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What Is the Birth Control Patch?

The birth control patch is a thin, beige, 1¾-inch (4½-centimeter) square patch that sticks to the skin. It releases hormones through the skin into the bloodstream to prevent pregnancy. Hormones are chemical substances that control the functioning of the body's organs.

How Does the Birth Control Patch Work?

The combination of the hormones progesterone and estrogen in the patch prevents ovulation (the release of an egg from the ovaries during the monthly menstrual cycle). If an egg isn't released, a female can't get pregnant because there's nothing for sperm to fertilize.

The hormones in the patch also thicken the mucus produced in the cervix, making it difficult for sperm to enter and reach any eggs that may have been released. The hormones can also sometimes affect the lining of the uterus so that if the egg is fertilized it will have a hard time attaching to the wall of the uterus.

Like other birth control methods that use hormones, such as the birth control pill or birth control ring, using the birth control patch is based on a female's monthly menstrual cycle. She puts on the patch on the first day of her menstrual cycle or the first Sunday after her menstrual cycle begins. She will change the patch on her skin once a week for 3 weeks in a row. (The patch should be applied to one of these four areas: the abdomen, buttocks, upper outer arm, or upper torso — except for the breasts.) On the fourth week, no patch is worn, and her period should start during this time.

Using the Patch

It's important to apply a new patch on the same day every week to make sure that it keeps working effectively. For example, someone who applies their first patch on a Monday should always apply the patches on a Monday.

When it's time to change the patch, pull the old one off first, before applying a new patch. Place the new patch on a different area from the old patch (but still on one of the four recommended areas) to avoid skin irritation. Don't apply the patch to skin that is red, irritated, or cut.

For the first 7 days on the patch, use an additional form of contraception as well to prevent pregnancy.

If you forget to apply a new patch on the right day, or if the patch becomes loose and falls off, read the instructions that come in the package or call your doctor. If this happens, you might need to use a backup method of birth control (such as condoms) or stop having sex for a while to protect against pregnancy. Also, if you stop using the patch for any reason, you will need to begin using another birth control method, usually after 24 hours of removing your last patch.

It's OK to do regular activities like swimming and exercise while wearing the patch. It can also get wet in the shower or in the bath. Do not remove the patch until the week is over (pulling the patch off to reposition or move it may cause it to lose some of its stickiness and it might fall off easily). If the patch does not stick well, apply a replacement patch. Don't try to decorate the patch, change the size of a patch by trimming it, or try to attach it with tape. Talk to your doctor if the patch falls off.

The patch should not be applied over makeup, creams, lotions, powder, or other skin products as these may prevent it from sticking well. (Skin products may also affect how hormones are absorbed by the skin.) 

When you remove the patch, fold it in half with the sticky sides facing each other (to prevent the chemicals from getting into other items in the trash and going to the soil) and throw it away (don't flush it down the toilet).

How Well Does the Birth Control Patch Work?

Ongoing studies suggest the birth control patch is as effective as the birth control pill. That means that about 9 out of 100 couples will have an unintended pregnancy during the first year of use. Of course, the chance of getting pregnant depends on whether you use the patch correctly. Delaying or missing a weekly application or removing a patch too early lowers its effectiveness and increases the chance of pregnancy.

For girls who weigh more than 198 pounds (90 kilograms), the contraceptive patch may be less effective in preventing pregnancy.

In general, how well each type of birth control method works depends on a lot of things. These include whether a person has any health conditions or is taking any medicines that might interfere with the patch. How effective the patch is at preventing pregnancy also depends on whether the method chosen is convenient — and whether the person remembers to use it correctly all the time.

Does the Birth Control Patch Help Prevent STDs?

The birth control patch does not protect against sexually transmitted diseases (STDs). Couples having sex must always use condoms along with the birth control patch to protect against STDs.

Abstinence (the decision to not have sex or any genital intimacy) is the only method that always prevents pregnancy and STDs.

Are There Any Problems With the Birth Control Patch?

The birth control patch is a safe and effective method of birth control. Most people who use the patch have no side effects. Smoking cigarettes while using the patch can increase the risk of certain side effects, which is why health professionals advise those who use the patch not to smoke.

Side effects that can happen with the patch are similar to those with the birth control pill. These may include:

  • irregular menstrual bleeding
  • nausea, headaches, dizziness, and breast tenderness
  • mood changes
  • blood clots (rare in those under 35 who do not smoke, but there may be a higher risk with the patch than with the Pill)

Other possible side effects seen in patch users include:

  • skin reactions at the site of application of the patch
  • problems with contact lens use — a change in vision or inability to wear the lenses
  • menstrual cramps

Many of these side effects are mild and tend to disappear after 2 or 3 months.

Who Is the Birth Control Patch Right for?

The birth control patch may be a good choice for someone who's sexually active, weighs less than 198 pounds (90 kilograms), and finds it hard to remember to take a pill every day or who has trouble swallowing pills.

In some cases, medical or other conditions make the use of the patch less effective or more risky. For example, it's not recommended for someone who has had blood clots, severe high blood pressure, some cancers, certain types of migraine headaches, or diabetes with certain problems. Anyone with unexplained vaginal bleeding (bleeding that's not during their periods) or who think they may be pregnant should talk to their doctors, discontinue using the patch, and use another form of birth control in the meantime.

Where Is the Birth Control Patch Available?

A doctor or a nurse practitioner (NP) must prescribe the patch. They'll ask questions about your health and family medical history, and may also do an exam, including a blood pressure check and possibly a pelvic exam. If recommending the patch, the doctor or NP will write a prescription and give you instructions on how to use it.

Those who start using the patch may be asked to return within a few months for a blood pressure measurement and to make sure that there are no problems. After that, a doctor may recommend routine exams once or twice a year or as needed.

How Much Does the Birth Control Patch Cost?

The cost of the patch can range from free to around $85 a month. Check your health insurance plan and what programs are available (such as Planned Parenthood) to get the best price.

Medically reviewed by: Lonna P. Gordon, MD
Date reviewed: January 2022