The birth control patch is a thin, adhesive patch applied to the skin that delivers hormones to prevent pregnancy. These patches, such as Xulane, Zafemy, and Twirla, contain synthetic estrogen and progestin, similar to those found in combination birth control pills. The hormones from the patch are absorbed through the skin into the bloodstream. This hormonal delivery primarily works by preventing ovulation, meaning the ovaries do not release an egg. Additionally, the hormones thicken cervical mucus, making it harder for sperm to reach an egg, and thin the uterine lining, which can make it less receptive to a fertilized egg.
Understanding the Patch Schedule
The standard schedule for the birth control patch involves a 28-day (four-week) cycle. You apply a new patch once a week for three consecutive weeks. This means you will wear three patches during a cycle, each for seven days.
Following the three weeks of patch use, the fourth week is designated as patch-free. During this week, you typically experience withdrawal bleeding, similar to a menstrual period. After these seven patch-free days, a new 28-day cycle begins by applying a new patch, even if bleeding is still occurring. Maintaining consistency is important; you should apply each new patch on the same day of the week, which becomes your “patch change day.”
For example, if you apply your first patch on a Monday, all subsequent patches in that cycle should also be applied on a Monday. This consistent weekly timing helps maintain a steady level of hormones in your system, which is important for the patch’s effectiveness in preventing pregnancy. Following this schedule precisely is necessary, as delaying or missing applications can lower its efficacy.
Proper Application and Replacement
The patch should be placed on clean, dry, and hairless skin. Avoid applying it to skin that is red, irritated, cut, or where lotions, creams, powders, or makeup have been used, as these can affect adhesion and hormone absorption.
Suitable body areas for placement include the buttocks, abdomen, upper outer arm, or upper torso, but never on the breasts. When applying a new patch, you first remove the old one. Then, carefully open the new patch’s foil pouch, peel away half of the clear protective lining, and apply the sticky side to the chosen skin area.
After placing the first half, remove the remaining clear lining and press the entire patch firmly with the palm of your hand for about 10 seconds, ensuring all edges adhere well. To prevent skin irritation, rotate patch sites with each new application, avoiding the exact same spot as the previous patch. This practice helps maintain skin health and consistent hormone delivery.
Handling a Missed Patch Change
Missing a patch change can affect contraceptive protection, and the necessary steps depend on when the change was missed. If you miss a change during weeks 2 or 3 of your cycle, and it has been less than 48 hours since your scheduled change, you should apply a new patch immediately. Your regular patch change day remains the same, and backup contraception is not typically needed in this scenario. If the patch has been off or partially off for less than 24 hours, you can reapply the same patch if it’s still sticky, or apply a new one, and your patch change day remains unchanged.
However, if you miss a patch change at the beginning of a new cycle (Week 1) or if a patch has been off for more than 48 hours during weeks 2 or 3, specific actions are needed. In such cases, you should apply a new patch as soon as you remember, which will become your new “Day 1” and establish a new patch change day. Crucially, you will need to use a backup method of contraception, such as condoms, for the first seven days of this new cycle. If unprotected intercourse occurred during the extended patch-free interval, emergency contraception may be considered. It is important to remember that there should never be more than seven consecutive patch-free days.
Important Considerations for Use
When starting the birth control patch, there are typically two main approaches: the “first-day start” or the “Sunday start.” With a first-day start, you apply the initial patch on the first day of your menstrual period, providing immediate contraceptive protection. If you opt for a Sunday start, you apply the first patch on the first Sunday after your period begins, but you will need to use a backup contraception method for the first seven days. If your period happens to start on a Sunday, you can apply the first patch that day without needing backup contraception.
Several factors can influence how well the patch adheres to the skin and, consequently, its effectiveness. Excessive sweating, certain products like lotions or oils, or placement in areas rubbed by tight clothing can compromise adhesion. If the patch becomes loose or falls off, check the instructions for your specific brand. Always refer to the detailed instructions provided with your birth control patch, as there can be minor differences in guidance. Consulting with a healthcare provider remains the best course of action for any questions or concerns regarding patch use, especially if skin irritation develops or if you are unsure about the correct procedure.