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The Birth Control Patch vs. The Pill: Which is Best For You?

Kristin Hall

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 1/30/2021

If you’re sexually active and don’t want to get pregnant, it’s important for you to use a reliable, proven form of contraception. 

The birth control patch and the birth control pill are both excellent options for preventing unwanted or accidental pregnancy. Both forms of contraception are easy to use, convenient and as much as 99 percent effective when used perfectly.

Despite these similarities, there are also several key differences between the birth control patch and the pill. We’ve listed these below, as well as the advantages and disadvantages offered by each form of contraception. 

The Birth Control Pill

The oral contraceptive pill (or, more commonly, “the pill”) has, since the 1960s, been a popular contraceptive for women. Designed for use every day, the pill is convenient, safe and very effective at preventing pregnancy when used correctly.

Today, two different variations of the pill are available. The combined birth control pill uses a mix of estrogen and progestin hormones to prevent pregnancy. The progestin-only pill, or “mini-pill,” only contains a low dose of a progestin hormone.

The combined hormonal birth control pill works by stopping ovulation. The progestin-only pill, however, stops ovulation only in about 40 percent of women who use it, but also works by thickening cervical mucus, which makes it more difficult for sperm to enter the uterus. 

Used at the same time every day without any missed doses, the birth control pill has a success rate of 99 percent. In “real life” conditions, with the occasional missed or late pill, the pill is about 91 percent effective at preventing pregnancy. 

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The Birth Control Patch

The birth control patch is a newer form of contraception that came to market that works similarly to the birth control pill. The first patch, Ortho Evra®, came onto the market in 2001, and today, the patch is sold under the name Xulane®

Like the combined birth control pill, the birth control patch uses a combination of estrogen and progestin hormones to prevent unwanted or accidental pregnancy. Unlike the pill, which delivers its hormones through the gastrointestinal tract, the patch delivers them into the bloodstream via the skin. 

The hormones in the patch stop you from ovulating, thicken the cervical mucus and may also prevent fertilized eggs from attaching to the uterine lining.

Like the pill, the patch is highly effective when used properly. If used perfectly, the patch is 99 percent effective at preventing pregnancy. In real life conditions, it’s about 91 percent effective.

The Patch vs. The Pill: Convenience

The pill and the patch are both convenient forms of birth control. If you choose to use the pill to protect yourself from pregnancy, you’ll need to remember to take it every day.

This makes the pill a convenient option if you can remember to take it every day, without any missed doses. However, it’s worth noting that if you’re going to take the pill, you should take it around the same time every day, because the progestin-only pill specifically only has a three-hour window 

If you choose to use the patch, you won’t need to apply it every day. Instead, you’ll need to set aside one day per week as your “patch day.” Once every week, you’ll need to remove your old patch and apply a new one to keep yourself protected from becoming pregnant.

This makes the patch a convenient option if you’re worried about forgetting to take your daily pill, or if you don’t like swallowing medication. Our Birth Control Patch 101 guide covers how and where you can apply the patch to your body. 

The Patch vs. The Pill: Effectiveness

As we mentioned earlier, the patch and the pill are both 99 percent effective when used according to the instructions. If you take your pill daily without any missed doses, or if you apply the patch on time every week, you’ll be almost completely protected from becoming pregnant. 

The Patch vs. The Pill: Side Effects

The birth control patch contains the same type of hormones as the combined birth control pill (a mix of ethinyl estradiol and a progestin hormone). Because of this, both medications have very similar side effects.

The most common side effects of the combined birth control pill are intermenstrual spotting (bleeding that occurs between periods), breast tenderness, fluid retention, nausea and certain changes to your menstrual cycle. Our guide to the birth control pill’s side effects covers these in more detail.

The most common side effects of the birth control patch are breast tenderness, headache, skin irritation where the patch is applied, nausea, abdominal pain, changes to your menstrual cycle, menstrual cramps and certain changes in mood. 

Our guide to the birth control patch’s side effects covers these in more detail. For the most part, the two medications (patch and combined pill) have almost identical lists of side effects, although certain side effects may occur more frequently with one medication than the other. 

In general, the side effects of both forms of contraception are very mild. Most occur shortly after you start taking the medication and disappear over the course of two to three months. It’s highly uncommon to experience persistent side effects from either the birth control patch or the pill. 

If you smoke, your risk of experiencing certain side effects — including cardiovascular issues — is significantly increased for both the patch and the pill. If you’re a smoker, make sure to tell your healthcare provider. Depending on your health history, they may recommend another form of birth control. 

It’s also important to let your healthcare provider know if you have a history of cardiovascular health issues, such as high blood pressure, high cholesterol or if you’ve previously had a heart attack. Other health conditions — such as diabetes — can also increase your risk of side effects. 

The Patch vs. The Pill: Availability

In the United States, the birth control patch is sold as Xulane. Since it’s a hormonal medication, you’ll need a prescription to purchase it. 

Internationally, the birth control patch is also sold under the brand name Evra. It’s a prescription medication in most countries, meaning you’ll need to meet with your healthcare provider to talk about using it before purchasing it from a pharmacy. 

In the United States, the birth control patch is available under a range of brand names. We also offer both the combined and progestin-only birth control pill online, subject to a consultation from one of our licensed healthcare providers.

Which One Is Better for You?

The birth control patch and the birth control pill are both highly effective at preventing accidental or unwanted pregnancy, making either form of contraception a good choice. If you follow the instructions provided with your medication closely, you’ll be 99 percent protected against pregnancy.

If you’re worried about forgetting to take your daily pill, or if you don’t like swallowing medication, the patch might be an appropriate choice for you. After all, you only need to think about it once a week on your patch day.

On the other hand, if you don’t like the idea of wearing a patch all week, or if you don’t have any concerns about forgetting to take your daily pill, the birth control pill could be the best option for you. 

Learn More About the Birth Control Patch

Are you considering the patch as your method of birth control? Our 101 guide to the patch, linked above, goes into more detail about how the contraceptive patch works, how you can use it, the potential side effects you could experience and more. 

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.