Contraceptive Patch vs. the Birth Control Pill: Which Is Best for You?

Birth control pills have been used since the 1960s. The pill uses hormones to prevent pregnancy. The combination pill contains estrogen and progestin. The minipill contains only progestin.

Birth control pills prevent pregnancy by stopping your ovaries from releasing an egg each month. The hormones thicken the cervical mucus, which makes it harder for sperm to swim to the egg. The hormones also alter the lining of the uterus, so that if an egg does get fertilized, it will be unable to implant in the uterus.

Who can use birth control pills? People who want pregnancy protection and can remember to take a pill every day. They’re best for people who don’t have risks like high blood pressure, smoking, blood clots, and heart disease.

The patch contains the same hormones as the pill: estrogen and progestin. You stick it on your skin in any of these areas:

• upper arm
• buttocks
• back
• lower abdomen

After the patch is in place, it delivers a steady dose of hormones into your bloodstream.

The patch works just like the pill. The hormones prevent an egg from being released and change both the cervical mucus and uterine lining. You only need to apply it once per week, unlike the pill, which you take every day. After 3 weeks (21 days) of use, you remove the patch for 1 week.

One possible problem is that the patch can fall off. This is rare, and it happens with less than 2 percent of patches. Usually, the patch remains sticky, even if you get sweaty while exercising or taking a shower. If your patch does fall off, reapply it if you can. Or, put on a new one as soon as you notice it’s gone. You might need to use a backup form of birth control if the patch has been off for more than 24 hours.

Who can use a contraceptive patch? People who don’t want to think about birth control more than once a week. The patch is best for those under 198 pounds and those who don’t smoke and don’t have risks like blood clotting problems or other blood disorders.

Both birth control methods are safe, but they do carry a small risk of side effects. Some of the more typical side effects that the pill can cause include:

• bleeding in between periods, which is more likely with the minipill
• headaches
• tender breasts
• nausea
• vomiting
• mood changes
• weight gain

These side effects usually improve after you’ve been on the pill for a couple of months.

The patch can cause side effects similar to those of the pill, including:

• spotting in between periods
• breast tenderness
• headaches
• nausea
• vomiting
• mood swings
• weight gain
• a loss of sexual desire

The patch can also irritate your skin, causing redness and itching. Because the patch contains a higher dose of hormones than the pill, the side effects may be more intense than with the pill.

Serious side effects from both the pill and patch are rare, but they can include heart attack, stroke, and blood clots in the legs, heart, lungs, and brain.

Learn more: Which birth control is right for you?

Certain birth control pills contain a different form of progestin called drospirenone. These pills include:

• Yaz
• Yasmin
• Ocella
• Beyaz
• Syeda
• Safyral
• Zarah

This type of progestin may increase your risk of blood clots more than usual. It can also raise the potassium level in your blood, which could be dangerous for your heart.

Because the patch delivers 60 percent more estrogen than the pill, it might increase the risk of side effects like blood clots, heart attack, and stroke. Overall, though, your chance of having one of these serious side effects is still low.

For both birth control methods, the risk of serious side effects is higher in those who:

• are age 35 or older
• have high blood pressure, high cholesterol, or uncontrolled diabetes
• have had a heart attack
• smoke
• are overweight
• have a history of blood clots
• have been in bed for a long time because of an illness or surgery
• have a history of breast, liver, or uterine cancer
• get migraine with aura

If one or more of these apply to you, your doctor may suggest using another birth control method.

It’s very important that you don’t smoke if you take the patch or pill. Smoking increases your risk of developing dangerous blood clots.

Be careful when taking certain medications because they can make your birth control pill or patch less effective. These include:

• the antibiotics amoxicillin, ampicillin, and tetracycline
• the antifungal medicines nystatin and griseofulvin
• HIV medications
• antiseizure medications
• migraine medications
• St. John’s wort

The pill and patch aren’t the only ways to prevent pregnancy. These are a few other birth control options.

Birth control implant

The contraceptive implant, sold under the brand name Nexplanon, is a tiny rod that a doctor or nurse places under the skin of your upper arm. It slowly releases hormones that prevent pregnancy.

Pros: The birth control implant is up to 99 percent effective at preventing pregnancy. It keeps working for up to 5 years.

Cons: Side effects include pain and bruising in your arm where you get the injection and bleeding between periods.

Intrauterine device (IUD)

An IUD is a T-shaped device that goes inside your uterus. The brands Mirena, Kyleena, Liletta, and Skyla release hormones. Paragard is a copper IUD. Both types prevent sperm from reaching the egg.

Pros: IUDs work for between 3 and 7 years, depending on the brand. And they’re about 99 percent effective at preventing pregnancy.

Cons: Insertion might be uncomfortable. An IUD can make your periods heavier in the first few months.

Birth control shot

The birth control shot, Depo-Provera, is an injection you get once every 3 months. It contains a manufactured version of the hormone progesterone that stops you from ovulating.

Pros: The shot is 96 percent effective at preventing pregnancy. And you only have to think about birth control four times a year.

Cons: Depo-Provera requires injections. It can cause side effects like spotting, nausea, and weight gain. And for some people, it can take 10 months to get pregnant after stopping.

Vaginal ring

The vaginal ring is a flexible plastic ring that is inserted into the vagina. It releases hormones that prevent pregnancy. You leave the ring in for 3 weeks and remove it for 1 week. The brand NuvaRing is disposable, while Annovera is reusable for up to 1 year. It’s 93 percent effective at preventing pregnancy.

Pros: The ring is easy to use, and it may make periods lighter. You may get pregnant right away after you stop using it.

Cons: You have to remember to put it in on time or it won’t protect you from pregnancy. The ring can cause side effects like spotting, sore breasts, nausea, and headaches.

Condoms

Condoms are sheaths made from latex or polyurethane. They cover the penis or line the vagina to prevent sperm from reaching the uterus. The external condom is about 87 percent effective, and the internal condom is 79 percent effective.

Pros: Condoms are cheap, easy to use, and available without a prescription. They also protect against STIs.

Cons: You have to use one every time you have sex. They’re not as effective at preventing pregnancy as other birth control methods.

Diaphragm or cervical cap

A diaphragm and cervical cap are both cup-shaped devices that go inside the vagina and cover the cervix. They block sperm from getting through the cervix into the uterus. Both the diaphragm and cervical cap must be fitted to you and used with spermicide to work properly.

Pros: These methods are convenient and they don’t interrupt sex. Plus, they don’t contain hormones that might cause side effects.

Cons: You need to use a diaphragm or cervical cap correctly every time you have sex. And they must be fitted to you to protect against pregnancy.

Sponge

A birth control sponge is a soft device made of foam and covered in spermicide. You can buy it over the counter without a prescription. It goes into the vagina and covers the cervix. The sponge is 86 percent effective in people who have never had a baby, and 73 percent effective in those who have had a baby.

Pros: The sponge is easy to use and convenient, with no prescription required.

Cons: You have to use it every time you have sex. It can take some time to get used to inserting the sponge.

Which is safer, the pill or a contraceptive patch?

Both the pill and the patch contain the hormones estrogen and progestin, but the patch delivers a higher dose of estrogen. Some studies have found an increased risk of blood clots with the patch. But overall, there isn’t enough evidence to prove the patch is riskier. Talk with your doctor about your risks before choosing a birth control method.

Does the patch make you gain weight?

No. Studies haven’t found evidence that people gain a significant amount of weight from using the patch.

Does the birth control pill make you gain weight?

No. There isn’t enough evidence to suggest this method leads to weight gain.

Do I need to go to the doctor to get prescribed birth control pills?

You will need a prescription for birth control pills. In a few states, you can get a prescription online or from a pharmacist.

Online retailers like Nurx, Hers, and Lemonade also offer birth control pills. They usually require a consult with one of their doctors first. These companies will refill the prescription through your local pharmacy or ship birth control straight to you.

If you aren’t sure which method you’d like to try, your doctor can be a great resource. They should be able to explain your options and answer any questions you may have.

There are a few things you may want to consider before choosing a birth control method:

• Do you want to deal with regular upkeep, or would you rather have something long term?
• What health risks are associated with this method?
• Will you be paying out of pocket, or will this be covered by insurance?

After you make your decision, be sure to stick with this method for a few months so that your body can adjust. If you find that this method isn’t what you expected, there are other options available.

Both the patch and pill are equally effective at preventing pregnancy. Your likelihood of getting pregnant depends on how closely you follow the directions.

Fewer than 1 out of 100 people who take the pill or apply the patch as directed will get pregnant in any given year. Nine out of 100 of those who don’t always use these birth control methods as directed get pregnant.

Talk through your birth control options with your doctor. Learn about all the benefits and the possible risks when making your choice. Pick the birth control that will be the most convenient for you and have the fewest side effects.