Services / Contraception

How does the contraceptive patch work?

The patch is applied to clean, dry and hairless skin. This may include skin on the buttock, abdomen, upper outer arm or upper torso (but do keep it away from areas of great rubbing). You should avoid placing it on your breasts, thighs or skin that is red, irritated or cut.

The patch has a strong glue to keep showering, bathing and swimming are all fine, but do check the patch is still in place after such activities.

If you start the patch in the first seven days of your cycle, then it will start working immediately. However, if you apply it after this time, you will need to wait 7 days for the patch to start working.

Once the patch is applied, the hormones estrogen and progesterone hormones are released through the skin. This:

• Inhibits ovulation
• Thickens the cervical mucus and thus making it harder for the sperm to enter the uterus
• Thins the uterine lining as so help prevent the implantation of a fertilised egg

Each patch will need to be changed every 7 days (and ideally in a new location to avoid skin irritation).

After three consecutive patches, you may either place a new patch or have a ‘withdrawal bleed’ (technically, this is not a period as there is no egg being passed out). It can take 1-5 days after removing the patch for this to happen. This can be different for many women but you normally get to know when your bleed is due to arrive.

What are some of the benefits of using the contraceptive patch?

• It does not interrupt sex
• It usually makes your bleeds regular, lighter and less painful
• It reduces the risk of cancer to the ovaries, womb and colon
• It can reduce symptoms of premenstrual syndrome
• It can sometimes reduce acne
• It may protect against pelvic inflammatory disease
• It may reduce the risk of fibroids, ovarian cysts and non-cancerous breast disease
• It is used weekly so you don’t have to remember to do something every day.

What are the possible side effects of using the patch?

Temporary side effects
These can include: headaches, nausea, breast tenderness and mood swings. However, they usually subside within a few months – if they don’t you may wish to consider another method. 

Breasts
Estrogen and Progesterone may lead to breast tenderness. However, it does not necessarily make them larger.

Weight
Whilst there is no evidence that using the contraceptive patch leads you to putting on weight, the hormones can affect women in different ways and some can see an increase in their appetite or fluid retention. 

Blood pressure
You may experience a slight increase in your blood pressure. We will monitor this upon starting and as you come in to collect additional months supplies.

Allergic to glue
In order to remain on your skin, the contraceptive patch is designed to be sticky. However, some women may be allergic/sensitive to this glue and in such cases another method will be recommended. 

In rare cases
The contraceptive patch may lead to a small increase of blood clots in the legs/lungs (Venous Thromboembolism or VTE). However, this risk is greatest upon starting the method but then subsides and remains stable throughout the use of the method. Stopping and then restarting the method is therefore discouraged as once settled it is safe to remain on the method.

Additionally, the use of the contraceptive patch is also associated with a small increased risk of breast cancer. However, this risk also subsides over time.

What can make the contraceptive patch less effective?

(a) If the contraceptive patch is partly detached:

For less than 24 hours then it should be re-applied in the same place or replaced with a new patch. No additional contraception is needed.

The next EVRA transdermal patch should be applied on the usual “Change Day”.

For more than 24 hours (or if you’re not sure) you may be at risk of pregnancy. As such, you will need to apply a new patch and continue as if it’s the first day of your contraceptive cycle. A non-hormonal contraceptive may be needed along with the patch for the first seven days only.

(b) If the contraceptive patch is no longer sticky:

Please apply a new contraceptive patch.

(c) If you are on certain medications:

Some medications used to treat Epilepsy, TB, HIV and over-the-counter drugs such as St John’s Wort can make the patch less effective thus and increase the chance of pregnancy. This will be discussed in your appointment.

Can anyone use the patch?

The patch is safe for the majority of women. However, women with the following may wish to consider an alternative method:

• History of blood clots
• Migraine sufferers (especially, specifically migraine with an aura)
• Uncontrolled or high blood pressure (hypertension)
• History of breast cancer
• History of acute liver disease or infection
• Body mass index (BMI) of 35 and over
• History of stroke, heart disease and atrial fibrillation
• Aged 35 and smoke
• Thrombogenic mutations
• Multiple risk factors for cardiovascular disease (i.e. smoking, hypertension, diabetes, obesity)
• Certain medications for Epilepsy, HIV and TB
• Immediate family with VTE under the age of 45 years

How do I stop using the contraceptive patch?

The safest way of stopping the patch is to change to your new method whilst using the patch for 7 days, simultaneously.

If you stop the patch in the first 7 days after your bleed, any sexual activity in the patch free week could result in a pregnancy if no other method is used.

If you are planning to conceive, you may wish to complete the 3 patches of the month, have your ‘withdrawal bleed’ and not restart the patch.

Women who are undergoing major surgery with prolonged immobilisation need to suspend the method and use a safer alternative, progesterone only pills, implant, injectables or coils.

When will my fertility return after I stop using the patch?

If you do not apply a new patch after a patch-free week, you may release an egg and may become pregnant straight away. However, for some women this can take a few months for periods to become more regular and for the hormone balance to return to normal.

I’ve just had a baby, can I have the contraceptive patch?

We recommend waiting 4 weeks after delivery before using the patch. Please note that the patch can slightly increase the risk of VTE which is much higher after having a child.

However, the manufacturers recommend delaying the use of the patch until your baby is fully weaned. This is because the hormones can pass for the mother to child whilst breastfeeding and this may have an effect on milk production and supply. Additionally, if you baby was born early, small for gestational age or growth retarded you may want to consider another method.

This, and more, will all be discussed at the time of your appointment.

Can I use the contraceptive patch after a miscarriage or abortion?

If the pregnancy was under 20 weeks, then you can start using this method immediately.

However, if the pregnancy was over 20 weeks, we recommend waiting until day 21 of your cycle or until when your period starts.