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Contraceptive Patch (Ortho Evra)

What is it?

The patch is a once a week method of birth control that uses similar hormones to a pill. It is a prescription.

How does it work?

The Patch prevents pregnancy by delivering continuous levels of hormones (progestin and estrogen) into the bloodstream through the skin. The Patch works the same way that pills do: by preventing ovulation. This means that the ovary does not release an egg to be fertilized. It also thickens the cervical mucus, which makes it more difficult for sperm to enter the uterus, and it changes the endometrium, which is the mucus membrane that lines the uterus, to reduce the chance of implantation. 

The Patch is worn for one week at a time and is changed on the same day of the week 3 times a month. The fourth week is patch free.

When do I start it?

If you start the patch from the first day of your period until the 5th day, you have immediate pregnancy protection. If it is later than the 5th day after the start of your period, use condoms for 7 days for contraception.

Where do I put it?

Choose a place on your body to put the Patch: your upper outer arm, abdomen, buttock or upper torso in a place where it won't be rubbed by tight clothing; for example, do not place the Patch at the waistband of your clothing. Do not put the Patch on your breasts, on cut or irritated skin, or in the same location as the previous Patch.

When do I change it?

The Patch works for seven days (one week). Apply a new patch on the same day each week (your Patch Change Day) for three weeks in a row. Make sure you have removed your old patch before applying the new patch.

During week 4, DO NOT wear a patch. Make sure you removed your old patch. (Your period should begin during this week.) Following week 4, repeat the cycle of three weekly applications followed by a patch-free week.


What if my Patch becomes loose or falls off?

If a Patch edge lifts up:

Press down firmly on the Patch with the palm of your hand for 10 seconds, making sure that the whole Patch adheres to your skin. Run your fingers over the entire surface area to smooth out any "wrinkles" around the edges of the Patch. The Patch must stick securely to your skin to work properly. If your Patch does not stick completely, remove it and apply a replacement Patch. Do not tape or wrap the Patch to your skin or reapply a Patch that is partially adhered to clothing

If the Patch has been off or partially off:

For less than 1 Day, try to reapply it. If the Patch does not adhere completely, apply a new Patch immediately. (No backup contraception is needed and your Patch Change Day will stay the same)

For more than 1 Day or if you are not sure how long the Patch was off, you may become pregnant. To reduce this risk, apply a new Patch and start a new 4-week cycle. You will now have a new Patch Change Day and must use non-hormonal backup contraception (such as a condom, spermicide, or diaphragm) for the first week of your new cycle.

How effective is it? The Patch is as effective as oral contraceptives:

  • Typical Use:  92%
  • Perfect Use:  99.7%   

What are the advantages unique to the patch?

  • Weekly routine compared to daily
  • No pills to swallow

What are the disadvantages unique to the patch?

  • Skin irritation and 1-2% experience partial or complete detachment of the Patch
  • Patch may be less effective for women over 198 lbs.
  • Only one formula and color are available at this time.

Like Birth Control Pills & other options, the patch does not protect against the transmission of sexually transmitted infections including HIV (AIDS).  Use latex condoms for increased protection against the transmission of sexually transmitted infections including HIV (AIDS).

  • You may be exposed to approximately 60% more estrogen as compared to taking the pill.  Why? Birth Control Pills go through the digestive system and are diluted; not so for the hormones in the Patch.

What are the possible side effects of the Patch?

Most common side effects: Include nausea, breast symptoms (discomfort, engorgement, or pain), headache, and skin problems. Irregular vaginal bleeding, problems wearing contact lenses, fluid retention in ankles. See product FDA insert for more details.


What are health risks with using the patch?

Hormones from the Patch get into the bloodstream and are processed by the body differently than hormones from birth control pills. You will be exposed to about 60% more estrogen if you use the Patch than if you use a typical birth control pill containing 35 micrograms of estrogen. In general, increased estrogen may increase the risk of side effects such as serious blood clots, especially in women who have other risk factors, such as smoking, obesity, or age greater than 35 years. This increased risk is highest when you first start using hormonal birth control. Some studies have reported that women who use the Patch have a higher risk of getting a blood clot. Talk with your healthcare provider about your risk of getting a blood clot before deciding which type of birth control is right for you.

Do not use the Patch if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects (heart and blood vessel problems) from hormonal contraceptives, including death from heart attack, blood clots, or stroke. The risk increases with age and the number of cigarettes you smoke.

Warning signs of a blood clot could be:

  • A Abdominal pain (severe) that cannot be explained by food or stomach flu
  • C Chest pain (severe or sudden or shortness of breath)
  • H Unusual or suddenly severe headaches with dizziness or vomiting
  • E Eye problems (blurred vision, flashing lights or blindness)
  • S Severe leg pain, one sided weakness or numbness in calf or thigh

Seek urgent medical care if you have any of these symptoms.