CONTRACEPTIVE PATCH

Much like the combined pill, birth control patches contain two hormones. One is a progestogen, and the other an oestrogen. These hormones occur naturally in your body too, and they impact the motions it goes through each month to prepare itself for possible pregnancy. Here are the basics:

Ovulation is when the ovary releases an egg. If that egg is fertilized, it travels to the uterus and attaches itself to the wall to grow. The lining of the uterus (aka the endometrium) gets thicker just before this, making it easier for a fertilized egg to settle in.

The hormones in the birth control patch stay busy trying to block every part of this process. They can stop ovulation, keep the endometrium from growing thicker, and change the density of the fluid in your cervix so it’s hard for sperm to swim through. So no egg, no welcoming walls to attach to, and no fertilization.

When you should start using the patch depends on whether you’re already using hormonal birth control.

If you haven’t been using other birth control methods, you can start using the patch on the first day of your period — or any day of your period up, until the fifth day. You’ll be protected against pregnancy straight away.

If you start on any other day, you won’t be protected immediately and should use a back-up birth control method like condoms for a week. That gives the hormones in the patch enough time to become active.

When switching from the combined pill to the patch, put the patch on one day before your pill-pack finishes. Changing from the contraceptive ring over to the patch, you should put on a patch two days before removing the ring.

You can wear the patch on your thighs, buttocks, upper outer arm or upper body. Just make sure to place it on clean, unbroken skin. Don’t place the patch on dry, irritated or cracked skin.

Wherever you place the patch, make sure that it won’t be rubbed by tight clothes. This could make the patch less sticky, causing it to fall off. Be careful when applying lotions, creams or powders to the area where the patch is too.

When it’s time for you to take your patch off and put on a fresh one, you should place your new one on the opposite side of your body. Change your placement each week — if you have just worn your patch on the left side, wear the next one on your right.

Whenever you use any kind of medication or hormonal birth control, there is a chance that you could experience side effects. The most common side effects related to hormonal contraception should be mild and easy to manage, and they normally go away after a month or two. 

But if the side effects you experience are making your life that bit more difficult, reach out to the doctor for some advice. They may advise that you switch to something else.

The most common side effects of using the birth control patch are:

• tender breasts
• nausea
• headaches
• irregular bleeding (breakthrough bleeding or spotting)

If you experience any of these side effects, don’t panic. They’re totally normal. 

There are more serious side effects of using the birth control patch too. They are rare, but they can have a significant impact on your health. 

If you experience any serious side effects when you’re using the birth control patch, take it off and go to the emergency room. 

More serious side effects include:

• migraine
• new or worsening depression
• severe pains in your stomach
• changes to your periods
• jaundice (yellowing of the eyes and skin)
• lumps in your breasts
• signs of a heart attack (chest pain, shortness of breath and feeling weak)
• signs of a stroke (your face drooping on one side, slurred speech and numbness on one side of your body)
• signs of a blood clot (throbbing in your leg, breathlessness and coughing up blood)

The patch is designed to stay on for a full week, even when you have a shower or go swimming. But sometimes, if the patch has rubbed against your clothes or if it wasn’t put on right, it can peel away.

If the patch has been off for less than 48 hours, you should stick it back on (assuming it’s still sticky enough). Press down on it for around 10 seconds to get it to reattach. After that, keep using your patch as normal and change it on the normal day. If the patch that came off isn’t sticky enough to be put back on your skin, put a fresh patch on but keep your original patch-changing schedule.

You don’t need to worry about using another form of birth control if your patch has been off for less than 48 hours.

If it’s been 48 hours or more (or if you’re not entirely sure how long the patch has been off your skin), you should use back-up birth control as your protection will have been compromised. Use condoms or a diaphragm for 7 days and put a new patch on your skin. This day will now become your changeover day and you’ll begin a new cycle.

If you have had unprotected sex since the patch has been off (or if you’re not sure your patch was still on when you had unprotected sex), you should take a pregnancy test.

The one birth control patch available in the UK is Evra. There are different names for the same patch in the USA, including Ortho-Evra and Xulane. It’s only available as combined birth control. At the minute, there’s no patch version of the progestogen-only pill.

Yes, hormonal birth control in general can be affected by other medications. So it’s important to let the licenced clinician know if you’re currently taking medication so they can determine that the patch is right for you. 

The patch is known to interact with:

• Hepatitis C medication; 
• epilepsy treatment;
• drugs used to treat HIV;
• St John’s wort;
• Ospemifene (taken to treat dyspareunia);
• Tamoxifen, sometimes known as Nolvadex (used to prevent and treat breast cancer);
• Tizanidine (treats muscle spasticity because of a spinal injury or multiple sclerosis).

No, the birth control patch isn’t suitable for all women to use. Because it is a combined birth control method, it contains oestrogen, which can be an issue for some women.

It’s not safe to use the patch if:

• you smoke
• you are over 35 years of age
• you have a history of blood clots
• you are allergic to any of the ingredients in the patch
• you have or had a cancer that is hormone sensitive (like breast cancer or womb cancer)
• you have liver disease
• you’re breastfeeding
• you’re diabetic

It’s important to let the doctor know if you have any health problems. 

In some cases, they may recommend a lower dose of hormones or the progestin-only pill instead.

Take our online consultation to get started. You’ll answer a few questions and our prescriber reviewing your profile will make treatment recommendations based on your medical history and what your birth control needs are. They’ll send you a list of options, which will include the patch if they think it’s a good fit. Once you pick the birth control you want, you’ll sign up for a subscription plan to make sure you get refills on a schedule that works for you.

A prescription will then be created for you and sent to our dispensing pharmacy. Once your patch is ready, you’ll receive it in secure packaging in one working day. And then again every 3, 6 or 9 months, depending on your choice of delivery schedule.

After 12 months, you’ll have a quick online check-up with the clinician, who will write another prescription as long as everything is going okay. Then you can continue to receive your patch, by subscription, as and when you need it.