Contraceptive patch

Page last reviewed: 13/07/2011

The contraceptive patch (transdermal patch) is a form of hormonal contraception worn by a woman to stop her getting pregnant when she has sex.

Unlike barrier methods of contraception, such as condoms, the contraceptive patch does not protect against sexually transmitted infections (STIs).

How it works

The contraceptive patch is a small, thin, beige patch about 5cm by 5cm in size. You stick it onto your skin and it releases two hormones - oestrogen and progestogen - through your skin and into your bloodstream. These are the same hormones as those used in the combined oral contraceptive pill. The hormones prevent your ovaries releasing an egg (ovulation) and stop you from becoming pregnant.

The patch needs to be changed for a new one each week. Every fourth week, you have a patch-free week when you have a withdrawal bleed, like a period.

Contraceptive patches are available from your GP, local family planning clinic or sexual health (GUM) clinic. Not everyone can use the patch, so it is important to see a doctor or nurse who can check your medical and family history and make sure it is suitable for you.

How effective is the contraceptive patch?

If used properly, the contraceptive patch is over 99% effective in preventing pregnancy. This means that if 100 women use the patch according to the instructions, less than one will get pregnant in a year.

Research has shown that the patch may be less effective for women who weigh 90kg (14 stone) or over.

Page last reviewed: 13/07/2011

The contraceptive patch works by releasing daily doses of the female sex hormones oestrogen and progestogen into your bloodstream through your skin. These hormones are similar to those made naturally by your body to control your periods and to help prepare your body for pregnancy.

The patch works in the same way as the combined oral contraceptive pill, by stopping your ovaries releasing an egg each month (ovulation), which could then be fertilised by sperm.

The contraceptive patch also has other effects that help prevent pregnancy:

  • It makes the mucus in your cervix (entrance to the womb) thicker, which makes it difficult for sperm to move through the mucus and into your womb, where it could reach an egg.
  • It makes the lining of your womb thinner, so it is harder for an egg to attach to the womb.

How to use it

Where to put the patch

You can use the contraceptive patch on most areas of your body as long as the skin is clean, dry and not very hairy. Do not stick it on sore or irritated skin, or anywhere it may get rubbed off by tight clothing. Do not stick the patch on your breasts.

When you first start using the patch, you can vary the position every time you use a new patch to reduce your risk of irritation.

When to change the patch

You apply a new patch once a week (every seven days) for three weeks and then stop using the patch for seven days. This is known as your patch-free week. During your patch-free week, you will get a withdrawal bleed, like a period, although this may not always happen.

After seven patch-free days, you apply a new patch and start the four-week cycle again. Start your new cycle even if you are still bleeding.

When the patch starts to work

If you start using the patch on the first day of your period, it starts working straight away. This means you can have sex without getting pregnant. If you start using it on any other day, you need to use an additional form of contraception for the first seven days.

What to do if the patch falls off

The contraceptive patch is very sticky and should stay on. It should not come off after a shower, bath, hot tub, sauna or swim, or after exercise.

If the patch does fall off, what you need to do depends on how long it has been off.

If the patch has been off for less than 48 hours

If the patch is missing for less than 48 hours:

  • Stick your patch back on as soon as possible (if it is still sticky).
  • If it is not sticky, replace it with a new patch (do not try to hold the old patch in place with a plaster or bandage).
  • Continue to use your patch as normal and change your patch on your normal change day.

If the patch has been off for less than 48 hours before you replace it, you will still be protected against pregnancy and do not need to use additional contraception.

If the patch has been off for 48 hours or more

If your patch has been missing for longer than 48 hours, or you are not sure how long it has been missing:

  • Apply a new patch as soon as possible and start a new patch cycle (this will now be day one of your new cycle).
  • Use another form of contraception, such as condoms, for the next seven days.

If you had unprotected sex in the previous few days, you may need emergency contraception. See your GP, nurse or local sexual health (GUM) clinic if you are concerned.

Bleeding in the patch-free week

Some women do not always have a bleed in their patch-free week. This is nothing to worry about if you have used the patch properly and have not taken any medication that could affect it.

See your GP or nurse for advice if you are worried, or do a pregnancy test to check if you are pregnant. If you miss more than two bleeds, get medical advice.

Am I protected from pregnancy during the seven-day break?

You are protected from pregnancy during your seven-day break if:

  • you used the previous three patches correctly
  • you start the patch cycle again on time
  • you are not taking any other medicines that will affect the patch

Page last reviewed: 13/07/2011

The contraceptive patch is not suitable for everyone. If you are thinking of using it, your GP or nurse will need to ask you about your health and your family's medical history to make sure the patch is suitable for you.

It is very important to tell them about any illnesses or operations you have had, or medications you are currently taking.

Who may not be able to use it?

Conditions and circumstances that may mean you should not use the patch include:

  • you are pregnant or think you may be pregnant
  • you are breastfeeding
  • you smoke and are over 35 years of age
  • you are 35 or over and stopped smoking less than a year ago
  • you are very overweight
  • you take certain medicines, such as antibiotics, St John's Wort or medicines used to treat epilepsy, TB or HIV

You will also not be able to use the patch if you have (or have had) any of the following conditions:

  • thrombosis (blood clots) in a vein or artery
  • a heart problem or disease affecting your blood circulatory system (including high blood pressure)
  • migraines
  • breast cancer
  • disease of the liver or gall bladder
  • diabetes with complications, or diabetes for more than 20 years

Page last reviewed: 13/07/2011

If it is used properly, the contraceptive patch is over 99% effective in stopping you from getting pregnant. This means that if 100 women use the patch according to the instructions, less than one will get pregnant in a year.

Other advantages of the patch include:

  • It is very easy to use and does not interrupt sex.
  • Unlike the pill, you do not have to think about it every day. You only have to remember to change the patch once a week.
  • The hormones from the contraceptive patch do not need to be absorbed by the stomach, so it is just as effective even if you vomit or have diarrhoea.
  • Like the pill, it tends to make your periods more regular, lighter and less painful.
  • It can help with premenstrual symptoms.
  • It may reduce the risk of cancer of the ovaries, womb and bowel.
  • It may reduce the risk of fibroids, ovarian cysts and non-cancerous breast disease.

Page last reviewed: 13/07/2011

The contraceptive patch has some disadvantages, such as:

  • It can be seen.
  • It can cause skin irritation, itching and soreness.
  • It does not protect you against sexually transmitted infections (STIs), so you may need to use condoms as well.
  • Some women get mild temporary side effects when they first start using the contraceptive patch, such as headaches, nausea (sickness), breast tenderness and mood changes. These side effects usually settle down after a few months.
  • Breakthrough bleeding (bleeding between periods) and spotting (very light, irregular bleeding) is common in the first few cycles of using the patch. This is nothing to worry about if you are using the patch properly. You will still be protected against pregnancy.
  • Some medicines can make the patch less effective. If you are prescribed new medicine or are buying an over-the-counter medicine, ask the doctor or pharmacist for advice. You may need to use an extra form of contraception while you are taking the medicine, and for two days afterwards.

Page last reviewed: 13/07/2011

There is a very small risk of some serious side effects when you use a hormonal contraceptive, such as the contraceptive patch or combined oral contraceptive pill. These are outlined below.

Blood clots

The patch slightly increases your chance of developing a blood clot, which can block a vein (venous thrombosis) or an artery (arterial thrombosis, which may lead to a heart attack or stroke). If you have had a blood clot before, do not use the patch.

Your risk of blood clots is higher during the first year of using the patch. Your risk is also higher if:

  • you smoke
  • you are very overweight
  • you are immobile (unable to move) or use a wheelchair
  • you have severe varicose veins
  • a close family member had a venous thrombosis before they were 45 years old

The risk of arterial thrombosis is greatest if:

  • you smoke
  • you are diabetic
  • you have high blood pressure (hypertension)
  • you are very overweight
  • you regularly have migraines with aura (visual problems)
  • a close family member had a heart attack or stroke before they were 45

You will probably not be prescribed the patch if any of the above apply to you.

Cancer

Current research suggests that all users of hormonal contraception, such as the contraceptive patch, are at a slightly increased risk of being diagnosed with breast cancer compared to people who do not use hormonal contraception. However, further research is needed to provide more definite evidence.

Research suggests there is a small increase in your risk of developing cervical cancer with long-term use of oestrogen and progestogen hormonal contraception.

For most women, the benefits of the patch outweigh the risks. However, discuss all risks and benefits with your GP or nurse before starting to use the patch. You will not be allowed to use the patch if you are considered to be at a higher risk of serious side effects.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

Browse Health A-Z