Patch

contraceptive patchThe patch is a small sticky patch that sticks to your skin and releases artificial copies of the hormones oestrogen and progesterone which are absorbed through your skin and into your bloodstream. It contains the same hormones as the combined pill, and it works in the same way. This means that it prevents ovulation (the release of an egg); it thickens cervical mucus, which makes it more difficult for sperm to travel through the cervix; and it thins the womb lining, making it less likely that a fertilised egg will implant there.

You can use it on most areas of your body, as long as the skin is clean, dry and not very hairy.

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

You should not stick it on:

  • Sore or irritated skin
  • Anywhere it may get rubbed off by tight clothing
  • 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.

Benefits:

  • Doesn’t interrupt sex
  • May reduce heavy or painful periods
  • You only need to replace it once a week
  • Usually makes periods regular, lighter and less painful
  • Fertility returns to normal when removed
  • You can wear it in the bath, in the swimming pool and while playing sports
  • It may protect against ovarian cancer, womb cancer and colon cancer.

Disadvantages:

  • It can increase blood pressure
  • Some women get temporary side effects, such as headaches, breast tenderness, mood changes and nausea
  • Some women develop a blood clot when using the patch, but this is rare
  • It may not be suitable for women who smoke and who are 35 or over, or who weigh 90kg (14 stone) or more.
  • It does not protect against sexually transmitted infections (STIs), so using a condom as well will help to protect you against STIs.

How effective is it?

The patch is 99% effective when used properly. This means that 1 in every 100 women who use it get pregnant every year. It is less effective if not used according to the instructions. With typical use, the patch is 91% effective.

What makes it less effective?

  • Forgetting to change it after seven days
  • If it falls off and is not reapplied or if a new one is not put on immediately
  • Use of some prescription medicines including some antibiotics, medicines used to treat epilepsy, HIV and TB and the complementary medicine St John’s Wort.

What to do if the patch falls off?

If it does fall off, what you need to do depends on how long it has been off, and how many days you had it on before it came off.

If the patch has been off 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 one in place with a plaster or bandage)
  • Continue to use your patch as normal and change it on your normal change day.
  • You will still be protected against pregnancy as long as the patch was on properly for seven days before the patch came off. If this is the case, you do not need to use additional contraception.
  • If you have had a patch on for 6 days or less before it falls off, you may not be protected against pregnancy and should use additional contraception, such as condoms, for 7 days.

If the patch has been off for 48 hours or more, or you're not sure how long it has been off:

  • 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 7 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.

What to do if you forget to take the patch off?

If you forget to take it off after week one or two, what you need to do depends on how long you have forgotten it.
If it has been on for:

  • Less than 48 hours longer than it should have been (eight or nine days in total)
    • Take off the old patch and put on a new one.
    • Continue to use your patch as normal, changing it on your normal change day.
    • You don’t need to use any additional contraception and you are protected against pregnancy
  • 48 hours or longer than it should have been (10 days or more in total)
    • Start a whole new patch cycle by applying a new patch as soon as possible. This is now week one of the patch cycle and you will have a new day of the week as your start day and change day.
    • Use another method of contraception, such as condoms, for the next 7 days.
    • Ask your doctor or nurse for advice if you have had sex in the previous few days and were not using a condom, as you may need emergency contraception
  • If you forget to take it off after week three
    • Take the patch off as soon as possible and start your patch-free break.
    • Start a new patch on your usual start day, even if you are bleeding. This means that you will not have a full week of patch-free days.
    • You will be protected against pregnancy and do not need to use any additional contraception.
    • You may or may not bleed on the patch-free days.

What to do if you forget to put a patch on after the patch-free week?

  • If you forget to put it on at the end of the patch-free week, put a new one on as soon as you remember
  • If you put it on 48 hours late or less (so the patch-free interval has been nine days or less), you will still be protected against pregnancy, as long as you wore the patch correctly before the patch-free interval
  • If you put it on more than 48 hours late, so the interval has been 10 days or more, you may not be protected against pregnancy and need to use additional contraception, such as condoms, for seven days. Ask your doctor or nurse for advice if you have had sex in the patch-free interval, as you may need emergency contraception.

For more information visit the FPA website