How to use Birth Control Patch to Avoid Pregnancy & Its Effectiveness

Understanding & Using a Birth Control Patch

Medically Reviewed By
Dr. Sabiha Anjum (Gynecologist/Obstetrician)
View more Gynecologist/Obstetrician Our Panel of Experts

Birth control methods have evolved over the ages to increase in effectiveness and convenience. The birth control patch is yet another kind of birth control method that can prevent unwanted pregnancy.

What is a Birth Control Patch?

A birth control patch (or Ortho Evra or Evra patch) is a patch which can be stuck to your body to help you in preventing pregnancy.

The Ortho Evra birth control patch has been recently replaced by a Xulane patch due to a change in the manufacturing company.

Please note that there are other birth control methods also available like vaginal patches and birth control pills. If you are looking for an effective birth control option, it is advisable to speak to your doctor who will prescribe the birth control patch which is most suitable for you.

How Does the Patch Work?

If you’re baffled on how the contraceptive patch works, here’s the answer. This birth control contraceptive patch works by releasing hormones (oestrogen and progestogen) like other birth control methods and preventing pregnancy. The hormones are absorbed through the skin. The patch stops ovulation and thickens the mucus in the cervix. The thick mucus makes it difficult for the sperm to reach the egg.

When you are using the patch, you will not be able to see any change in it or feel it working. However, it is continuously releasing the hormones, estrogen and progestin, into your blood. To keep it working effectively, you need to change the patch each week for three weeks. You also need to remember to start the next cycle of patches after the fourth patch-free week.

How to Use a Birth Control Patch

How to Use a Birth Control Patch

To use a birth control patch, first, you need to decide where to put the birth control patch on your body. The patch can be stuck on clean, dry skin, like the outer arm, stomach or back.

You should peel half of the plastic liner and avoid touching the sticky side of the patch. The sticky side should be applied to the body part which you have chosen, and then the liner needs to be peeled off. This sums up how to apply birth control patch easily on your own.

Ensure the area of skin you choose is clean and dry. The patch should not be applied if there is any skin irritation.

When Can You Use it?

This patch should be applied on the skin once in a week for three weeks. It should be removed in the fourth week, which is when you have your period. After seven patch-free days, you can apply a new one.

It is important to apply a new patch at the end of the patch-free week, or else it increases the risk of pregnancy. You may still be bleeding or spotting by the time you put on the new patch, which is normal. In case you want to skip your periods, then you may skip the patch-free week and start a new month of patches.

You may start using the patch any day in the month. However, the effectiveness depends on when you start using the patch, hence initially you may have to use a backup birth control method. If you start using the patch within the first 5 days of your periods, then it starts working right away and you will not need to use a backup birth control method. You can start using the patch any day of the cycle.

You should put on a new patch on the same day each week. The patch should be checked to make sure that it is in place.

How Effective is the Birth Control Patch?

If the patch is applied correctly for the three weeks, it can be more the 99% effective in preventing pregnancy. The effectiveness of the birth control patch depends upon the correct application of the patch, which allows the release of the hormones in the body in the correct manner.

As per statistics by Planned Parenthood:

  • Less than 1 out of 100 women have the chance of getting pregnant if the patch is used as per the directions.
  • About 9 women out of 100 will get pregnant if the patch is not used as per directions.

This birth control method is less effective for overweight women and for those who are taking other medication or supplements. You should consult your doctor about the medications to see if they will affect the patch. The patch does not protect against sexually transmitted infections so a condom should be used to reduce the risk of such infections.

What Can Be the Side Effects of the Birth Control Patch?

Ortho Evra is a contraceptive patch which is a combination of female hormones that prevent ovulation. Some side effects of the contraceptive patch are:

What Can Be the Side Effects of the Birth Control Patch?

  • Nausea
  • Vaginal bleeding or clotting
  • Vomiting
  • Headache
  • Irritation on the skin where the patch has been applied
  • Dizziness
  • Breasts may become tender, enlarge, or swell
  • Discharge from the nipples
  • Irritation or itching in the vagina
  • Increased vaginal discharge
  • Missed or irregular periods
  • Acne
  • Severe stomach ache
  • Bloating
  • Darkening of facial skin
  • Increase in hair growth
  • Loss of hair on the scalp
  • Changes in weight or appetite
  • Reduced sex drive

Please note that these side effects are rare, and not all women experience them. You should consult your doctor if you find any serious side effects like:

  • Breast lump
  • Mood swings
  • Severe abdominal pain
  • Dark coloured urine
  • Yellowing eyes or skin

Who Shouldn’t Use the Birth Control Patch?

Although most women can use the patch, there are some risks associated with this form of contraception. These risks are rare and are mostly caused by other medical conditions or medications that you may be taking.

Women should not use this patch if:

Who Shouldn’t Use the Birth Control Patch?

  1. You have high blood pressure, diabetes, are overweight or have high cholesterol.
  2. If you smoke (the risk of blood clots and stroke is increased).
  3. Ortho Evra should not be used if you are more than 35 years old.
  4. If you are pregnant, you should stop using the birth control patch.
  5. You have missed two menstrual periods back to back.
  6. You have recently delivered a baby (it’s best to wait for 4 weeks before using the birth control patch).
  7. There is abnormal vaginal bleeding for which you have not consulted the doctor.
  8. There is a history of stroke or attack.
  9. You have heart problems that cause blood in the heart to clot, such as uncontrolled valve disorder, or a rhythm disorder.
  10. You have an inherited blood-clotting disorder.
  11. You have problems with your eyes or kidneys.
  12. You have a history of hormone-related cancer.
  13. Suffer from severe migraines.

Comparing Advantages

There are a lot of contraception options available today. However, while evaluating the right option for you, you should consider a few things like –

  • Do you want an option with low maintenance or one that is long term?
  • What are the health risks attached to the birth control option?

Pros of Using a Birth Control Patch

  • The patch is extremely low maintenance, convenient, safe and affordable.
  • The patch contains the same hormones as the birth control pills, which are oestrogen and progestin. The only difference is that the patch needs to be applied once a week and the pill has to be taken every day.
  • A birth control patch will deliver a steady dose of hormones into your body, so it works similar to the birth control pill.
  • Hormone levels do not fluctuate if there is a steady stream of hormones being released into the body.
  • The birth control patch is a reliable pregnancy protection for women.

Cons of Using a Birth Control Patch

  • Since the patch is stuck to your body, there is a chance that it may fall off. You can reapply the same one or a new one immediately.
  • There are some side effects of the patch (though rare). Since the patch comes with an increased dosage of hormones compared to the pill, the side effects may be more intense than with the birth control pill.
  • The type of progestin may increase the risk of blood clots and heart attack more than usual. As per reports, the risk could be up to 60% higher. Overall, however, the chance of having even one of these serious side effects is still low.
  • The birth control patch causes skin irritation.

Does Birth Control Patch Protect Against Sexually Transmitted Diseases (STDs)?

The birth control patch does not protect you against sexually transmitted diseases. Any couple who is having sex must use a condom (male or female) alongside the patch for protection against STDs. The best part about using a condom is that they also prevent pregnancy, so it is like using two methods of birth control.

What If I Decide to Get Pregnant? What Should I Do?

If you decide to get pregnant, then you have to just stop using the birth control patch. The fertility returns as soon as the patch is removed, typically within a few weeks. In some cases, it may take a few months as well.

After discontinuing with the birth control patch, you may start using a condom. It is advisable to wait for one menstrual cycle before you start trying to conceive.

It is important that you consult your doctor before you start trying.

You should also have some dosage of folic acid (400 mg) every day, at least one month in advance before you start trying to conceive.

What Happens If I forget to Change the Patch?

The patch, when used correctly is a highly effective method of contraception. However, its effectiveness can go down if you fail to use it properly.

Following are a few guidelines to help you in case you forget to apply your patch (depending on which week of your cycle you are in):

  • Week 1, First Patch – If you have forgotten to apply the patch on your scheduled start day, then you should stick on the new patch as soon as you remember. This day then becomes your change day for every week. In order to avoid pregnancy, use a back-up birth control method for seven days.
  • Weeks 2 or 3, Second or Third Patch – Since there are two days of continued release of hormones, there is a two-day window to change the patch at the start of week 2 or 3. In case you have left the patch on for up to two days more, then you can apply the new patch at this time. There is no requirement of changing the patch-change day or additional contraception. If you have forgotten to replace the patch for more than two days, then there is a high risk of failure of the birth control method. In case you have had sex during this time, you may use emergency contraception and use backup contraception for seven days.
  • Forget Taking Off Your Third Patch – If you have forgotten to take off the patch at the beginning of Week 4, don’t worry. Just remove it whenever you remember and can begin your new cycle (Week 1) on the regular scheduled patch change day.


Here are a few frequently asked questions about birth control patches.

1. Can I use the patch during breastfeeding?

If you are breastfeeding and all is going well for the initial six weeks, it is alright to use the birth control patch. However, if you are not able to produce as much milk as you would like or are facing issues in nursing the baby, then you should avoid using the patch, as this may reduce the amount of milk that you will produce.

2. What if the patch falls off?

If the birth control patch falls off or becomes loose, you should remove it and replace it with a new patch. If the patch has been removed for more than 24 hours, then you are not protected during this time and need to use an alternate form of contraception for the next seven days after the new patch is applied.

If the patch has been removed for more than 24 hours and you have had unprotected intercourse during the time, then you should use emergency contraception to decrease the risk of pregnancy.

3. What would I do if I don’t get my period during my patch-free week?

Usually, a woman gets her periods within two to three days after the patch has been removed—some experience scanty bleeding.

Some women may skip the period altogether. If you been using the patch as per directions and you still skip the periods, there is no need to panic. You should just apply a new patch as per schedule.

However, if you miss two periods consecutively or miss a period when you have not used the patch correctly, you may be pregnant. You should call your doctor before applying the next patch and use an alternate contraceptive in the meantime.

4. Can I apply the patch on the same area?

You can change the area to apply the patch every week. It helps to keep changing the location of the patch.

5. Is it safe to stop using patch occasionally?

As long as you do not develop a problem with the patch, which would require you to stop using it, there is no medical reason to stop using it or take a break. You may stop using it if you switch to another reliable contraceptive method.

6. Are there any medications that reduce the effect of the patch?

Yes, there are some medications and supplements which may reduce the effectiveness of the birth control patch. Some of them include antibiotics like Rifampin, Rifampicin, and Rifamate and a few anti-seizure medicines. Also, hormonal contraceptives may lessen the potency of other drugs. You should always inform your doctor about the patch when required.

You also need to tell the doctor prescribing the patch about other medications and supplements that you take. Mostly, medications, including routine antibiotics, will not reduce the effectiveness of the patch. However, if you are required to take medication which may interfere with the contraceptive action, then you can opt for an alternate method of contraception.

7. Can I use it in water?

Yes, you can. The patches are generally waterproof and do not lose their potency in water. They can be used while swimming, bathing, or showering and their effect will not decrease.


Birth control patches are effective only when used in the right way with proper care and dedication. For the best results, it is best to consult your doctor before making this your primary choice of contraception.

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