Patch

What is the birth control patch?

The birth control patch (sometimes called Evra) is a small, thin plastic patch containing 2 hormones (estrogen and progestin) that you wear on your skin.

In order to get pregnant, sperm must enter your vagina*, swim up into your uterus and fertilize an egg that has been released from your ovaries during ovulation. The patch prevents you from ovulating.
The patch thickens the mucus on your cervix (the opening to your uterus). This makes it harder for sperm to travel into your uterus and fertilize an egg.
The patch thins the lining of your uterus (the endometrium). This makes it harder for a fertilized egg to implant in your uterus and become a pregnancy.

The patch is 99% effective. This means that if 100 people used the patch correctly for one year, only one person would get pregnant.
Because the patch may be used incorrectly, it is closer to 92% – 97% effective with typical use.
If you use the patch incorrectly, your risk of getting pregnant increases.
The patch may be less effective if you weigh more than 198 lbs.

The patch works on a 28-day cycle, using 3 patches per cycle.
Week 1: apply the first patch on clean, dry, lotion-free skin.
Week 2: remove first patch and apply second patch on the same day of the week that you applied your first patch.
Week 3: remove second patch and apply third patch on the same day of the week that you applied your second patch.
Week 4: remove third patch. Do NOT apply a new one. The next 7 days (week 4) will be “patch-free.” You can expect your period sometime during this week.
At the end of that 7 day patch-free week, apply a new patch.
Remember, you are protected from pregnancy during the patch-free week as long as you have been using the patch correctly and you apply your next patch on time.
Some people use the patch continuously (no patch-free week) to avoid having their period, sometimes called “stacking.” If you are interested in doing this, speak to your clinician first.
If you are late removing or applying your patch, consult the instructions in your patch package and/or call your clinician to see if you need to come in for an appointment and/or use a back-up method of birth control for 7 days.

If you decide, along with your clinician, that the patch is right for you, they will write you a prescription. You can purchase your patches at a pharmacy (approximately $20/month) or at PPT’s Health Services (approximately $10/month).
If you start the patch within the first 5 days of getting your period, you are protected from pregnancy right away.
If you start the patch 6 or more days after getting your period, you are not protected from pregnancy until you have been using the patch for a full week. To avoid pregnancy during this time, use a back-up method of birth control like condoms or spermicides.
A clinician may recommend that you use a back-up method of birth control for a longer period of time when you start the patch.
Some people like to start the patch on the first Sunday following the start of their period, whether they are still bleeding or not. This will likely keep you from getting future periods on the weekend.

You can wear the patch on your butt, back, the outside of your arm or on your lower abdomen (stomach). Do not place the patch on or near your breasts*.
You can shower, swim, exercise and do regular activities while wearing the patch. In 98% of cases, the patch does not fall off.

You may experience minor side effects such as nausea, sore breasts, moodiness and/or spotting (a little bit of bleeding that is lighter than your period). These usually go away within the first 3 months of using the patch.
You may experience skin irritation on the spot that you wear your patch. Every time you change the patch, switch sides or apply it to a different site to avoid skin irritation.
If after 3 months you are still experiencing side effects or your side effects are severe, you may want to try a different method of birth control.
There is a rare risk of getting blood clots, or having a heart attack or stroke while using the patch. Smoking, obesity, and other health conditions increase this risk. Speak to your clinician for more information.
Signs of a blood clot include: blurred or loss of vision, chest pain or difficulty breathing, migraine headaches, severe abdominal cramps, or severe pain in the leg. If you experience any of these symptoms, get medical attention right away.

If you use the patch correctly, your chances of getting pregnant are very low.
You don’t have to do anything before or after you have sex.
You don’t have to do something every day.
You are less likely to have side effects than you are with the pill.
Your period will likely become shorter, lighter, less painful, and more regular.
The patch can improve acne and increase bone strength.
It doesn’t affect your ability to get pregnant in the future.
Your partner(s) don’t have to be involved.
The patch lowers your chances of ovarian and endometrial cancer and fibroids.

You have to remember to remove and apply a new patch every week.
If the patch comes off or starts to peel back, your risk of getting pregnant increases and you may need to use a back-up method of birth control for seven days (one week).
The patch comes in only one colour, light beige, which may not match your skin.
You may experience side effects.
You may not be able to use the patch if you have certain health problems.
If you have a personal and/or family history of breast cancer or you are HIV positive, talk to your clinician for more information.
If you smoke and you use the patch, your risk of getting a blood clot is higher
You need a prescription.
It can be expensive. However, PPT’s Health Services sells the patch at a reduced cost.
The patch does not protect you from sexually transmitted infections (STIs).

For a downloadable resource on this topic, please visit Planned Parenthood Toronto Factsheet Database.

If you have questions about this topic, feel free to contact one of our peer educators. [Link]

*We know that these aren’t the words everyone uses for their bodies (eg. trans folks), and support you using the language that feels best for you.

Last Edited: May 2020