The birth control patch is a small adhesive patch that you wear on your skin. It is used to prevent pregnancy by delivering hormonal contraception through the skin.
The birth control patch works similarly to combination oral birth control pills. It prevents pregnancy by releasing hormones into your bloodstream that keep your ovaries from releasing an egg.
There are currently two birth control patch brands approved in the United States: Xulane and Twirla. Both deliver an estrogen and a progestin, similar to a combination oral pill. However, the type of progestin is different in each patch.
The birth control patch is worn for a week at a time for 3 weeks in a row. During the fourth week, you do not wear the patch, and this is when you have your period. After the fourth week, the cycle is repeated, and you apply a new patch. You need to remember to apply the patch the same day of the week, even if you are still bleeding.
A healthcare professional must prescribe the birth control patch. It does not protect against sexually transmitted infections (STIs).
The birth control patch releases hormones called estrogen and progestin, which are absorbed through the skin into the body. Estrogen and progestin prevent ovulation — meaning, they stop your ovaries from releasing an egg.
Estrogen and progestin also thin the lining of the uterus, which makes it harder for a fertilized egg to implant into the uterus. Lastly, the two hormones thicken the cervical mucus, which makes it harder for sperm to reach the egg.
The patch can be placed on the:
- upper back
- upper arm
It cannot be placed on the breasts. Estrogen- or progesterone-containing items should never be placed on the breasts due to the risk of breast cancer.
The patch is hormonal and contains estrogen (ethinyl estradiol) and progestin (levonorgestrel or norelgestromin). The Xulane patch contains ethinyl estradiol and norelgestromin. The Twirla patch contains ethinyl estradiol and levonorgestrel.
The patch is 99 percent effective with perfect use. It is 91 percent effective with typical use. This means that 9 pregnancies per 100 people per year are expected with typical use.
Ways that some people misuse the patch include:
- not changing the patch weekly as prescribed
- not replacing the patch if it becomes detached
- not realizing when the patch has fallen off
You should be able to wear the patch while exercising.
You should also avoid using creams, lotions, or oils on the skin where the patch is placed.
An ideal candidate for the birth control patch is a person who prefers a contraceptive option that’s:
- not taken or applied daily
It is also good for a sexually active person who finds it difficult to remember to take a pill every day or who may not be able to swallow pills.
The ideal candidate will also weigh less than 198 pounds. The birth control patch is not as effective in people who weigh over this amount.
This is due to the fact that it takes twice as long for the body of a person with overweight or obesity to adjust and respond to the contraceptive. And it’s not just upon starting the patch. This adjustment period may occur every time a new patch is applied, potentially making it less effective.
Women with body mass indexes (BMI) over 30 are likely to experience more blood clots (thromboembolic events) than those with BMIs under 30.
People should not use the birth control patch if they:
- have high blood pressure
- have a history of stroke, heart attack, or blood clots
- have a history of migraine with aura
- have some forms of lupus
- have breast cancer or a history of breast cancer
- have diabetes
The birth control patch should also not be used by people who experience hypersensitive reactions to topical bandages or adhesive applications.
You should speak with your doctor if you have any questions or concerns about whether or not the patch is a good option for you.
The patch is not recommended for women over age 35 who smoke. Cigarette smoking increases the risk of serious side effects from the patch, including strokes, heart attacks, and blood clots. Women over 35 who are not overweight and who don’t have uncontrolled hypertension (high blood pressure), or a clotting disorder may use the patch.
The pros of the patch are:
- You don’t have to remember to take it every day.
- It does not interfere with sex.
- It may make your period more regular, lighter, and shorter.
- It may reduce cancer of the uterus and ovaries.
- It may reduce menstrual cramps.
- It may reduce acne facial hair growth.
The cons of the patch are:
- It may cause skin irritation.
- It may cause breakthrough bleeding.
- It may cause breast tenderness.
- It may cause nausea and vomiting.
- It may cause weight gain.
- It may cause headache.
- It does not protect against HIV and other STIs.
The birth control patch is a hormonal form of birth control that comes in the form of a small adhesive patch you wear on your skin. It works similarly to combination oral birth control pills by releasing hormones into your bloodstream that prevent your ovaries from releasing an egg.
Stacy Henigsman, DO, is an OB/GYN working with Allara Health. She is board-certified by the American Osteopathic Board of Obstetrics and Gynecology. Henigsman received her DO from Western University and completed her OB/GYN training at the University of California, Irvine.
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