 

    Abdominal Pain

    Abdominal pain affects 8.1 percent of women who use the birth control patch, according to the FDA data above. It can manifest as mild discomfort in your lower abdominals or cramps that can begin shortly after you start using the patch as your form of birth control.

    Like many other common side effects, abdominal pain occurs because of the hormones in the birth control patch. The combination of ethinyl estradiol and norelgestromin can cause you to feel bloated, putting pressure on your abdomen, and even directly contribute to cramps.

    Abdominal pain from the birth control patch is usually temporary and tends to occur during your first cycle of the medication. Over time, as your body adjusts to the higher hormone levels, most cramping and discomfort gradually fade away.

    In the meantime, you can treat cramping and other abdominal pain using over the counter pain relief drugs — such as Tylenol (acetaminophen) or Advil (ibuprofen) — holding a hot water bottle to your abdomen, taking a warm bath and getting plenty of rest. 

    Dysmenorrhea (Menstrual Cramps)

    The hormones in the birth control patch can cause you to experience dysmenorrhea, or cramps before and during your period. According to data from the FDA, dysmenorrhea affects 7.8 percent of women who use the patch as their method of contraception. 

    Menstrual cramps are caused by uterine contractions. They usually start one to two days before your period and can affect your back and thighs, as well as your lower abdomen. Although pain is usually mild, it can occasionally be severe and intense.

    Most of the time, menstrual cramps from the birth control patch pass on their own as your period ends. Like other side effects, they’re most common in the first few months after you begin using the patch. Over time, it’s normal for any extra cramps and period discomfort to disappear.

    If you get menstrual cramps after starting the patch, the tactics listed above for lower abdominal pain are often effective at managing discomfort. You should also avoid alcohol, limit your intake of caffeine and use other proven techniques to manage pain during your period

    Menstrual Disorders (Spotting, Late or Missed Period)

    The birth control patch may cause you to experience light bleeding between your periods. It can also affect the timing of your menstrual cycle, meaning you might get your period earlier or later than normal. 

    This is a common side effect of most forms of hormonal birth control, meaning you might also get these side effects if you use the pill or ring. 

    Vaginal bleeding and menstrual disorders affect 6.4 percent of women who use the birth control patch, according to the FDA data above. Like other side effects of the patch, side effects related to your menstrual cycle are most common in the first few months of use. 

    Common menstrual issues associated with the patch include spotting, a form of light bleeding that can occur outside your normal period. After you start to use the patch, your flow might be lighter than normal. It’s also quite common to get a shorter period. 

    In some cases, you may totally skip your period after you start using the birth control patch. If this happens, it’s best to take a pregnancy test to check that you're not pregnant. Most of the time, your period should settle into a normal cycle after a few months of using the patch. 

    Changes in Mood and Affective Disorders

    Like other forms of hormonal birth control, the birth control patch may cause you to experience mood swings, anxiety and other affective disorders. These side effects are associated with the ethinyl estradiol that’s released from the patch into your bloodstream.

    Although the evidence is mixed on the link between hormonal birth control and your mood, this side effect is reported fairly often by women who use the patch. According to the FDA, 6.3 percent of women who use the patch report experiencing mood, affect and/or anxiety disorders.

    Like other side effects, changes in your mood and issues such as anxiety tend to occur during the first few months after you start using the patch. Most of the time, they’ll gradually disappear over the course of several months as your body adjusts to the hormones in the patch. 

    Other Minor Side Effects of the Birth Control Patch

    In addition to the side effects listed above, the birth control can cause a range of less common minor side effects. These include:

    • Diarrhea
    • Dizziness
    • Fatigue
    • Acne
    • Pruritus
    • Vaginal yeast infection
    • Muscle spasms
    • Insomnia
    • Changes in libido
    • Vaginal discharge

    These side effects occur in less than five percent of women who use the birth control patch. Like most of the common side effects listed above, they tend to occur in the first few weeks after you start to use the patch. Over time, it’s normal for most side effects to gradually fade away and stop. 

    The Birth Control Patch and Weight Gain

    The hormones in the birth control patch may cause you to retain more water than normal. This can cause your weight to increase suddenly — often by as much as five to 10 pounds — in the first few weeks after you start using this form of contraception. 

    This sudden weight increase is common with most forms of hormonal birth control, including the pill. 

    If you experience sudden weight gain after you start using the patch, it doesn’t mean that you’ve gained fat. Most of the time, you’ll simply be retaining more fluid than normal due to the sudden increase in estrogen and progestin hormones.

    Fluid retention from the birth control patch can take anywhere from a week to several months to fully disappear. You’ll typically notice your weight gradually decreasing, along with a reduction in any bloating and abdominal discomfort, over the course of several weeks. 

    In the meantime, you can help your body shed extra fluid by reducing your sodium (salt) intake and staying active. As counterintuitive as it sounds, drinking more water than normal can also help your body flush out extra fluid and return you to your pre-patch body weight. 

    Rare, Serious Side Effects of the Birth Control Patch

    Just like the pill, ring and other forms of hormonal contraception, the birth control patch is very safe. Every year, millions of women rely on hormonal birth control pills and patches to avoid pregnancy without any significant issues. 

    However, it’s still possible for the birth control patch to cause more serious side effects. These are rare and typically affect people who are predisposed to certain health issues due to genetic or lifestyle factors. 

    We’ve listed these side effects below, along with scientific data covering how common they are and why they can happen. We’ve also listed key health factors that can contribute to certain side effects that you should be aware of before using the patch.

    Deep Vein Thrombosis (DVT) and Stroke

    All forms of hormonal contraception are linked to an increase in your risk of having a stroke, with the birth control patch no exception. The patch may also increase your risk of experiencing deep vein thrombosis (DVT), a type of blood clot that forms in one or several deep veins. 

    Stroke, deep vein thrombosis and other cerebrovascular diseases are extremely rare in healthy women who use the patch. If you’re a non-smoker with healthy blood pressure and no history of cardiovascular issues, your risk of experiencing these side effects is extremely low.

    However, if you smoke (particularly if you’re 35 or older), have hypertension or any other heart issues, you have the greatest risk of stroke, DVT and other cerebrovascular diseases from the birth control patch.

    Your doctor may recommend an alternative form of contraception if your age, health history or habits cause you to have a high risk of cerebrovascular disease. 

    Other Cardiovascular Issues

    In addition to DVT and stroke, the hormones in the birth control patch may increase your risk of experiencing other cardiovascular problems. This increase is largest in women 35 or older who smoke, particularly heavy smokers.

    These cardiovascular issues range from an increased risk of vascular diseases to myocardial infarction (heart attack). This increased risk is common with all hormonal contraceptives, with study data showing no increase in risk between the birth control patch and the pill.

    As mentioned above, if you’re aged 35 and over and smoke, or if you have a history of cardiovascular issues, your doctor may recommend an alternative method of contraception.

    Overall, cerebrovascular and cardiovascular issues from the birth control patch are extremely rare among young, healthy women.

    Learn More About the Birth Control Patch

    Used properly, the birth control patch is a safe, convenient and effective way to stop yourself from becoming pregnant. With an effectiveness rate of 91 percent to 99 percent, the patch is as effective as the pill, with its own range of unique advantages.

    Our guide to the birth control patch goes into more detail on how the patch works, as well as how you can use it as your method of contraception. You can also learn more about how the patch compares to the pill in our guide to the birth control patch vs. the birth control pill. 

    This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.