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A birth control patch is a square-shaped plastic sticker that looks like a Band-Aid. It’s applied to the skin on certain parts of the body to prevent pregnancy.
Two birth control patch brands are available in the United States: Twirla and Xulane. Both are extremely similar, except Twirla contains a slightly lower level of hormones.
- Effectiveness. If you follow the instructions perfectly, the birth control patch is 99 percent effective. Even with typical use, the efficacy rate is still relatively high at 91 percent.
- Easy to use. The patch only needs to be applied once per week and replaced weekly. This can make it easier for people who may forget to take a daily pill.
- Can help with period problems. The patch can help regulate the menstrual cycle and make periods lighter and less painful. Premenstrual symptoms may also be positively impacted.
- Skin irritation. The skin can become irritated, itchy, or sore where the patch is applied. This may particularly affect people with sensitive skin.
- No protection against sexually transmitted infections (STIs). Hormonal birth control is only effective for pregnancy prevention. You’ll need to use a barrier method, like condoms, to protect against STIs.
- Can fall off. It’s possible for the patch to come loose or fall off completely, so it’s a good idea to check it every few days.
- May be visible. While you can apply the patch in a place that’s unlikely to be seen, it does only come in one light color, making it more obvious on darker skin tones.
- Needs to be changed weekly. The patch has to be changed on the same day each week in order to work. Setting reminders can help you remember. But if you’ll have a hard time remembering, longer acting forms of birth control, like the implant or intrauterine device (IUD), may be better.
Each path contains synthetic versions of two hormones: estrogen and progesterone.
When stuck to the skin, the patch releases these hormones and the skin absorbs them into the bloodstream.
If you first use the patch between days one and five of your period, it’ll be effective immediately. But starting it at any other time means you’ll need a secondary form of contraception, such as condoms, for at least a week.
Some people experience side effects for the first few months of use. These can include:
- tender breasts
- changes to the timing, heaviness, or frequency of periods
- itchiness, dryness, swelling, or a rash in the area where the patch has been applied
As with other forms of hormonal birth control, there’s also the potential for rare but serious side effects, such as:
- deep vein thrombosis
- heart attack
- pulmonary embolism
- blood clots
- gallbladder disease
- high blood pressure
However, not all side effects are negative. Some people specifically use hormonal contraception, like the patch, for some better effects, such as lighter or more regular periods and acne prevention.
There’s also evidence that the patch can help protect against anemia and certain cancers, including ovarian, womb, and bowel cancer.
Introduced in the United States in 2002, the birth control patch is highly effective when used correctly.
With perfect use, it’s 99 percent effective. But the reality is that efficacy rate drops to 91 percent for people who may not follow the directions all the time.
According to Planned Parenthood, that works out to around 9 out of 100 users becoming pregnant every year.
It’s not just how well you use the patch that can affect its effectiveness. Certain medications can affect how well it works, as can a weight of 198 pounds or more.
A health professional can help you decide if the patch is right for you.
Depending on medical history and current lifestyle choices, the patch may not be suitable.
Those who may not be able to use the patch include people who:
- are pregnant or nursing a newborn child
- smoke and are aged 35 or over
- take certain medications, such as HIV medications
- have had blood clots in a vein or artery
- have high blood pressure, migraine with aura, or a heart condition
No form of hormonal birth control can prevent STIs, as they only work to prevent pregnancy.
So you’ll need to use a barrier method, like condoms, during sexual activity to reduce the risk of contracting or transmitting an STI to others.
Both quick to apply and straightforward to use, here’s how you put on the patch and swap it for a new one.
How do you put the birth control patch on?
First, decide where you want to apply the patch. This should be an area of clean, dry skin, such as your:
- upper arm
- upper back
Here are places you should avoid placing the patch:
- on your chest
- any areas that are sore or irritated
- areas that might get rubbed with tight clothing
- areas where you might apply lotion, powder, or makeup to help keep the patch sticky
Open the foil pouch so that it lies flat and peel the patch off the foil.
Next, peel half of the plastic off the patch. Be careful not to touch the sticky part.
Stick the patch to your skin, peeling off the rest of the plastic. Push it against the skin for 10 seconds using the palm of your hand.
How long does the birth control patch last?
Each patch is designed to last for a full week. After 7 days, you’ll need to take it off and put on a new one.
It’s a good idea to check your patch is still in place every day. While activities, like short swimming sessions, shouldn’t affect it, the Twirla patch has been known to lose stickiness after 30 minutes in water.
If the patch comes loose less than 24 hours after you first applied it, and it’s still sticky, try to reapply. If it’s not sticky, replace it with a new patch.
If your patch is loose or detaches more than 24 hours after you applied it, throw it away and apply a new one. It’s also recommended that you use a method of backup birth control for the next 7 days.
The day you replace the patch will become your new changeover day.
How do you take the birth control patch off?
On the same day of the following week, it’s time to remove the patch and apply a fresh one.
Simply peel it off and dispose by folding it in half so that it sticks to itself. Place in a sealed plastic bag and throw it away in the trash.
Apply a new patch using the above steps.
Do this for 3 weeks. On the fourth week, you can take a break from using the patch, starting again the week after. During this week, you may have a withdrawal bleed, which is similar to a period.
However, the Xulane patch can be applied during the fourth week to skip this bleed. You may still experience some bleeding or spotting for the first few months.
What if you forget to take it off?
The process differs, depending on how many hours you’ve left the old one on for.
If it’s been less than 48 extra hours, simply take off the old patch and put on a new one, sticking to your original change day for future swaps.
If you’ve kept it on for 10 days or longer, swap it for a new one and stick to your usual change day.
You’ll also need to use a backup form of contraception, like condoms, until you’ve had the same patch on for 7 days in a row.
People who forget to remove the patch after the third week can take it off and apply a new patch on the usual start day. This means a shorter patch-free period.
The patch vs. the pill
Both the patch and combination birth control pills use estrogen and progestin to prevent unwanted pregnancy. But they deliver the hormones differently.
The pill is taken orally each day, whereas the patch is applied to your skin once each week.
Progestin-only pills, also known as minipills, deliver hormones the same way. However, they don’t contain estrogen.
When used correctly, both the pill and patch are equally effective at preventing pregnancy.
The patch vs. the IUD
There are two kinds of IUDs: a progestin type and a non-hormonal, copper type.
Both are small T-shaped devices that prevent fertilization of the egg and need to be inserted into the uterus by a healthcare professional.
The progestin IUD can prevent pregnancy for 3 to 7 years, depending on the type you choose. And it’s highly effective — fewer than 1 in 100 users will become pregnant.
The non-hormonal IUD, known as ParaGard, has the same effectiveness. But it can last up to 10 years.
IUDs are great if you prefer a lower maintenance form of birth control that you don’t need to think about for years.
They can come with some side effects, such as irregular bleeding, for the first few months. The copper IUD can also result in heavier and longer lasting periods compared with other birth control methods.
The patch vs. the vaginal ring
The vaginal ring is inserted into the vagina and left in place for 3 continuous weeks. On the fourth week, it’s removed. A new one is inserted at the start of each new month.
The ring works similarly to the patch, as it contains the same hormones. It’s also highly effective, as fewer than 1 in 100 people will become pregnant when using the ring as directed.
The vaginal ring offers similar benefits. Not only can it stay in place during penetrative sex, but it may also result in lighter periods and less cramping.
The patch vs. the implant
Another form of hormonal birth control, the contraceptive implant, is a tiny plastic rod that’s inserted just under the skin of the upper arm by a doctor or other healthcare professional.
It slowly releases a progestin hormone into the body and lasts up to 5 years before needing to be replaced.
Like the IUD, the implant is more than 99 percent effective at preventing pregnancy, which means it’s more effective than the patch. Plus, you don’t have to think about it each day or week.
The patch vs. the sponge
The contraceptive sponge is a soft, round piece of plastic foam with a loop for removal. It’s available over the counter in many drugstores.
The sponge doesn’t contain any hormones and is instead filled with a spermicide known as nonoxynol-9. This slows sperm down and helps prevent sperm from reaching the egg.
You insert the sponge deep into your vagina up to 24 hours before having penis-in-vagina sex to prevent pregnancy. This means it requires a little more time and preparation than other forms of birth control, including the patch.
You can have sex multiple times with the same sponge inserted. However, it shouldn’t be kept in for more than 30 hours.
The sponge is less effective than the patch. With perfect use in people who haven’t given birth, it’s around 91 percent effective. For people who have given birth, perfect use equates to 80 percent efficacy.
In reality, people don’t tend to use the sponge perfectly. So it’s usually about 88 percent effective for people who haven’t given birth and 76 percent effective for people who have.
A pack of patches, which will last for one month, may be free if you have health insurance or qualify for Medicaid.
If you can’t access the patch through insurance or a government program, it can cost up to $150 per pack, according to Planned Parenthood.
You’ll also need to pay for an appointment with a clinician to get a prescription if you’re not covered by insurance.
No matter where you get the patch from, you’ll need a prescription to access it. A typical clinician’s office or centers like Planned Parenthood can prescribe the patch.
You may also be able to get a prescription straight from a pharmacist or through online services. Many health insurance plans cover the cost of birth control, meaning it may be free or low cost.
If you don’t have insurance and are on a lower income, organizations, such as Planned Parenthood and Title X family planning clinics, may be able to significantly reduce the cost. You might also qualify for free birth control under Medicaid.
Platforms that offer virtual consultations include:
- Lemonaid Health. This service offers the Xulane birth control patch after a $25 medical consultation. However, Lemonaid Health doesn’t deliver the patch to you — you’ll have to pick it up from a local pharmacy.
- SimpleHealth. After completing an initial consultation and medical questionnaire, you’ll have to pay a $20 one-time consultation fee. SimpleHealth can prescribe the patch for free with most insurance plans. But if you’re not insured, the cost is currently $130 per month. After you receive a prescription, the service will send you the birth control patch every month.
- PlushCare. PlushCare offers prescriptions for the patch. You’ll first have to book an appointment with a clinician through the platform and talk with them about your medical history and contraceptive needs. They’ll place a prescription for you at your local pharmacy. However, you’ll have to become a member of PlushCare prior to making an appointment. It costs $14.99 a month (or $99 annually) for a membership, and folks without insurance have to pay a $119 copay for their first visit.
- Nurx. With Nurx, you can request a prescription for the patch via an online intake form and a $15 consultation fee. Once a clinician has reviewed your questionnaire, Nurx’s pharmacy will fill your prescription and send a 3-month supply to you. The patch costs as little as $0 with insurance and starts at $180 without insurance.
The birth control patch is a safe, effective, and straightforward form of hormonal birth control. It only needs to be replaced weekly, so might be easier for some people than a daily option, like the pill.
However, there are longer acting forms of contraception for those who want birth control that lasts several years at a time.
If you think the birth control patch or another form of contraception may be right for you, consult a healthcare professional to learn more.
Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.