10 Questions About The Patch, Answered

We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. No gender, sexual orientation, or question is off limits, and all questions remain anonymous. This week’s topic: the birth control patch.

Q: I’ve gotta stop taking the pill because I’m not all that good at remembering to take it, specifically on the weekends when my schedule is different and I’m not always at home. I’m freaked out by all the super long-term options, like the IUD and arm implant , but I still want a method of hormonal birth control because it makes my skin nice and I just trust it more. I’ve heard the patch mentioned sometimes, but I don’t know that much about it. Is the patch as effective as the Pill? How often do you have to put it on, and how long does each patch last? How does the hormone get into your skin?

A: The transdermal patch is a great birth control option if you want a method of contraception that you don’t have to think about every day. Here's what you need to know about this under-sung hero of birth control.

1. What Is It?

The transdermal patch looks like a square band-aid that’s about two inches by two inches in size. It’s made out of thin plastic, has adhesive on one side, and comes in one color — fake-white-person-skin-color, often called beige.

You wear one patch for a week at a time, and then swap it out for a new one. After you do this for three weeks in a row, you skip a week — which is when you get your period. So basically, if you’re using the transdermal patch method of birth control, you’re wearing a small sticker on your body three quarters of the time. Not intrusive, but people who see you naked will definitely see you rocking it.

2. How Does It Work?

The patch works like other methods of hormonal birth control. Each patch contains synthetic versions of two hormones your body makes naturally: estrogen and progesterone. These hormones prevent pregnancy by stopping your ovaries from releasing mature eggs and also making your cervical mucus thicker so that it acts as a physical barrier preventing sperm from getting up into your uterus in the first place.

3. How Well Does It Work?

If you use the patch exactly as you’re supposed to — putting on a new one exactly once a week, taking a week off after your third week, and then starting again exactly a week later — it’s over 99 percent effective. This means that fewer than one out of every 100 people using the patch perfectly will get pregnant every year. For those of us who aren’t perfect, typical use is 91 percent effective, or nine out of every 100 people getting pregnant every year.

There are a few medications that can undermine the efficacy of this birth control method. If you’re taking rifampin (an antibiotic), griseofulvin (an antifungal), some HIV medications, some anti-seizure medications, or the herbal supplement St. John’s wort, tell your doctor before you start the patch. Also really important to know — the patch isn’t as effective if you weigh more than 198 pounds. If this is you, tell your doctor because she may suggest you use something that will work better.

It’s also important to note that like other forms of hormonal birth control, the patch doesn’t protect you against sexually transmitted infections.

4. How Soon Does It Start Working?

How soon you’re protected from pregnancy depends on when you start your first patch, in relation to your period. If you start the patch method in the first five days of your period, you’re protected immediately. If you start after that, there’s a gap of seven days when you won’t be protected yet — so use a backup method of contraception for that week.

5. Will I Get A Period?

When you’re on the patch, you will still get a period each month, although it may be lighter and shorter than it was without the patch — this is totally normal and many people find it to be a benefit. Your period will come during the week when you’re not wearing a patch. If you’re still experiencing your period when it’s time for you to put your next patch on, that’s OK.

If you don’t want to get your period ever, there are a bunch of birth control options out there on the market for you! These include the birth control injection, the hormonal IUD option, and the implant. Using the patch continuously (as in, putting on a new one each week without a gap week every fourth week) is still being tested and is not currently FDA approved. If you don’t want your period to change at all, then hormonal birth control may not be for you.

6. What Are The Potential Benefits?

People love the patch because it’s easy to use and doesn’t interrupt the moment. As mentioned already, it can make your period lighter and shorter, which many people like. It can also help improve acne, painful menstrual cramps, and premenstrual syndrome (PMS), and may additionally protect against bone density loss, non-cancerous breast growths or cysts, ectopic pregnancies, both endometrial and ovarian cancers, and pelvic inflammatory disease.

It’s good to know that many of these health benefits span hormonal birth control options.

7. What Are The Potential Side Effects?

Some people bleed between their periods, get nauseated, and experience breast tenderness when they’re on the patch. Usually, these symptoms go away after around three months. Side effects that may not go away include skin irritation where you put your patch and changes to your libido, as well as some way rarer, but more serious, health problems.

If you are experiencing irritation, try moving the patch to another spot to see if that works better, and cortisone cream to relieve the itching.

8. How Do I Get It?

To get the patch, you need a prescription from a doctor. Once you have a prescription, you can pick up your box of patches at your local pharmacy or clinic. Depending on your insurance, it can cost you anywhere from nothing to $80 a month.

9. How Do I Use It?

The patch is pretty easy to use if you follow these steps.

Step 1: Keep Your Patches Stored Correctly

Your patches like cool, dark places, so keep them at room temperature and make sure they’re not in direct sunlight. Also don’t take it out of its packages until you’re ready to put it onto your body.

Step 2: Choose Where You Want To Put It

The patch can go on your butt, stomach, upper arm, or back — but not your breasts. Choose a place that works for you, and make sure you stick with it all week. You can always change the location when you put your next patch on the next week.

Step 3: Make Sure The Area Is Clean & Not Irritated

Don’t put your patch on an area of skin that has cuts or is otherwise irritated, because that won’t feel good. And also don’t put on any moisturizers or makeup on the area before you put on your patch — it might make it easier for your patch to fall off!

Step 4: Administer Your Patch

The transdermal patch is basically an adult sticker so its mechanism probably isn’t wholly unfamiliar to you, but there are some tips for putting it on correctly. First off, peel half of the back off — that way you can hold onto a non-sticky part when you stick it to your skin. Put the sticky side onto your skin in the desired area, and then pull off the rest of the back so that the whole sticker is on your skin. Make sure not to touch the sticky part with your fingers, because it’s super sticky and hard to get off. Finally, push down on the patch for about 10 seconds, to make sure it’s really on there.

Step 5: Set An Alarm (Or Some Sort of Reminder)

The hardest part of using the patch as your birth control method is remembering to change it every week, so it’s important to figure out a method for reminding yourself. A weekly phone alarm is a great option, and there are also offerings to help you remember — like Bedsider’s awesome text and email reminder system. It’s also important to make sure you have enough new patches stashed for the next week, so that you’re not left in the lurch when the next patch day comes around.

Step 6: Keep An Eye On It

As we all know from putting stickers all over our bodies as children (No? Just me?), sometimes stickers start to fall off. While the patch is way stickier than most stickers, it’s still important to check it every day to make sure it’s still where it should be.

Step 7: Swap Out Your Week-Old Patch For A New One

After one week, repeat Step 4, but with a new patch. If you’re putting the new patch in the same place, make sure that place is clean. You can get any leftover adhesive off by rubbing it with baby oil (but make sure to wash the oil off afterward). This will erase any unsightly darker patches created by fuzz catching in the adhesive.

Step 8: Make Sure To Discard Your Old Patch Correctly

When ditching your old patch, make sure to fold it in half (sticking it to itself) and put it in a sealed plastic bag before you throw it out.

Definitely don’t flush it down the toilet — the patch still has some hormones in it, and you don’t want that to get into our water supply or soil.

10. What Do I Do If It Falls Off?

Patches actually don’t fall off that often — only around five percent of the time. But if it happens to you, don’t panic. If you notice within 24 hours and the patch is still sticky, you can just put it back on. If it’s within that time frame but the patch isn’t sticky anymore (or you can’t find it), just put on a new patch. If it’s been more time than that, put a new patch on but also use a backup method of contraception (like condoms or a diaphragm) for the next seven days. Planned Parenthood has a handy guide for timing this correctly based on which patch of the month you’re dealing with.

It’s important to only put on a patch if it’s sticky. Never try to salvage a not-really-sticky-anymore patch with bandages or tape. The hormones are mixed with the adhesive, which means that if your patch isn’t sticky anymore, it’s probably not as effective either.

If you have vaginal sex without your patch on (like maybe it fell of and you didn’t notice until afterwards), go ahead and take emergency contraception to protect yourself against pregnancy.

The Bottom Line

The transdermal patch is a great birth control option to check out — particularly if you like getting your period, don’t want to have to remember to do something every day but feel confident you can remember to do something once a week, and (the most important part in my opinion) you’re excited to wear a sticker for most of your life. If this sounds like you, talk to your doctor about getting a prescription for the patch. She’ll help you figure out all the details.

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