Using the Patch

“The patch” is a transdermal (through the skin) method of using birth control. This method is an alternative to other methods made especially for those who do not prefer pills, vaginal rings, intrauterine devices, injections or implantable devices.

When the patch is applied to your skin, the hormones estrogen and progesterone move from the adhesive on the patch, through your skin and into your body. Your body then knows that estrogen and progesterone are coming from somewhere else (the patch), so your ovaries do not need to release those hormones. 

While using the patch, your hormones temporary go to sleep. While they are “napping,” they do not release hormones, and do not cause the release of an egg, which is a major way that the patch works to prevent pregnancy.

Forgetting to replace the patch as suggested can cause the ovaries to “wake up.” When that happens, the ovaries release hormones and may release an egg, which could result in pregnancy.

  • Apply your first patch to clean, dry skin in the recommended locations as directed (upper outer arms, buttocks and lower abdomen).
  • The day you apply the first patch is your “patch change day.” After applying the first patch, replace the patch once every week for three weeks on the patch change day. Alternate sites of placement to minimize irritation. 
  • On the fourth week you will not wear a patch. This is the “patch free week.” You should start your period this week. Most people start their period on the second or third day of this week. 
  • After seven days with no patch, apply a new patch on your “patch change day.” You might or might not still be on your period; it does not matter either way. You will again use one patch each week for three weeks and then one week without the patch.  
  • If an edge or corner of the patch becomes loose, try to press it down again. 
  • If the patch comes off and you are sure it has been off for less than 24 hours, apply a new patch. Stay on the same schedule with your patches and keep the same patch change day.
  • If the patch comes off and you have no idea when it came off, apply a new patch and start a new cycle. (This becomes patch No. 1 and this is your new patch change day.)
  • If you forget to replace a patch, your ovaries may “wake up.” Be sure to use condoms during intercourse for the next seven days to prevent pregnancy; start a new patch cycle if you are not pregnant.
  • If you have questions about what to do, call the triage nurse, 513-636-4681, option 2. 

Most people don't have any side effects with the patch. However, during the first three months you may experience:

  • Bleeding or spotting when the patch is on. This is called breakthrough bleeding and is usually worst during month one, less during month two and by month three most people have regular periods during the patch free week. If breakthrough bleeding continues after month three, you may need a different method.
  • Write down the dates of any bleeding that you have on a calendar. Bring the calendar to each visit with your clinician.
  • Other problems are not common, but you may have nausea, breast tenderness, headaches, or mood changes. If they occur, they are usually mild and don't last long. These symptoms usually occur when applying a new patch. This may be avoided by applying the patch at night.
  • If you are having problems that are making you feel miserable, do not stop using the patch, but call the triage nurse, 513-636-4681, option 2.
  • The patch does not cause weight gain. 
  • Severe headaches (the worst headache you've ever had)
  • Dizziness
  • Vision changes
  • Chest pain
  • Severe abdominal pain
  • Pain or swelling in the calf of one leg
  • Shortness of breath
  • The patch does not protect against sexually transmitted diseases. Use condoms every time you have sex. 
  • Never run out of patches. Call your pharmacy for a refill when you remove your patch on week three. If your pharmacy tells you that there are no more refills, call the triage nurse and ask for a refill. 
  • Never use someone else's patches or share yours with anyone else. 
  • If you are having a problem, don't just stop using the patch. Call the triage nurse, 513-636-4681, option 2.
  • The Ortho Evra patch is the only birth control patch available at this time. If you are unhappy with this method, discuss other methods of birth control with your doctor or nurse practitioner. 

If you have questions, contact the Teen Health Center at Cincinnati Children's Hospital Medical Center, 513-636-4681.


Last Updated 11/2013