Xulane (norelgestromin and ethinyl estradiol transdermal system) is a convenient form of hormonal contraception designed to prevent pregnancy. This transdermal patch delivers hormones through the skin, offering a weekly birth control method. It provides an alternative for individuals seeking a non-oral contraceptive option.
How Xulane Prevents Pregnancy
Xulane releases two hormones, norelgestromin (a progestin) and ethinyl estradiol (an estrogen). These hormones primarily prevent pregnancy by inhibiting ovulation, stopping the release of an egg from the ovary.
They also thicken cervical mucus, making it harder for sperm to enter the uterus. Additionally, these hormones alter the uterine lining, reducing the likelihood of a fertilized egg implanting.
Onset of Xulane’s Contraceptive Protection
The time it takes for Xulane to become fully effective depends on when the first patch is applied in relation to an individual’s menstrual cycle. There are two primary methods for starting Xulane.
One method, known as the Day 1 Start, involves applying the first Xulane patch during the first 24 hours of a menstrual period. When initiated this way, Xulane provides immediate contraceptive protection, and backup birth control is not needed.
Alternatively, individuals can choose a Sunday Start, where the first patch is applied on the first Sunday after their menstrual period begins. With this approach, a non-hormonal backup contraception method, such as condoms and spermicide, is necessary for the first seven days of the first cycle. If a period happens to start on a Sunday, the patch can be applied that day, and no backup method is required.
In situations where Xulane is not applied within the first 24 hours of a menstrual period or if using the Sunday start method, the seven-day waiting period with backup contraception is important. This allows the hormone levels to build sufficiently in the body to reliably prevent pregnancy.
Using Backup Contraception Initially
The need for backup contraception depends on the chosen start method for Xulane. If the patch is applied on the first day of a menstrual period, immediate protection is typically achieved, and backup is not required. However, if starting on the first Sunday after a period begins, or at any other time outside the first 24 hours of menstruation, a backup method should be used for the first seven days. This temporary measure helps bridge the gap until the hormones establish complete contraceptive action.
What Can Affect Xulane’s Effectiveness
Several factors can reduce Xulane’s effectiveness: Proper application is important; if the patch does not stick securely, falls off for more than 48 hours, or is not replaced promptly, its contraceptive protection may be compromised.
Body weight also affects Xulane’s effectiveness. The patch may be less effective in individuals weighing 198 pounds (90 kilograms) or more. Additionally, Xulane is not recommended for those with a body mass index (BMI) of 30 kg/m² or higher due to a potential increase in blood clot risk.
Certain medications and herbal supplements can interfere with Xulane’s ability to prevent pregnancy. These include some seizure medications, such as phenytoin, carbamazepine, oxcarbazepine, topiramate, and lamotrigine. Specific antibiotics like rifampin, rifabutin, and griseofulvin, certain HIV medications, and the herbal supplement St. John’s Wort can also reduce the patch’s effectiveness.