The contraceptive patch (Ortho Evra)

Originally Published: September 20, 2002 - Last Updated / Reviewed On: December 5, 2014
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Dear Alice,

I saw this commercial on TV last night about the birth control patch. Is it as good as the pill? Do you keep the same patch on for a week or do you have to remember to put one on every day just like having to remember to take the pill? I was just wondering, because I forget a lot to take my pill and just wanted to know if that was easier. Are the side effects worse than the pill?

Thanks!

Dear Reader,

As effective as the birth control pill, the prescription contraceptive, Ortho Evra, is the first birth control patch to be approved by the U.S. Food and Drug Administration (FDA). The contraceptive patch is 99 percent effective in preventing pregnancy when it's used correctly and consistently according to the manufacturer’s guidelines. You’re smart to consider an alternative birth control option, such as the contraceptive patch, if forgetting to take the pill occurs frequently. Unlike the daily regimen of the pill, you only have to remember to replace the patch with a new one three times a month. As far as the side effects are concerned, it’s hard to say whether the patch's potential side effects are worse than those associated with the pill. The experience and severity of side effects can vary from person to person. This variance likely contributes to the reasons why many women try several birth control methods before finding one that works best for them (i.e. one that is compatible with their lifestyle and few or no side effects are experienced). As you already seem familiar with the pill, it'll be good to go over the similarities among the methods as well as some notable differences and considerations to help you determine whether the patch might be an option for you.

Utilizing similar hormones as the pill, the patch prevents pregnancy by slowly and continually supplying the bloodstream with progestin and estrogen. This, in turn, suppresses ovulation and causes the cervical mucus to thicken, making it difficult for sperm to enter the uterus. Additionally, both methods are reversible, meaning fertility resumes quickly when it’s no longer used. The cost of a four-week supply of the patch is comparable to that of a birth control pill pack. Another thing these two methods have in common: neither the pill nor the patch protect against sexually transmitted infections (STIs).

While the cost and what makes the methods effective are similar, the way you use the methods are not. The patch follows a four-week cycle consisting of 28 days. For the first week, a new patch is placed on the skin (within the first 24 hours of your menstrual period OR the Sunday after your period starts) and worn for seven continuous days. It’s recommended that the patch only be placed on the clean, dry skin and only on one of these four body parts: the buttocks, the abdomen, the upper arm, or the upper torso. The patch is then replaced on the same day of the week for the next two consecutive weeks. However, the patch should not be placed in the same location each week. For the fourth week, when a woman menstruates, no patch is used.

When adhered to the skin, the patch has to remain in that spot for the seven day duration. Activities including showering, bathing, swimming, exercising, and sweating should not loosen the patch. If it's no longer sticky, has been stuck to itself or another surface, has other material stuck to it, or if it has become loose or falls off, reapplying the patch is not advised. Changing the location of the patch after it has been placed on the skin is also not advised as it may become loose. If your patch loosens from your skin for more than 24 hours, it’s possible to become pregnant. Immediately begin a new 4-week cycle by affixing a new patch. Similarly, there’s also a risk of pregnancy if you forget to change the patch on day one of the first week. As soon as you remember, apply the first patch of that cycle. In both of these instances, this day will become your new "patch change day" and day one. To prevent a pregnancy, use a non-hormonal back-up method of birth control — such as the male or female condom, diaphragm, sponge, or cervical cap — for one week.

As with most prescription medications, there is a chance of side effects with the patch, which may include:

  • Headaches
  • Skin reaction where the patch is placed
  • Nausea
  • Upper respiratory infection
  • Menstrual cramps
  • Abdominal pain
  • Breast swelling or discomfort

The patch also exposes the wearer to more estrogen than the birth control pill. This extra estrogen can increase the risk of blood clots, strokes, and heart attacks.

Use of the patch is not recommended if you’re already using oral contraceptives, are allergic to any part of the method, take certain medications, or have certain medical conditions. One notable issue with this method is that it may be less effective for those who weigh 198 pounds or more. If you’re interested in the contraceptive patch, talk with your health care provider about your medical history to be sure that it’s right for you. More detailed information about Ortho Evra is also available on the FDA website and the Ortho Evra manufacturer's web site.

Alice

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