How to use the contraceptive skin (transdermal) patch

The skin (transdermal) patch is a highly effective method of birth control when it is used exactly as directed. The patch failure rate is the same as that of birth control pills. Only about 3 out of 1,000 women who use the patch exactly as directed for a year will become pregnant. On average, about 8 out of 100 patch users become pregnant per year. This is usually because the patch is not used as directed. Sometimes it is because the patch is less effective for women who weigh more than 198 lb (89.8 kg).¹ It also can happen when the patch is exposed to direct sunlight or heat.

Talk to your health professional about what day to start using the patch. It is usually recommended that the first patch be placed on the first day of your next menstrual period. If the patch is started on any other day, use a backup contraceptive for 7 days. Start the patch on a day that is easy to remember.

The patch can be applied to your lower abdomen, buttocks, or upper body but not on the breasts. Apply a new patch once a week on the same day of the week for 3 weeks. The patch delivers the hormones daily over 7 days. Wear each patch continuously until you replace it the following week. No patch is worn during the fourth week, so you have a menstrual period.

A small number of women have reported that the patch has partially or completely come off. If this happens before your patch is due to be changed, apply a replacement patch right away.

A small number of women have some mild to moderate skin irritation from the patch.

When you remove a patch, dispose of it carefully. Because of environmental concerns about hormones in the water supply, don't flush it down the toilet.

Patch warnings

The patch delivers more estrogen than low-dose birth control pills do. Some research has found that women using the patch are more likely to get dangerous blood clots in the legs and lungs. The risk may be higher if you smoke or have certain health problems. The U.S. Food and Drug Administration suggests that you talk to your doctor about your risks before using the patch.

Direct sunlight or high heat can increase, then lower, the amount of hormone released from a patch. This can give you a big dose at the time and leave less hormone for the patch to release later in the week. This increases your risk of pregnancy. Avoid direct sunlight on the hormone patch. Also avoid using a tanning bed, heating pad, electric blanket, hot tub, or sauna while you are using a hormone patch.