What to Know About the Birth Control Patch

When it comes to birth control, you have a plethora of options, from birth control pills and implants to IUDs and injections. But there's a certain contraceptive that seems to fall by the wayside, and that's the birth control patch.

In fact, one study reports that less than 11% of people surveyed reported using the birth control patch. This number is a relatively small percentage when you consider that 95% of people reported using male condoms, 79% reported using the pill, and nearly 65% use the withdrawal method. 

This lack of use may partly stem from the fact that people simply don’t know what the birth control patch is or how it works. If you find yourself in this camp, keep reading. Below you will find all the details about the birth control patch so you can decide if it’s right for you. 

What Is the Birth Control Patch?

The birth control patch is a thin, square adhesive that sticks to your skin like a bandage. Once it's stuck to a body part—like your stomach, bottom, or hip—the patch releases a continuous dose of contraceptive hormones. These hormones are absorbed into your bloodstream through your skin.

“The birth control patch contains both estrogen and [synthetic] progesterone [or progestin] packaged in a less than two-inch square,” says Ashanda Saint Jean, M.D., F.A.C.O.G., an OB-GYN with Westchester Medical Center and associate professor of obstetrics and gynecology at New York Medical College. “The hormones enter the bloodstream and ideally can successfully prevent pregnancy when used as directed.”

People who use the patch must replace it weekly for three consecutive weeks, adds Dr. Saint Jean. “During the fourth week, a patch is not applied, and menstruation occurs. Application of the patch and prevention of adhesive disruption is paramount to efficacy and thus pregnancy prevention." It's also important to keep in mind that, like other forms of non-barrier birth control, the patch does not protect against STIs.

How Does the Birth Control Patch Work?

Once the patch is affixed to your skin, the hormones that are released into your system prevent ovulation, says Melanie Bone, M.D., a board-certified OB-GYN at Daye and a clinical affiliate assistant professor at Florida Atlantic University Charles E. Schmidt College of Medicine. “The patch also thickens cervical mucus, making it more difficult for sperm to travel through the cervix. Additionally, it thins the lining of the womb for a decreased chance of implantation by a fertilized egg.”

There are three primary birth control patches on the market—Xulane, Zafemy, and Twirla—which are combined hormone birth control methods. These patches can be applied to the lower abdomen, buttocks, or upper torso (but not the breasts), but Xulane can also be applied to the upper outer arm, says Cristin Hackel, BS, RNC, MSN, WHNP, a nurse practitioner at Nurx. 

“They work by absorbing the hormones through the skin to prevent pregnancy and regulate periods,” Hackel adds.

What Are the Side Effects of the Birth Control Patch?

The side effects of the birth control patch are similar to those of the birth control pill, says Annelise Skor Swigert, M.D., a board-certified OB-GYN at Southdale ObGyn. “[Some people] experience mild headaches, nausea, breast tenderness, and/or light spotting when they first begin using the patch. Some may also find the adhesive irritates their skin.”

Similar to the birth control pill, other potential side effects may include acne, abdominal pain, vomiting, mood swings, weight gain, dizziness, fatigue, and fluid retention, adds Dr. Bone. 

It’s also important to note the risks, says Dr. Swigert. “Risks of the birth control patch—as with all estrogen-based forms of birth control—include the potential for a blood clot or DVT (deep vein thrombosis). This often occurs deep within the leg. This risk is very small—about 1 in 1,000 in nonsmokers.”

Pros and Cons of the Birth Control Patch

When considering whether the birth control patch is right for you, it's important to weigh both the pros and the cons of this method. Here are some of the things you may want to think about.

Birth Control Patch Pros

One of the biggest benefits of using the patch is that you don't have to remember to take a pill every day, says Dr. Swigert. “The patch stays on for a week—including through showers or swimming. It needs to be changed weekly, which some find to be more manageable.”

The patch also offers a more consistent supply of hormones than other forms of contraceptives, because of its constant, transdermal application. This can reduce the side effects that some people experience when starting a new form of birth control, she adds.

The birth control parch can also be removed at any time, allowing for a quicker return to fertility compared to other methods such as an intrauterine device (IUD), adds Dr. Bone. It's also non-invasive, compared to an IUD or an implant.

“The patch allows the patient a quick-start method for pregnancy prevention, with the advice of barrier contraception, condoms, for the first one to two weeks,” says Dr. Saint Jean. “It is a favorable option for those who want a non-invasive contraceptive choice and an effective birth control method. It has an efficacy between [91%-94%] when used as directed and without disturbance of transdermal hormonal delivery.”

Birth Control Patch Cons

Aside from the risks and side effects that need to be considered, the cons of the birth control patch really come down to its use. For instance, you need to remember to change it each week in order for it to be effective. 

“Any disruption in the delivery system of hormones can impair the birth control patch's efficacy and prevention of pregnancy,” says Dr. Saint Jean. 

Some people are also concerned about the patch being visible, Dr. Swigert says. “We do typically recommend applying the patch low on the pelvis, which should reduce visibility.”

Sometimes the patch may not adhere well or may not stay in place for someone who is very active or spends a lot of time in the water, notes Hackel. “The Xulane patch also contains a higher dose of estrogen than most birth control options which may increase the risk of a blood clot in some people.”

Who Should Not Use the Birth Control Patch

It’s important to note that the birth control patch is not right for everyone. People with a BMI (body mass index) of 30 or greater should not use either patch, because there may be a higher risk of blood clots for people in this group, says Hackel.

“Xulane is not recommended for people who weigh more than 198 pounds, because it may be less effective,” she adds. “And Twirla may be less effective for people with a BMI of 25 or greater.”

What’s more, birth control that contains estrogen is not considered safe for anyone over the age of 35 who smokes. It’s also not recommended for someone with high blood pressure, migraines with aura, or a history of blood clots, says Hackel.

“Ultimately, a [person] should feel comfortable with their form of birth control and use it consistently,” Dr. Swigert says. “If the birth control patch wouldn’t accomplish that, then a health care provider can recommend other options.”

If you find yourself with further questions about the birth control patch, or any forms of contraception, be sure to reach out to an OB-GYN or healthcare provider for more information.