About Birth Control Patches
Summary
Birth control patches contain hormones that are absorbed through the skin. They work similarly to birth control pills but only need to be changed once a week. The hormones prevent the ovaries from releasing an egg, thicken cervical mucus to block sperm, and make the uterine lining less suitable for pregnancy.
Why a Patient Might Choose This Method
A patient may choose the birth control patch if they want the effectiveness of a combined hormonal contraceptive without having to remember a daily pill. The patch only needs to be changed once a week, making it a convenient option for people who prefer a simple routine. It provides predictable menstrual cycles and can help reduce menstrual symptoms while offering the flexibility to stop treatment at any time if pregnancy is desired.
How It Is Used
The birth control patch is a small adhesive patch that is applied to the skin and changed once each week. A new patch is applied weekly for 3 consecutive weeks, followed by 1 patch-free week during which withdrawal bleeding typically occurs. The patch can be placed on the abdomen, buttocks, upper outer arm, or upper torso (excluding the breasts). Once applied, it continuously delivers hormones through the skin and does not require daily attention. Some patients may also use the patch continuously under the guidance of their healthcare provider to reduce or eliminate menstrual bleeding.
Hormones Used in Birth Control Patches
Birth control patches contain one estrogen and one progestin. Together, these hormones prevent ovulation, thicken cervical mucus, and make the uterine lining less favorable for pregnancy.
| Hormone | Class | Purpose |
|---|---|---|
| Norelgestromin | Progestin | Prevents ovulation and thickens cervical mucus. |
| Levonorgestrel | Progestin | Prevents ovulation and thickens cervical mucus. |
| Ethinyl Estradiol | Estrogen | Suppresses ovulation and improves cycle control. |
Patch Options and Comparisons
Several contraceptive patches are available. While all provide once-weekly contraception, they differ in hormone formulation, estrogen exposure, and patient eligibility.
| Patch | Hormones | Type | Advantages | Potential Disadvantages |
|---|---|---|---|---|
| Xulane | Ethinyl Estradiol + Norelgestromin | Combined hormonal patch | Weekly dosing, predictable cycles, widely available | Estrogen-related clot risk, skin irritation, may be less effective in higher body weights. |
| Zafemy | Ethinyl Estradiol + Norelgestromin | Generic equivalent of Xulane | Same benefits as Xulane, often lower cost | Same risks and side effects as Xulane. |
| Twirla | Ethinyl Estradiol + Levonorgestrel | Combined hormonal patch | Lower estrogen exposure than Xulane, weekly dosing | Reduced effectiveness in patients with BMI ≥30 kg/m²; estrogen-related clot risk. |
Practical Use Details
How the Patch Is Used
- Apply one patch weekly for 3 weeks
- Followed by 1 patch-free week
- During the patch-free week, withdrawal bleeding typically occurs
- Some patients use patches continuously to reduce or eliminate bleeding
If a Patch Falls Off
- If detached for less than 24 hours, reapply or replace it as soon as possible and continue the usual schedule.
- If detached for more than 24 hours, or if the duration is unknown, apply a new patch and start a new patch cycle. Backup contraception may be needed for the next 7 days.
Key Points
- Change the patch on the same day each week.
- Check daily to make sure the patch is fully attached.
- Avoid lotions, oils, powders, or creams under the patch, as they may affect adhesion.
- The patch remains effective during bathing, swimming, and exercise when properly attached.
How Specific Patches Are Used
Xulane and Zafemy
- Apply one patch weekly for 3 consecutive weeks
- Place the patch on the abdomen, buttock, upper outer arm, or upper torso (excluding the breasts)
- Replace with a new patch on the same day each week
- After the third week, remove the patch and have a patch-free week
- Withdrawal bleeding usually occurs during the patch-free week
- Can also be used continuously (under provider guidance) to reduce or eliminate bleeding
Twirla
- Apply one patch weekly for 3 consecutive weeks
- Place the patch on the abdomen, buttock, or upper torso (excluding the breasts)
- Replace with a new patch on the same day each week
- After the third week, remove the patch and have a patch-free week
- Withdrawal bleeding usually occurs during the patch-free week
- Top of Form
Clinical Pearl
Patients should routinely check that the patch remains fully attached to the skin, especially after swimming, bathing, or vigorous exercise. A partially detached patch may not deliver hormones consistently.
Ready to discuss birth control options?
Choosing a birth control method can feel overwhelming, but you do not have to sort through the options alone. APNS can help you review your health history, preferences, and goals so you can make an informed decision with guidance from a healthcare provider.