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The Birth Control Patch 101: How it Works, Side Effects & More

Kristin Hall

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 7/26/2020

If you’re sexually active and don’t want to become pregnant, it’s essential that you use some form of protection.

The birth control patch is a highly effective and convenient way to decrease your chance of becoming pregnant. 

Easy to use, readily available and affordable, it offers a range of advantages over other forms of birth control such as condoms, the pill, the ring and the injection. 

Similar to the birth control pill, the birth control patch uses hormones to reduce your risk of becoming pregnant. In the United States, the patch is sold under a variety of brand names, including popular options such as Xulane® and Ortho Evra®.

Below, we’ve explained how the birth control patch works, as well as how to use the patch to prevent yourself from becoming pregnant. We’ve also covered the patch’s major advantages and disadvantages compared to other contraceptives, as well as its potential side effects.

What is the Birth Control Patch? 

The birth control patch is a small, square patch that’s worn on your skin to decrease your chances of becoming pregnant. Discreet and convenient, the patch is similar in size to a medium-sized Band-Aid®, making it easy to hide out of sight under your clothing. 

Like other forms of birth control, the patch uses certain hormones to stop you from becoming pregnant. Each patch contains a small dose of estrogen and progestin hormones. When you wear the patch, your body absorbs these hormones through the skin. 

The birth control patch is sold around the world under a variety of brand names. In the United States, the most common are Xulane and Ortho Evra. Both of these patches contain the same active ingredients — a combination of ethinyl estradiol and norelgestromin. 

Before you can buy the birth control patch, you’ll need a prescription from your healthcare provider. 

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How Does the Birth Control Patch Work?

The birth control patch works in the same way as a combined birth control pill — by releasing a combination of estrogen and progestin hormones into your body to lower your risk of becoming pregnant. 

Most brands of the birth control patch, such as Xulane, contain a mix of ethinyl estradiol (a type of synthetic estrogen hormone) and norelgestromin (a progestin hormone). 

After these hormones are absorbed by your body, they block you from ovulating, meaning your ovaries stop releasing eggs. By stopping your ovaries from releasing eggs, it becomes harder for sperm to come into contact with an egg and fertilize it.

The hormones in the patch also thicken your cervical mucus, making it more difficult for sperm to enter into your uterus. Finally, they also change your uterine lining, making it less likely that a fertilized egg can successfully attach itself to the lining of your uterus.

Like other forms of hormonal contraception, the birth control patch doesn’t protect you from any sexually transmitted diseases (STDs). 

How Effective is the Birth Control Patch?

With perfect usage, the patch is 99 percent effective at preventing you from becoming pregnant. This means that roughly one out of every 100 women who use the birth control patch perfectly will get pregnant per year.

Under normal, real-life conditions, the patch is 91 percent effective, meaning about nine out of every 100 women who use the patch will get pregnant every year. 

This makes the patch similar in effectiveness to combined birth control pills such as Yaz®, which is 99 percent and 92 percent effective with perfect and real-life usage. 

The patch becomes less effective if you forget to change it at the right time, if it falls off before a week has passed or if you don’t apply it correctly. It might also be less effective if your weight is higher than 198 pounds (we’ve explained this in more detail further down the page). 

How to Use The Birth Control Patch

Using the birth control patch is simple. To get started, simply apply the patch to your body. Each patch lasts for seven days, meaning you’ll need to replace the patch exactly one week from the date you first put it on.

This makes it easy to set a schedule for replacing your patch — just set aside one day per week as your “patch day” to switch from your current patch to the next one.

After you’ve used three patches (meaning 21 days have passed), you’ll need to have one week without the patch. During this week, you’ll get withdrawal bleeding similar to your period. After a week has passed without you using the patch, it’s time to start your next cycle. 

If you don’t want to get withdrawal bleeding every 21 days, you can use the birth control patch to skip your period. To do this, start using a new pack of patches every three weeks, without a break between packs. 

The birth control patch is effective right away if you apply your first patch within five days of the start of your period. This means that you can have sex with your partner without needing to use a condom (although it’s important to remember that you won’t be protected from STDs). 

If you apply your first patch more than five days after the start of your period, it won’t start working immediately. To stay protected, you’ll need to use a condom for seven days. After seven days have passed, you can have sex without using a condom or other form of birth control.  

How to Apply the Birth Control Patch

Applying the birth control patch is a simple process. Open the pouch containing the patch and remove the protective film. Apply the patch by pressing down gently on your skin. Count to 10 as you’re pressing down on the patch to make sure it’s properly attached to your skin. 

You can attach the birth control patch to your upper outer arm, upper torso, buttocks or abdomen. Do not apply the birth control patch to your breasts. 

Before applying the patch, check that your skin is clean and completely dry. The patch works best when it’s applied to skin that doesn’t have very much hair. Don’t use lotion, oils, powder or makeup on the skin where you put your patch — that can keep the patch from sticking.

On “patch day,” peel off the old birth control patch and replace it with a new one. Fold the old patch in on itself so that the adhesive and hormone surface is covered, then store it inside a sealed plastic bag before throwing it away. 

It’s best to store your unused birth control patches in a dry, room temperature location that’s away from direct sunlight. Think: your medicine cabinet and bedside table. Make sure you keep each patch inside its protective pouch until you need to use it. 

What if the Birth Control Patch Falls Off? 

The adhesive used on the patch is designed to stay attached to your skin in a wide range of circumstances, meaning it’s unlikely that it will fall off. You can safely swim, shower, exercise until you’re sweating heavily and even use a sauna without affecting the patch. 

However, it is possible for the patch to come loose and fall off. If this happens, there are two things that you can do:

  • If it’s been less than two days (48 hours) since the patch fell off, stick it back on. If it sticks, use it. If it doesn’t, replace it with a new patch and replace your patch on your normal “patch day.”

  • If it’s been more than two days since the patch fell off, do not stick it back on. Instead, apply a new patch and start a new cycle from the beginning. Take note of the day you applied the replacement patch — this is your new “patch day.”

    To keep yourself protected from pregnancy, use condoms for at least seven days after you start your new birth control patch cycle. 

In general, it’s uncommon for the birth control patch to fall off. If your patch falls off often, it’s possible that you aren’t applying it to your skin correctly. Follow the instructions above (make sure to press down gently on the patch for 10 seconds) to check that it’s applied evenly. 

Advantages of the Birth Control Patch

The biggest advantage of the birth control patch is its convenience. The patch is easy to use and only needs to be applied to your body once a week, meaning there’s less of a risk of you forgetting to use it on time than with a daily use birth control pill. 

Since the hormones in the patch are absorbed dermally, they won’t disrupt your stomach. This means it won’t be less effective if you have a condition that affects your ability to digest food or absorb medication through the stomach. 

As well as its convenience, the patch offers all of the same benefits as other forms of hormonal birth control. It can lighten your periods, make PMS symptoms easier to tolerate and even lower your risk of developing ovarian cysts and certain forms of cancer, such as endometrial, ovarian and colorectal cancers.

Disadvantages of the Birth Control Patch

The biggest disadvantage of the birth control patch is that you need to wear it on your skin for it to remain effective. 

Experts typically recommend wearing the patch on your upper torso, upper outer arm, buttocks or abdomen for optimal effectiveness. These areas are usually easy to hide in clothing, but can make your patch difficult to cover if you need to wear a bathing suit or gym clothes.

Since the patch looks almost identical to a Band-Aid, this usually isn't a big deal. However, it’s definitely a disadvantage that’s worth keeping in mind if you swim, work out or play sports that require you to wear clothing that might reveal your birth control patch. 

The patch is waterproof and will stay firmly attached to your skin in most conditions. However, it’s still possible for it to fall off in some situations. In this case, you’ll need to either stick it back on (if the adhesive is still effective) or replace it with another patch.

Although it’s uncommon, the patch can cause some skin irritation, redness and itching for some women. 

Since the patch is a form of hormonal contraception, it has similar side effects to the combined birth control pill. After you start using the patch, you might experience headaches, nausea and breast tenderness, as well as mood changes and light bleeding in between periods. 

We’ve covered these side effects in more detail below. For most women, they’re mild and only occur after you first start using the patch. Once your body adjusts to the hormones in the patch, it’s unusual to experience anything other than very mild side effects. 

Like other forms of hormonal contraception, the birth control patch may not be fully effective if you weigh more than 198 pounds (90 kg). Options such as the birth control implant and copper IUD are both safe and effective contraceptives for women with a high BMI. 

Finally, certain medications can interact with the birth control patch, making it less effective at preventing pregnancy. Like the side effects of the patch, we’ve covered these in greater detail below. 

Side Effects of the Birth Control Patch

The birth control patch is a safe, highly effective form of contraception. The majority of women who use it don’t experience any issues. However, like all hormonal medications, the patch can occasionally cause side effects.

For the most part, birth control patch has similar side effects of combined birth control pill

According to the FDA, the most common side effects of the birth control patch are headaches, nausea and skin irritation where the patch is applied. The patch could also make your breasts feel tender and slightly painful. 

Other side effects include abdominal pain, discomfort during your period, mood swings, muscle spasms, acne, diarrhea, dizziness and fatigue. It’s also common to retain a small amount more fluid than normal after you start using the patch, which is easy to mistake for weight gain. 

However, in some cases, you may retain enough fluid to cause your ankles and fingers to swell, or to cause a rise in blood pressure. If this is the case, contact your healthcare provider.

Like other hormonal contraceptives, the birth control patch can cause spotting — light bleeding that occurs outside your normal period. Most of the time, these side effects are temporary and will pass on their own after you’ve used the patch for several months.

Although they’re highly uncommon, the birth control patch is also associated with several more severe side effects. These include an increased risk of certain cardiovascular issues, including hypertension, heart attack and stroke.

Many of these side effects are significantly more common in smokers, particularly smokers aged 35 and older. Our guide to the side effects of the birth control patch explains them in more detail, with data on how common each side effect is and why it happens. 

While these side effects can sound scary, it’s important to remember that the birth control patch and other forms of hormonal contraception are used safely and effectively by millions of women around the world. Serious side effects, although alarming, are very rare. 

So, Is It Worth It? 

The birth control patch is a safe, convenient and highly effective form of contraception. Used in normal, real-life conditions, the patch is between 91percent and 99 percent effective at preventing unwanted pregnancy.

Thanks to its convenience factor and effectiveness, the patch is a useful alternative to the birth control pill. However, like all forms of birth control, it’s important to use it correctly to make sure you’re fully protected. 

Learn More About the Birth Control Patch

Interested in learning more about using the patch to prevent yourself from getting pregnant? Our guide to the birth control patch vs. the pill compares these two common forms of birth control in more detail, with information on each option’s unique advantages and disadvantages. 

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.