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Regardless of which birth control patch brand you choose, the patch is an accepted form of contraception and up to 99% effective when used correctly.

The birth control patch is considered a relatively safe, low maintenance method of hormonal contraception.

Many people choose the patch instead of another birth control method — such as the pill, intrauterine device (IUD), shot, or implant — because it’s easy to care for while still being highly effective.

Xulane, Zafemy, and Twirla are the only birth control patches currently on the market that are approved by the Food and Drug Administration (FDA). But you have several options when it comes to where you order your patch.


  • It can be highly effective, with an up to 99% success rate when used correctly.
  • It’s low maintenance.
  • It may regulate your menstrual cycle.
  • You can get pregnant right away when you stop using the patch.
  • Planned Parenthood says it may lessen or prevent certain conditions, like acne, bone thinning, premenstrual syndrome, cysts in your bones or ovaries, and more.


  • It doesn’t protect against sexually transmitted infections (STIs).
  • It may irritate your skin.
  • You may experience some side effects, like spotting or bleeding between periods, sore breasts, nausea, and headaches.
  • Because the patch gives higher exposure to estrogen, the risk of side effects is increased compared with regular birth control pills.
  • According to the American College of Obstetricians and Gynecologists (ACOG), the patch may be less effective for people with a body mass index (BMI) higher than 30 or who weigh more than 198 pounds.
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The current FDA-approved birth control patch brands available are Xulane, Twirla, and Zafemy.

You might also be familiar with the brand name Ortho Evra. Ortho Evra, Xulane, and Zafemy contain the same active ingredients (ethinyl estradiol and norelgestromin). Zafemy and Xulane are generic versions of Ortho Evra. Ortho Evra was discontinued in 2014 in the United States.

Another option, Twirla, contains ethinyl estradiol and levonorgestrel as its active ingredients.

These three patches are very similar, and used almost identically.


Xulane is a birth control patch that contains two female hormones: an estrogen called ethinyl estradiol, and a progestin called norelgestromin. When used as directed, this combination can be just as effective as the pill.

To use Xulane, place the patch securely on your skin once each week for 3 weeks. Do not apply your patch during week 4. After week 4, begin a new 4-week cycle.


Zafemy is a birth control patch that contains the same active ingredients as Xulane — an estrogen called ethinyl estradiol and a progestin called norelgestromin. Zafemy is the most recently FDA-approved birth control patch in the United States.

Similar to Xulane, you place the Zafemy patch on your skin once each week (be sure to change your patch on the same day of each week) for 3 weeks. Week 4 will be your patch-free week, and then you will start a new 4-week patch rotation cycle.


The Twirla patch also contains two female hormones: a progestin called levonorgestrel and an estrogen called ethinyl estradiol.

Twirla is a relatively safe and effective method of birth control. Apply your first Twirla patch during the first 24 hours of starting your period. Then you will change your patch on that same day each week for 3 weeks, followed by a patch-free week, for a total cycle of 4 weeks.

In person

To get a birth control patch, you can visit your healthcare professional or a local health clinic for an appointment. They will discuss your medical history with you, and together, you’ll decide what form of birth control is best.

Some healthcare professionals may perform exams before prescribing the patch, but most people don’t need a pelvic exam to get the patch. You will most likely be given a prescription to pick up the patches at your local pharmacy.


If you’re using a telehealth platform or another online company instead of an in-person visit, you’ll need to provide some information about your medical history. Depending on the company you use and your location, you may need to also complete a video or phone consultation with a healthcare professional.

If you decide together that the patch is a good form of birth control for your lifestyle and medical history, they will prescribe the patch. The company will either be able to ship it to your door or provide a prescription at your local pharmacy.

Birth control patches are a relatively safe method of hormonal contraception (although they carry a risk of side effects, just like any medication). These small patches stick to your skin and need to be replaced once per week, on the same day each week.

The patches work by gradually releasing hormones into your bloodstream to prevent pregnancy. According to the National Health Service (NHS), each patch contains estrogen and progesterone, just like the combination pill.

The patch prevents ovulation, or the release of an egg each month. However, the patch does not protect against STIs, so it’s a good idea to continue using condoms as an additional barrier.

Many people prefer the patch because it’s low maintenance. You only need to change it once per week. After every 3 weeks, you’ll remove the patch for 1 week. This is when you should get your period.

The patch can stay on when you shower or swim. It can also help regulate your period. And since it’s hormone-based, ACOG suggests it may even lower the risk of ovarian, womb, and bowel cancer.

However, there is a risk of blood clots or certain types of cancer from using the patch. This risk increases if you are over the age of 35 and smoke.

You need a prescription to get a birth control patch. Additionally, your healthcare professional may recommend going with a different form of birth control if you:

  • breastfeed
  • smoke
  • have a BMI higher than 30
  • take certain medications, such as St. John’s wort or medications used to treat epilepsy, tuberculosis, or HIV
  • have certain health conditions, such as liver or gallbladder disease, diabetes-related complications, chest pains, high blood pressure, heart problems, a history of blood clots, or a history of breast, uterine, or liver cancer

According to Planned Parenthood, the patch is 99% effective when used correctly. When you account for user error (sometimes called typical use), the patch is 91% effective, according to ACOG.

Following the instructions as closely as possible will help ensure the patch is effective for you. Some factors that may impact effectiveness include:

  • not replacing the patch every week
  • not changing your patch on the same day each week
  • the patch falls off after 1 or 2 days

If you’re on a birth control patch, you might experience side effects, including:

  • an increased risk of blood clotting problems, heart attack, stroke, liver cancer, gallbladder disease, and high blood pressure
  • skin irritation
  • breast tenderness or pain
  • headaches
  • nausea or vomiting
  • abdominal pain
  • mood swings
  • weight gain
  • dizziness
  • acne
  • diarrhea
  • muscle spasms
  • vaginal infections and discharge
  • fatigue
  • fluid retention

Aside from skin irritation, which is specific to the patch, these are common side effects of all hormonal birth control.

However, as the patch delivers a higher dose of estrogen than a birth control pill, some people using birth control patches may have a higher likelihood of estrogen-related side effects, such as headaches, nausea, breast tenderness, and blood clots.

Only three birth control patches are available in the United States: Xulane, Zafemy, and Twirla.

The main difference between the three patches is the hormones they release. Xulane and Zafemy contain an estrogen called ethinyl estradiol and a progestin called norelgestromin. Twirla contains ethinyl estradiol and a progestin called levonorgestrel. Twirla also delivers a slightly lower dose of estrogen than Xulane and Zafemy.

A healthcare professional can help you figure out the best choice for you.

Although there aren’t many patches approved in the United States, you do have several options for where you order your birth control. You can visit a healthcare professional in person or choose an online birth control service. These services accept most major insurance plans and can sometimes deliver your patch for free.

Xulane and Zafemy are types of birth control patches designed to prevent pregnancy, and they both release 35 micgrograms (mcg) ethinyl estradiol and 150 mcg norelgestromine every day.

They are both generic versions of the formerly available patch called Ortho-Evra. The Zafemy patch is slightly smaller (12.5 square centimeters, or cm2) than Xulane (14 cm2).


Twirla and Xulane are hormonal birth control patches intended to prevent pregnancy. They are very similar. Xulane delivers a slightly higher dose (35 mcg per day) of estrogen than Twirla (30 mcg per day).

People with a history of certain medical conditions, such as blood clots, heart disease, stroke, liver disease, and breast cancer, or who smoke should be cautious when considering estrogen-containing medications like Twirla or Xulane.

It’s worth talking with your doctor to see which patch is a better choice for you.

Birth control patches work by releasing hormones into your system through your skin. These hormones are estrogen and progestin — the same hormones found in most birth control pills.

When your body absorbs the hormones, they prevent your ovaries from releasing any eggs. The birth control patch also thickens the cervical mucus. That way, if an egg does slip through, sperm would have trouble reaching it.

The patch is nearly as effective as other birth control methods. Planned Parenthood says that when used perfectly, both the birth control patch and the pill are 99% effective.

An IUD is more than 99% effective. And, when used correctly, so is the birth control shot, according to the NHS.

However, the efficacy rate for typical use of the birth control patch is around 91%.

Your doctor or healthcare professional may advise against using the patch if:

  • You have a BMI higher than 30.
  • You’re 35 years or older and you smoke.
  • You’re pregnant or breastfeeding.

You also may want to avoid the patch if you have health conditions such as:

  • liver or gallbladder disease
  • diabetes-related complications
  • chest pains
  • high blood pressure
  • heart problems
  • a history of blood clots
  • a history of breast, uterine, or liver cancer

The exact cost of your birth control patch will vary based on where you get your birth control. Some insurances may cover birth control patches for free or with a small copay. Many online services will offer an affordable out-of-pocket cost to deliver to your door for free.

Like any method of birth control, there is a chance that you might get pregnant on the patch.

When used perfectly, the birth control patch is over 99% effective. With typical use, it’s 91% effective.

The birth control patch is a relatively safe, effective method of hormonal contraception. And with so many telehealth services available, it can be relatively easy to get Xulane, Zafemy, or Twirla from whichever source you prefer.

Always consult with a trusted healthcare professional for personalized advice and guidance regarding the use of birth control patches or any other contraceptive method. They can provide tailored recommendations based on your individual health needs and preferences.