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The Contraceptive Patch: An Introduction



The contraceptive patch ,also known as the birth control patch or EVRA®, contains two types of hormones - a progestogen called norelgestromin and an estrogen called ethinylestradiol. Just like the combined oral contraceptive (COC) pill, the contraceptive patch works in a similar way to prevent an unintended pregnancy.

The contraceptive patch is the same as other combined hormone methods of contraception, in terms of its benefits, risks, side effects and who should not take it. Just like the COC pill, this method is more than 99% effective at preventing pregnancy if used correctly. To ensure that you are on the safest and most effective method of contraception, it is best to consult a doctor. Our friendly team of female doctors will gladly help you select the right method of contraception.

To find out more about the risks, benefits and who should not take the patch, do check out our series of articles on the COC pill, which has more information about this.


How is the patch used?



A contraceptive patch should be applied once a week for 3 weeks. In order to get the most protection, the first patch should be applied on day 1 of the cycle, and the patches should be changed on days 8 and 15. The third patch is removed on day 22, and a 7 days patch-free interval should follow. During the patch-free interval, you would get what is known as withdrawal bleeding (or a period). After the 7 days patch-free interval, a new patch should then be applied to start the next contraceptive cycle.

The patches should be applied to areas of the skin that are clean, dry and hairless. You may choose to apply the patch to either of the following areas:

  • Upper outer arms

  • Upper torso (not breast)

  • Buttock

  • Lower abdomen

The patches should not be applied to red, broken or inflamed skin. Make-up, creams, lotions, powders, or other products should not be used in the area where the patch is placed, or they could affect the stickiness of the patch. Patches usually remain adherent in water or during exercise; however it is good practice to check it regularly to make sure it is placed correctly.


If you started the patch on days 2-5, no additional contraception is required. However, if the patch was started later in the cycle, it is recommended to either use additional precautions (i.e. barrier methods such as condoms) or abstain from having sexual intercourse for 7 days.


The instructions of how to start the patch may be different if you are using it after being on another contraceptive method (including emergency contraception). You may wish to consult a doctor if you are switching from another contraception to the patch. Our doctors will be able to guide you through the process and answer any concerns or queries that you may have.



Advantages of using the contraceptive patch

  • The patch is easy to use and does not affect sexual intercourse.

  • It is very convenient and you do not have to worry about taking a pill every day. However, you do need to remember to change the patch once a week.

  • The patch is not affected by nausea, vomiting or severe diarrhoea.

  • It has similar benefits to the birth control pills.

Disadvantages of using the contraceptive patch

  • The patch may be visible.

  • It may cause skin irritation, itching and soreness (around the site of application).

  • Studies have shown that there is a higher incidence of breast discomfort, dysmenorrhoea, nausea and vomiting associated with the patch compared to the COC pill.

  • It does not protect you against STIs, so you may need to consider other precautions such as barrier contraceptives.

  • You do need to remember to change the patch every week.

  • It has similar risks and side effects that are associated with the COC pill.

__________ References

The Faculty of Sexual & Reproductive Healthcare of the Royal College of Obstetricians & Gynaecologists. (2017, Amended 2020). Emergency Contraception. Retrieved from https://www.fsrh.org/standards-and-guidance/documents/ceu-clinical-guidance-emergency-contraception-march-2017/

https://patient.info/doctor/combined-hormonal-contraception-pill-patch-vaginal-ring

Skin patch and vaginal ring versus combined oral contraceptives for contraception. Cochrane Database Syst Rev. 2013 Apr 304:CD003552. doi: 10.1002/14651858.CD003552.pub4. https://www.singhealth.com.sg/patient-care/medicine/evra-transdermal-patch/ https://www.nhs.uk/conditions/contraception/contraceptive-patch/

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