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Here’s what you should know about using the birth control patch.

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

Often, people choose the patch instead of another birth control method — such as the pill, intrauterine device (IUD), shot, or implant — because the patch is highly effective and easy to care for.

Xulane 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. Here, we’ll share information about the available patches and explain how various telehealth birth control websites work.

Regardless of which birth control patch brand you choose or where you get it, the birth control patch is still 99 percent effective when used correctly. It is a safe form of contraception.

Birth control patches are a safe method of hormonal contraception. These small patches stick to your skin and need to be replaced once per 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 progestogene, just like the combination pill.

The patch prevents ovulation, or the release of an egg each month. However, the patch does not protect against sexually transmitted infections (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, the American College of Obstetricians and Gynecologists suggests it may even lower the risk of ovarian, womb, and bowel cancer. There is a small risk of blood clots or cancer from using the patch.

You need a prescription to get a birth control patch. Additionally, your doctor will likely recommend going with a different form of birth control if you:

  • breastfeed
  • smoke
  • are overweight
  • 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 percent effective when you use it correctly. When you account for user error, the patch is 91 percent effective. Sticking to the instructions as closely as possible will help ensure the patch is effective for you. Some factors that may affect its effectiveness include:

  • if you don’t put a new patch on every week
  • if the patch falls off after 1 or 2 days
  • if you are in a larger body

Pros

  • It’s highly effective with a 99 percent 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 (PMS), cysts in your bones or ovaries, and more.

Cons

  • It doesn’t protect against STIs.
  • It may irritate your skin.
  • You may experience some side effects, like spotting or bleeding between periods, sore breasts, nausea, and headaches.
  • More exposure to estrogen increases the risk of side effects compared with regular birth control pills.

The main birth control patch brands available are Xulane and Twirla. Planned Parenthood says these are the only two patches approved by the FDA in the United States.

You might also be familiar with the brand name Ortho Evra. Ortho Evra and Xulane contain the same active ingredients, and Xulane is the generic version of Ortho Evra. Ortho Evra was discontinued in 2014 in the United States, leaving Xulane and Twirla as the primary options available.

Xulane

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, then begin a new 4-week cycle.

Twirla

The Twirla patch also contains two female hormones: a progestin called levonorgestrel, and an estrogen called ethinyl estradiol. Similar to Xulane, Twirla is a safe and effective method of birth control. Apply your first Twirla patch during the first 24 hours of starting your period.

To get a birth control patch from a doctor in person, visit your general health practitioner or a local health clinic for an appointment. The nurse or doctor will discuss your medical history with you, and together, you’ll decide what form of birth control is best.

Some doctors 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, 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 doctor or nurse practitioner.

If the doctor decides the patch is a good form of birth control for your lifestyle and medical history, they will prescribe the patch. The company may ship it to your door or provide a prescription at your local pharmacy.

SimpleHealth

Birth control prescription service SimpleHealth prescribes Xulane. They accept almost all major insurance plans, and birth control is free with most plans. Xulane costs $130 per month out of pocket or $0 copay with most insurance.

To get birth control from SimpleHealth, fill out a questionnaire about your medical history and pay a one-time consultation fee of $15. After a doctor reviews your information, they’ll write you a prescription for a method of birth control. Then your birth control, including refills, will be automatically shipped to your door.

Nurx

Telemedicine company Nurx accepts most forms of private health insurance for medications. Nurx provides Xulane for as little as $0 with insurance or $180 per month without.

Nurx users can get birth control by sharing information about their health history. A licensed medical professional will review your information and write you a prescription for birth control, and you’ll need to pay $15 for the medical consultation. Then, Nurx will ship your birth control to your door with free delivery.

Lemonaid

Lemonaid offers a mail-order pharmacy where you’ll need to pay out of pocket. Alternatively, if your insurance plan covers the medications prescribed by Lemonaid, you can ask this telehealth company to send your prescription to your local pharmacy. Birth control from Lemonaid is a flat fee delivered every 3 months for $15 per pack.

To get a Xulane birth control patch from Lemonaid, you’ll pay $25 for an online consultation with the company’s medical team. Some states require a phone consultation, others do not. You can then pick up a Xulane patch from your local pharmacy. Otherwise, your birth control will be delivered every 3 months for $15 per pack.

Pandia Health

Pandia Health offers the Twirla birth control patch. First, you’ll pay $20 to fill out the company’s online form. Next, the doctor will review your medical history and write a prescription. Finally, Pandia will deliver your birth control patch straight to your doorstep for free.

If you have insurance, you’ll pay as little as $0 for the first month of Twirla, and after that, as little as $25 per month. If you’re paying out of pocket, you can expect to pay $50 per month for Twirla. Pandia accepts almost all insurances.

Birth control patches work by releasing hormones into your system through your skin, according to the NHS. 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.

Yes, the patch is nearly as effective as other birth control methods. Planned Parenthood says that when used correctly, both the birth control patch and the pill are 99 percent effective. An IUD is more than 99 percent effective. And, when used correctly, so is the birth control shot, according to the NHS.

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

  • You are a person in a larger body.
  • You are 35 years or older and you smoke.
  • You’re pregnant or breastfeeding.

You also may need 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

You might be interested in the patch if:

  • You have trouble swallowing pills.
  • You want to return to fertility at any time.
  • You forget to keep up with daily medication.

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

Only two birth control patches are available in the United States: Xulane and Twirla. Since both patches are very similar, you shouldn’t have much trouble choosing one.

The main difference between the two patches is the hormones they release. Xulane contains an estrogen called ethinyl estradiol and a progestin called norelgestromin, while Twirla contains ethinyl estradiol and a progestin called levonorgestrel. 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 opt for a telehealth service that accepts most major insurance plans and automatically delivers your patch for free.

What birth control brand is the cheapest?

The exact cost of your birth control patch will vary based on where you get your birth control. But without insurance, you can expect to pay approximately $175 for a box of Twirla and the same price for a box of Xulane.

Can you still get pregnant on the patch?

Like any method of birth control, there is a small chance that you might get pregnant on the patch. If you use the patch perfectly, pregnancy happens to less than 1 in 100 women during the first year of using the birth control patch.

The birth control patch is a safe, effective method of contraception. And with so many telehealth services available, it should be simple and quick to get Xulane or Twirla from whichever source you prefer.


Hailey Hudson is a full-time freelance writer and content marketer based out of Atlanta, Georgia. She focuses in the health, marketing, and education industries. Clients include Livestrong, Runner’s World, Dell, and others. Hailey is also a novelist and a musician.