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Birth Control Patch FAQs: 19 Common Questions About Xulane Answered

Kristin Hall

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 1/28/2021

The birth control patch, sold under brand names such as Xulane, is a common form of hormonal contraception. Designed to protect you from pregnancy for an entire week, it’s a safe, convenient alternative to options like the birth control pill. 

Got questions about the birth control patch? We’ve got answers. Below, we’ve answered 19 of the most frequently asked questions about the birth control patch, from how you can use it to its unique advantages, potential side effects and more. 

How Does the Birth Control Patch Work?

The birth control patch works the same way as the combined birth control pill — by releasing a small amount of estrogen and progestin hormones into your body. Xulane®, a common type of birth control patch, contains the hormones norelgestromin and ethinyl estradiol.

Unlike the pill, which delivers these hormones via your stomach, the birth control patch delivers them through your skin

These hormones prevent you from ovulating, meaning your ovaries will stop releasing eggs as long as you continue using the patch. They can also thicken your cervical mucus, reducing the risk of your partner’s sperm successfully entering your uterus. 

Finally, the hormones in the patch may make it more difficult for a fertilized egg to successfully implant itself in your uterus, further reducing your risk of pregnancy. 

Like other forms of hormonal birth control, the effects of the patch are temporary. If you decide to stop using the patch, its effects on your body will stop and you’ll be able to become pregnant after having sex. 

How Effective is the Birth Control Patch?

Used perfectly, the birth control patch is 99 percent effective at preventing you from becoming pregnant. In this case, “perfect usage” means applying the patch exactly once per week at the same time of day, without ever changing a patch late or letting the patch fall off. 

In short, among women who use the birth control patch perfectly, only one out of every 100 will get pregnant annually. 

Like most forms of birth control, the patch is slightly less effective with normal, “real life” usage conditions. Under “real life” conditions, the patch is 91 percent effective. This means that about nine women out of every 100 who use the patch normally will become every year. 

These percentages assume that the patch is your only form of birth control. If you use condoms as well as the patch, your risk of becoming pregnant is significantly lower — and your risk of contracting various STIs decreases, too. 

With its 91 percent to 99 percent effectiveness rate, the patch is roughly as effective as most combined birth control pills. For example, Yaz, a popular combined birth control pill, has an effectiveness rate of 92 percent to 99 percent

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How Long Does the Birth Control Patch Take to Work?

The birth control patch starts working either immediately or within seven days, depending on the time in your menstrual cycle at which you first use it. 

If you start using the patch within the first five days of your period, it will start working as soon as you apply it. 

If you start using the patch more than five days after the start of your period, you’ll need to wait for seven days before it’s completely effective. During the first seven days, you’ll need to use a condom when you have sex to protect yourself from pregnancy. 

How Big is the Birth Control Patch? 

The birth control patch looks like a square Band-Aid® and measures 1.5 inches on each side. It has a flat surface and is slightly larger than a quarter, making it easy to hide under your sleeve, t-shirt or other clothing. 

Is the Birth Control Patch Easy to Use?

The birth control patch is a very easy form of contraception to use. Unlike the birth control pill, there’s no need to use it every day. Instead, all you need to do is remove your old patch every week and replace it with a new one. 

Applying the birth control patch to your body is simple. The patch is designed to stay stuck on even if you swim, sweat or play sports, making it unlikely for it to fall off. If it does fall off your body, replacing it with a new patch is a simple, stress-free process. 

Is the Birth Control Patch Better Than the Pill?

The birth control patch offers several advantages over the pill, the biggest of which is that you only need to use it once every week. It can also be a better choice if you don’t like swallowing pills and find the birth control pill inconvenient.

On the other hand, the pill has its own range of advantages and disadvantages that make it a better choice for some and a worse choice for others. Our guide to the patch vs. the pill covers the key advantages, disadvantages and unique features of each form of birth control. 

Where is the Best Place to Stick the Birth Control Patch?

The birth control patch needs to be applied to dry, clean skin. It’s most effective when you stick it to a patch of skin that doesn’t have much hair, as hair can make it more difficult for the adhesive in the patch to stick to your body.

The best places to stick the birth control patch are your upper outer arm, your upper torso, your buttocks and your abdomen. You should not apply the birth control patch to your breasts. 

To make sure the patch stays stuck on for the entire week, it’s best to apply it to an area of your body that doesn’t move often. If you swim or play sports, areas such as your lower abdomen or buttocks are perfect, as they make it easy to hide the patch under your shorts or swimsuit.

Can the Birth Control Patch Fall Off?

The birth control patch uses a strong adhesive, meaning it should stay attached to your skin for the entire week without any problems. However, while it’s uncommon, it’s possible for the patch to fall off if you expose it to conditions that affect the adhesive. 

If the birth control patch falls off, you’ll need to either stick it back on or replace it with another patch, depending on how much time has passed since you noticed it fell off. Our Birth Control Patch 101 guide explains what you can do if this happens. 

Is the Birth Control Patch Waterproof?

The birth control patch is waterproof, meaning you don’t need to take it off before you shower, swim or take a bath. You should not remove the patch before going in water, as this can make the adhesive less sticky and prevent the patch from working effectively. 

The patch is also designed to stay on your skin after you sweat, meaning it should stay firmly attached to your skin during and after intense exercise. Just make sure you apply the patch to dry skin when you first use it, as this will help the adhesive stick to your body. 

How Often Do You Need to Change the Patch?

The birth control patch works for seven days, after which you’ll need to take it off and replace it with a new one. 

Replacing the patch is easy. After you’ve used your first patch, take note of the day you applied it to your body. This is your “patch day.” When it’s your next patch day, you’ll need to replace the old patch with a new one. 

For example, if you applied your first birth control patch on a Monday, then you’ll need to replace it every Monday. After you’ve used three patches, you can either take a patch-free week and get your period, or begin a new cycle by starting a new box of patches. 

To make sure you replace your patch on time every week, it can help to add a reminder to your calendar. After a few weeks, you’ll find it easy to keep track of where you are in your cycle and how close you are to your next patch day. 

Does the Birth Control Patch Have Side Effects?

The birth control patch is a safe form of contraception for most users. However, like other hormonal medications, it can have side effects. Most of these side effects are mild and temporary, with the majority of side effects disappearing after you use the patch for several months.

Common side effects of the birth control patch include nausea, headaches, skin irritation to the area the patch is applied, abdominal pain and discomfort during your period. 

Like other hormonal contraceptives, the patch may also cause you to experience mood swings, acne, muscle spasms, diarrhea, dizziness and fatigue. The hormones in the patch can also lead to a mild increase in fluid retention. 

The majority of these side effects occur in the first few months of using the patch. Over time, it’s common for these effects to gradually fade away until they’re no longer noticeable. Most women who use the patch do not report that side effects are a significant concern.

The patch is also linked to several more severe side effects, although they’re rare. Our guide to the side effects of the patch lists these in more detail, with data on how often they occur and the best options for managing these side effects. 

Can Smokers Use the Birth Control Patch?

Smoking while using the birth control patch is linked to a significantly higher risk of certain side effects, including several serious cardiovascular side effects such as heart attack, blood clots and stroke. These side effects are particularly common in people aged 35 and up. 

These risks are common with other forms of hormonal birth control, meaning you’re also at risk if you smoke and use the birth control pill. 

If you smoke, it’s important to inform your healthcare provider before considering the birth control patch or any other form of hormonal contraception. Depending on your age, cardiovascular health and other factors, they may recommend an alternative method of contraception. 

Does the Birth Control Patch Cause Weight Gain?

The combination of estrogen and progestin hormones in the birth control patch can cause you to retain water. This is similar to premenstrual water retention, which can cause you to gain several pounds of fluid before and during your period.

Because of this, it’s common to experience a small increase in your weight after you start using the birth control patch. This increase is normally mild — at most, you might weigh a few pounds more in the first few weeks after you start using the patch than you did before.

Since this weight gain is caused by fluid retention, it doesn’t mean that you’ve gained fat. Most of the time, your body will shed the extra water over the course of one to two months, meaning you’ll go back to your normal weight as long as your diet and activity level stays the same. 

Our guide to birth control and weight gain explains this process in more detail, as well as what you can do to deal with temporary weight gain after you start using hormonal birth control. 

Does the Birth Control Patch Affect Fertility?

The birth control patch will significantly reduce your risk of becoming pregnant while you actively use it. However, there is no evidence that it has any effects on your fertility in the long term. This means that if you’d like to become pregnant, you can stop using the patch without any issues. 

Does the Birth Control Patch Protect Against STDs?

Used properly, the birth control patch will significantly reduce your risk of pregnancy. However, it does not provide any protection against sexually transmitted infections (STIs). If you are worried about potentially getting an STI, make sure you use condoms in addition to the patch.  

Is the Birth Control Patch an Emergency Contraceptive?

The birth control patch is not an emergency contraceptive and should not be used to prevent pregnancy after you’ve had unprotected sex. Using the birth control patch after you have sex will not reduce your risk of becoming pregnant.

If you’ve had unprotected sex and need to use emergency contraception, use a morning-after pill such as Ella® or EContra® EZ (levonorgestrel), or a non-hormonal emergency contraceptive such as the copper IUD. 

Where Can You Buy the Birth Control Patch?

The birth control patch is a prescription medication, meaning you’ll need to talk to a healthcare provider and get a prescription before you can buy it. 

If you already have a prescription, you can purchase the patch from most pharmacies. The birth control patch is usually sold in a three-pack of patches, and is designed to protect you for three weeks. After three weeks, you’ll need to take a patch-free week or start a new pack of patches.

What’s the Difference Between Xulane, Evra and Ortho Evra?

Xulane, Evra® and Ortho Evra® are three brand names used to market the norelgestromin and ethinyl estradiol birth control patch. 

Ortho Evra is an old brand name. The birth control patch is no longer produced or sold under the Ortho Evra brand in the United States. As this brand was sold for several years, you might occasionally see it mentioned in articles and videos about the birth control patch.

The birth control patch is currently sold under the brand name Xulane. This patch contains the same ingredients as Ortho Evra. If you previously used Ortho Evra, you can switch to Xulane without any issues. 

Internationally, the birth control patch is sold under a variety of different brand names. In the UK and Canada, it’s sold as Evra. Like Xulane, the Evra patch uses the same active ingredients as Ortho Evra, with each patch containing a combination of norelgestromin and ethinyl estradiol. 

How Should You Dispose of Used Birth Control Patches?

To dispose of a used birth control patch, fold it so that the adhesive is covered. Then, dispose of the patch inside a sealed plastic bag. This will prevent the hormonal adhesive from coming into contact with other objects. You can dispose of this bag with the rest of your garbage. 

Do not flush your used birth control patches down the toilet or dispose of them without covering the adhesive. 

Learn More About the Birth Control Patch

Interested in learning more about the birth control patch? Our Birth Control Patch 101 guide explains how you can use the Xulane birth control patch to protect yourself from pregnancy, as well as the advantages and disadvantages the patch offers over other forms of contraception.

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. Learn more about our editorial standards here.