How to use the contraceptive patch

The contraceptive patch (Evra) is a type of combined contraceptive. This means it contains a mixture of oestrogen and progestogen. It’s a good option for women who feel they might forget to take the pill daily. It also has the added advantage of not being affected by sickness and diarrhoea.

The patch is 99% effective when used correctly. If the patch isn’t always used correctly 9 out of 100 women who use the patch will get pregnant.

How does the patch work?

The patch, sometimes called the birth control patch, works by releasing a daily dose of hormones into your bloodstream. These hormones stop your body releasing an egg. They also thicken the mucus in your cervix, making it difficult for sperm to move through and reach an egg. And they make the lining of the uterus thinner, so it’s harder for an egg to implant.

When should I start using the patch?

As long as you’re sure you’re not pregnant you can start using your patch at any point in your cycle. You’ll be protected from pregnancy:

Immediately – if you start on the first day of your period
Immediately – if you start anytime between the first and fifth day of your period (provided you don’t have a very short or irregular menstrual cycle)
After 7 days – if you start the patch at any other time in your cycle. You’ll need to use other contraception, such as condoms, if you have sex during the first 7 days.

How to apply the Evra patch

You can put the patch anywhere on your body provided it’s not too hairy and the skin is dry and clean. It’s good to avoid putting it somewhere that will get rubbed a lot by clothes, e.g., near a bra strap or the top of your trousers/skirt.

Don’t put the patch on skin that is irritated or sore and don’t put it on your breasts.

How do I use the patch?

The Evra patch is designed to be changed each week for 3 weeks and then you have a four or seven-day break. During this break you will likely have a withdrawal bleed. This isn’t a period, but it might feel like one. It’s just your body reacting to the break in hormones. After your break you apply a new patch and start the cycle again.

But there are a variety of different ways you can use the contraceptive patch, particularly if you want to avoid having the withdrawal bleed:

You can apply a patch once a week for nine weeks in a row and then have a break for four or seven days. This is called tricycling. You’ll usually have a withdrawal bleed in your break. You then apply a new patch on the fifth or eighth day and start the cycle again.
You can apply a new patch once a week without a break. This is called continuous use. You won’t have a withdrawal bleed, but you might get some bleeding. This should reduce as you use the patch over a long period of time.
You can apply a new patch once a week without a break for at least three weeks. If after this time you get bleeding that’s unacceptable to you for three to four days, you can take a four-day break and then reapply the patch. Use three more patches before you take another break. This is called flexible extended use.

Protection during your patch-free days

You will be protected from pregnancy in your patch-free break provided:

You’ve used the previous three patches correctly
You start your next patch cycle on time
You’re not taking any other medicines that will affect the way the patch works. These medicines include St John’s Wort and those used to treat epilepsy, HIV and TB. Check with your clinician about using the patch if you’re on any of these treatments.

Missing a patch or applying a patch late

Your patch comes off

The contraceptive patch is very sticky, so it shouldn't come off.

If it does come off, try and get it back on as soon as possible. If it's lost its stickiness, then you should apply a new one.

If the patch is off for less than 24 hours, you don't need to use extra contraception if you're having sex.

If it's been off for more than 24 hours, you do need contraception for the next seven days and if you've had unprotected sex, you might need emergency contraception.

You put your patch on late/change it late

If you're less than 24 hours late putting the new patch on, apply the new one as soon as you can. You shouldn't need any extra contraception if you're having sex.

If you're more than 24 hours late putting the new patch on, apply the patch as soon as you remember. Use condoms for the next seven days if you're having sex, and if you have unprotected sex you might need to use emergency contraception.