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Contraceptive patch

The contraceptive patch, is a small beige 5cm by 5cm patch that is applied to the skin like a plaster. To prevent pregnancy, it controls fertility by releasing two hormones through the skin; oestrogen and progestogen which are similar to those produced naturally in women's ovaries. The brand that is currently available in the UK is Evra.

Here are some key facts:    

  • The patch is over 99% effective when it is used correctly
  • You wear each patch for one week, change it every week for three weeks and then have a patch-free week
  • You can wear the patch in the bath or swimming pool
  • You usually experience a monthly ‘withdrawal bleed’
  • It can help with heavy periods and pre-menstrual symptoms (PMS)
  • It can help with acne
  • Unlike some methods of contraception, the patch is not affected by diarrhoea or vomiting because the hormones don't need to be absorbed by the stomach
  • Some medicines can affect how well it works
  • It doesn't protect you against sexually transmitted infections (STIs) so use a condom as well

How does the patch work?

Pregnancy happens when sperm reaches an egg and fertilises it. The patch works in three ways to interrupt this process:

  • It stops eggs being released from the ovaries (ovulation)
  • It makes it harder for the sperm to reach the egg
  • It makes the uterus (or womb) lining thinner so that a fertilised egg cannot implant.

If used correctly, the patch is over 99% effective at preventing pregnancy. This means that less than one woman in 100 will get pregnant in a year.

 

How do you get the patch?

The contraceptive patch is available free of charge from a range of services including contraceptive clinics, your GP and Brook. Find your nearest using our find a service tool.

When you go to get the patch, an appointment will typically include:

  • A few questions about your medical and family history, to work out what would suit you best.
  • You'll discuss other medicines you are taking in case they make the patch less effective.
  • The doctor or nurse will take your blood pressure and they will weigh you.

You will not be required to have an internal or breast examination for the patch.

When you first start the patch you will usually be given a three month supply. Follow up appointments and reviews can be up to every 12 months providing there are no issues. You can return to the clinic at any time if you are worried about anything. If you wish to change to a different method, talk to your doctor or nurse as you may need to miss out the patch-free week or use additional contraception.

Contraception and sexual health services such as Brook are free and confidential, including for people under the age of 16. Health professionals work to strict guidelines and won’t tell anyone else about your visit unless they believe you're at serious risk of immediate harm. Find out more about Brook’s confidentiality policy.

How do you use the patch?

The patch is worn continuously for seven days, on the eighth day it should be changed, by removing it, throwing it away carefully using the disposal sachet provided and immediately putting a new one on. The patch should be changed every week for three weeks (21 days).

After three weeks you don't wear a patch for seven days. Most women have a bleed at some point during the seven-day break. After the break, you should apply a new patch and start the four-week patch cycle again. You should apply the new patch even if you are still bleeding.

Where you can wear the patch

Patches can be worn discreetly on most areas of the body, including the upper arm, shoulder or buttocks, but should not be applied to the breasts or to broken or irritated skin.

You should avoid placing the patch anywhere that may be rubbed by tight clothing, and change the position of each patch to help reduce the chance of skin irritation. You should also avoid covering the patch with body cream or lotions, as these may cause it to become loose. 

Advantages of the contraceptive patch

  • It doesn’t interrupt sex
  • You only have to replace the patch once a week
  • Unlike some methods, the patch is not affected by diarrhoea or vomiting because the hormones don't need to be absorbed by the stomach
  • There is no evidence that it causes additional weight gain
  • There are no long term effects to your fertility
  • It can help make bleeds lighter and more regular, and reduce period pains
  • It may also help to reduce premenstrual symptoms (PMS)
  • It can improve acne in some people
  • The patch can also have additional health benefits, such as reducing the risk of some cancers

Disadvantages of the contraceptive patch

Any medication can have some side effects and a very small number of women may develop complications, but discussing you and your family’s medical history with the doctor or nurse will help reduce the risk of negative side effects.

For most women the benefits will outweigh the possible risks. Disadvantages can include:

  • Temporary side effects during the first few months including headaches, nausea, breast tenderness and mood swings
  • In the first few months of use there can be breakthrough bleeding and spotting
  • It doesn’t protect you against sexually transmitted infections (STIs), so you will need to use a barrier method such as condoms
  • It can cause skin irritation in some women
  • It can be seen

Starting to use the patch and when you are protected from pregnancy

You can start the patch at any time in your menstrual cycle. If you put the first one on in the first five days of your period, you will be protected against pregnancy straight away. 

If you start using it after day five of your period, you need to use a barrier method of contraception (such as condoms) for the first seven days.

If you have a short menstrual cycle, where your period normally comes every 23 days or less, starting the patch on the fifth day of your period may mean you are not immediately protected (because you might ovulate early in your menstrual cycle). If you think this might be the case, speak with a doctor or nurse about whether you need to use additional contraception, such as condoms.

What if the patch falls off?

The patch should stay on as it is very sticky. However, if it does fall off, what you need to do depends on how long it has been off.

  • If it has been off for less than 48 hours, stick the patch back on as soon as possible. If it does not stick don’t try to hold it in place with anything else – you will need to replace it with a new patch. You can now continue to use your patch as normal and change to a new patch on your usual change day. No additional contraception is required providing there has been consistent and correct use for seven days prior to the removal / detachment.
  • If the patch has been off for more than 48 hours, apply a new patch as soon as possible and start a new four-week patch cycle. Use another form of contraception, such as condoms, for the next seven days. If you had unprotected sex in the previous few days you will need to speak to a doctor or nurse as you may need emergency contraception. 

What if I forget to take the patch off or put a new patch on?

This depends on where you are in the four-week patch cycle, and how long you have forgotten to take the patch off or put on a new one.

After week one or two in the cycle:

  • If it has been on for less than 48 hours longer, take off the old patch and put on a new one. Continue to use your patch as normal, changing it on your normal change day. You don’t need to use any additional contraception and you are protected against pregnancy.
  • If it has been on for more than 48 hours longer, you will need to start a whole new four-week patch cycle by applying a new patch as soon as possible. This is the first day of your cycle. Use another method of contraception, such as condoms, for the next seven days. If you had unprotected sex in the previous few days you will need to speak to a doctor or nurse as you may need emergency contraception.

After week three in the cycle:

  • Take the patch off as soon as possible and start your patch-free break. Start a new patch on your usual start day. You will be protected against pregnancy and do not need to use any additional contraception. 
  • If you are more than seven days late in removing your patch you may not be protected against pregnancy. Put on a new patch – this is the beginning of a new patch cycle. You may need to use additional contraception, such as condoms, or use emergency contraception if you have had sex in the previous few days. Seek advice from your doctor or nurse.

After the patch-free week:

  • Put on a new patch as soon as you remember – this is now the beginning of your new four-week patch cycle. If you put the new patch on less than 48 hours late, you will still be protected against pregnancy as long as you wore the patch correctly before the patch-free interval.
  • If you put the new patch on more than 48 hours late you may not be protected against pregnancy and will need to use additional contraception, such as condoms, for seven days. If you had unprotected sex in the previous few days you will need to speak to a doctor or nurse as you may need emergency contraception.

Things that interfere with how the patch works

  • Forgetting to change the patch after seven days
  • If the patch falls off
  • If you forget to put a new one on at the end of the week
  • If you forget to put a new one on after your seven day break
  • Some medicines can reduce the effectiveness of the patch, such as those used to treat epilepsy, HIV and TB and the complementary medicine St John's Wort. Commonly used antibiotics do not reduce the effectiveness of the patch, but it is always best to check with the doctor, nurse or pharmacist first

How will it affect periods?

At some point during your patch-free week most women will have a bleed. This is called a 'withdrawal bleed' (which doesn’t always happen) and it can start at any point during the seven-day break. This bleeding is brought on by the reduction in hormones, from not wearing a patch during the seven-day break.

This can happen at any point during this patch-free week, and you should start using your next patch on time whether or not you are still bleeding.

In the first few months of using the patch there can be some breakthrough bleeding or spotting. This should settle down after around three months and it is important to continue using the patch correctly.

Can you miss out the patch-free week?

Some people do this when they want to put off bleeding, for example if they are going on holiday. You can miss out the patch-free week by using another patch straight away. This isn’t harmful and you will still be protected against pregnancy. Sometimes you will still get bleeding. 

What happens when you stop using the contraceptive patch?

Maybe you want to get pregnant or perhaps you’d like to use a form of long-acting reversible contraception (LARC) that doesn’t involve changing a patch every week. Here's what happens when you stop using the contraceptive patch.

How quickly the hormones leave your system: the hormones from the patch will usually leave your body within a couple of days - no matter how long you have been using the patch for.

How quickly you can get pregnant: this will vary, and will depend on when ovulation (releasing an egg) starts up again. For some people, it may be a matter of days or weeks, for others it may take up to three months. But generally speaking, fertility levels should return quite rapidly, so it’s important to use another method of contraception if you don’t want to get pregnant.

What happens to your periods: if you find you have irregular periods after stopping using the patch and are worried, or if it's taking a long time for your periods to start again, you can ask your doctor or nurse for advice.

What physical changes there might be: everyone reacts slightly differently when they stop using the patch. Some people may find they have skin problems initially, although as your hormone levels self-regulate over the course of a few weeks or months, symptoms may subside once again. If symptoms persist or worsen please see your doctor or nurse for help and advice. 

If you stop using the patch but don't want to become pregnant remember to use another method of contraception

Using the contraceptive patch after having a baby

You can start to use the patch from 21 days after giving birth. If you start on day 21 you will be protected from pregnancy straight away. If you start after 21 days you will need to use additional contraception for seven days. If you are breastfeeding a baby under six months old a different method of contraception is usually recommended as the patch can reduce your flow of milk.

Using the contraceptive patch after an abortion or miscarriage

You can start using the patch immediately after a miscarriage or abortion and you will be protected from pregnancy immediately.

Last review: August 2017
Next review: August 2019