The contraceptive patch

It is a small (4cm x 4cm) beige patch you stick on your skin. It releases oestrogen and progestogen (the same hormones that are in the combined oral contraceptive pill) into your body to prevent pregnancy. Unlike the contraceptive pill, you do not have to remember to take a pill every day because each patch lasts for a week.

The patch is used by women (and some transgender men). But contraception is the responsibility of both partners. It is important for everyone to support their partner to use the contraceptive method that is right for them – it is also a way to show you care.

You may not be able to use the patch if:

• you are pregnant or think you may be pregnant
• you are breastfeeding a baby less than six weeks old
• you smoke and are aged 35 or over
• you are very overweight
• you have certain health conditions such as blood clots in a vein or artery, a heart problem, high blood pressure, some blood conditions, breast cancer, some migraines and disease of the liver or gallbladder.

Certain medications, such as some HIV treatment and antibiotics used to treat tuberculosis and meningitis, can make hormone contraceptives less effective. Check with a healthcare professional about whether the patch is the right contraceptive for you.

From a healthcare professional, either at a sexual health clinic or your local health facility. You might also be able to get it from a community-based programme. For example, some youth-clubs work with youth-friendly nurses to provide sexual health services.

The patch contains the hormones (chemicals made by your body) oestrogen and progestogen which are released into your body through the skin and stop an egg being released (known as ovulation). The hormones also thicken the mucus on your cervix (which joins the vagina to the womb). This blocks sperm so it can’t swim to fertilise an egg.

If you start using the patch during the first five-to-seven days of your menstrual cycle, you'll immediately be able to prevent pregnancy. If you have it after that, you should use condoms for seven days.

Advantages

• it is easy to use and does not interrupt sex
• you don’t have to remember to take a pill every day, just change your patch once a week
• you are in control of whether you get pregnant or not
• the hormones are not absorbed through the stomach, so it works even if you are sick (vomit) or have diarrhoea
• it can stop heavy or painful periods and period-related mood swings (premenstrual syndrome)
• you can stop using the patch at any time, and your natural fertility will return quickly 
• you can use the patch any time after giving birth if you are not breastfeeding. If you are breastfeeding, the patch can normally be used six weeks after giving birth.

Disadvantages

• you need to remember to change the patch every week
• depending on where you stick the patch, people may be able to see it
• it can make your skin itchy or sore
• it doesn’t protect you or your partner from STIs, including HIV – only condoms prevent pregnancy and STIs
• in the first few weeks of using the patch you might get side effects, such as tender breasts, mood changes and light bleeding between periods
• some people using contraceptives involving the hormone oestrogen – which includes the patch – have a small chance of getting more serious side effects, including blood clots, but this is rare
• some medication can make the patch less effective. This includes some HIV treatment and antibiotics used to treat tuberculosis and meningitis. Check with a healthcare professional about using the patch if you’re taking any other drugs.

You stick the patch directly onto your skin – choose somewhere that is clean, dry, not very hairy, and is not likely to get rubbed off by clothing. 

You wear the patch for seven days. On day eight, you change the patch to a new one. You do this every week for three weeks, then you have a week without wearing a patch. After the patch-free week, you put a new patch on and begin the cycle again (three weeks with a new patch each week; then a week without a patch).

During your patch-free week you will probably get some bleeding, like a period, but this doesn’t always happen.

Condoms are the only type of contraceptive that protect you and your partner from HIV and STIs, so it is worth using them even if you are using the patch.

No. Once you stop using the patch, you’ll be able to get pregnant straight away.

Here are a few questions to help kick-off discussions on the issues you need to talk about! You can share them on social, on WhatsApp or just get talking.

It is rare for the patch to fall off. If it does, what you need to do depends on how long the patch has been off your skin for. You might want to choose somewhere to stick the patch where you can see that it's still stuck on. 

If it’s been off for less than 48 hours (two days):

• stick a new patch on and carry on as normal (changing the patch when you would normally)
• don’t try and stick the old patch back on
• you are still protected against pregnancy if the patch has been off for less than 48 hours and you’ve used your patch correctly for the past seven days.

If it’s been off for more than 48 hours:

• put on a new patch as soon as you realise
• if you’re in week one or two of your patch cycle, change that new patch on your normal change day
• If you’re in week three of your patch cycle, start a new cycle when you put the new patch on – treat this as the first day of your first week, and don’t do a patch-free week
• you need to use additional contraception, such as condoms, until you’ve had a patch on for seven days in a row after the patch has fallen off (if it fell off for more than 48 hours).

If you’ve remembered about the patch less than 48 hours after you were meant to replace it (you’ve been wearing the same patch for eight or nine days):

• take off the old patch as soon as possible and put on a new one and then change it on your normal change day.
• you will still be protected against pregnancy if you’ve been using the patch correctly.

If you’ve remembered about the patch more than 48 hours after you were meant to replace it (you’ve been wearing the same patch for ten days or more):

• take off the old patch and put on a new patch as soon as possible
• change it on your normal change day
• you will need to use other contraception, such as condoms, until you’ve had the patch on for seven days in a row.

If you’ve forgotten to take your patch off at the end of week three (when you are meant to be in your patch-free week):

• take the patch off as soon as possible
• start your patch-free break and start a new patch on your usual start day, even if you’re bleeding: don’t have a full “patch-free week”
• you’ll still be protected against pregnancy and won’t need to use any additional contraception.

And here are some tips to help you remember to take your patch off:

• set an alarm/reminder on your phone
• ‘buddy up’ with someone who is also using contraceptive patches or other time-dependent medicine so you can remind each other 
• ask your partner to remind you. 

Put on a new patch as soon as possible. You then start your patch cycle from this day – with a new start day and a new patch-change day.

If you forget to put a new patch on for more than 24 hours after you were supposed to put a new patch on (you’ve had 8 days or more not wearing a patch), you may not be protected against pregnancy. You will need to use additional contraception, such as condoms, for seven days after putting the new patch on.

And here are some tips to help you remember to put a new patch on:

• set an alarm/reminder on your phone
• ‘buddy up’ with someone who is also using contraceptive patches or other time-dependent medicine so you can remind each other 
• ask your partner to remind you. 

The patch contains hormones, but these are similar to the hormones the body produces naturally. Some people do experience mood swings – particularly in the first few weeks of using the patch – but not everyone will. 

No, this is not usually one of the side effects. Some people think the patch leads to weight gain because a lot of people first get one at an age when their body is changing naturally anyway. 

If you are using a patch and experience side effects that you are worried about, talk to your healthcare professional as there are plenty of other contraception methods you can try.

You don’t have to wear the patch in a place many people or anyone would see. You just need to stick the patch to clean, dry skin – this could be on your belly, buttocks (butt cheeks), back or upper arm.

Most people will still get some bleeding during the patch-free week of your patch cycle.

Some types of the patch (including the Xulane and Evra brands) can be used without a patch-free week if you want to skip your period. But these aren't available in all countries.

If someone is thinking about using contraceptive patches, the best thing you can do is give them clear and accurate information, respect their decisions, be open and do not judge.

They might feel embarrassed about discussing sex with you. If they are, connect them with a friendly healthcare professional, a helpline or factual online resources, like this website.