Island Sexual Health Society Be informed, not surprised

upclose view of evra patch and foil pouch

The patch is a hormonal method of birth control that you reapply once a week. Make an appointment to get a prescription or to find out more.

The birth control patch is a thin vinyl square patch that is worn on the body. It contains two hormones (estrogen and progestin), and works to prevent pregnancy in the same way that the birth control pill does.

The patch does not protect against sexually transmitted infections. We always recommend the use of a condom with the patch to reduce the risk of STIs and increase pregnancy protection.

Make an appointment at any of our sexual health clinics in Greater Victoria to get a prescription for the patch or to talk about other birth control options.

The patch in detail

How the birth control patch works

The birth control patch contains 2 hormones, estrogen and progestin, that are absorbed through the skin and enter the bloodstream. These hormones work to prevent pregnancy in the same way as those in the birth control pill:

  • Prevents the ovaries from releasing an egg (ovulation)
  • Thins the lining of the uterus (endometrium) making it difficult for a fertilized egg to implant
  • Thickens cervical mucus to block sperm from entering the uterus

Each package contains three birth control patches. Each patch is worn for one week and is then discarded. The fourth week of your cycle is “patch-free,” and this is when you will have a withdrawal bleed (usually similar to lighter period bleeding)

The patch is about 99% effective at preventing pregnancy when used perfectly.

You can continue to do all of the activities you normally do while using Evra. It has been extensively tested for use while bathing, swimming, showering, working out etc.

Birth control patch advantages, side-effects and risks

Possible side-effects are usually minor

For most users, the contraceptive patch is safe, effective and convenient. Some users may experience minor side effects such as breast tenderness or headaches while using the patch, but these should disappear during the first 2-3 months of use. If not, just make an appointment to see one of our doctors.

While there are some rare but serious risks associated with hormonal contraception, the risks are smaller than the health risks associated with pregnancy.

However, there are some people who may not be able to use the pill because of their health history. Our doctors can suggest alternative methods of birth control.

Advantages of the birth control patch

  • Decreased cramping and bleeding during withdrawal bleeds
  • Regulates bleeding and can be used to control timing of periods
  • Reliable, 99% effective when taken correctly
  • convenient
  • May be easier to use for people who forget to take pills
  • Similar to the pill the patch may reduce the risk of ovarian cysts, benign breast disease, endometriosis, ectopic pregnancy, ovarian and endometrial cancer

How would I know if I was having a serious health problem related to the Patch?

Call your doctor immediately or go to the nearest medical treatment centre if you have any of the following:

  • A – Abdominal pain, severe
  • C – Chest pain (severe); cough; or shortness of breath
  • H – Headaches (severe) or increased frequency or intensity of headache, dizziness, weakness, or numbness
  • E – Eye problems: vision loss of blurring, speech problems
  • S – Severe leg pain in calf or thigh

While there are some serious risk associated with the patch such as blood clotting problems and stroke, these risks are relatively small when compared with the health risks associated with pregnancy. For most users, the patch is safe, efficient and convenient. Your healthcare professional will help you determine whether or not this  could be an appropriate option for you.

How to use the birth control patch

The patch uses a four week cycle

Like most birth control pills, the Evra birth control patch is based on a 4 week or 28 day cycle.

A patch is applied on the same day of the week for 3 weeks in a row (21 days), and the fourth week is patch-free. You should have a period like bleed during this fourth week.

For example, if you start using the patch on a Sunday, then your patch change day will always be Sunday. You will only wear one patch at a time; remember to remove the previous one! When the fourth week ends you will begin the cycle again by applying a new patch, even if you still have bleeding.

  • Setting up a  weekly reminder on your mobile phone through the alarm/calendar app is a great way to help you remember to remove/apply your patch on the correct day of the week.

Can I use more than 3 patches in a row to skip a period? 

No, it is not safe to do with the Evra Patch.

The patch must be applied properly

The patch can be applied to the following parts of the body:

  • Buttocks, abdomen, upper torso (except the breasts) or arm.
  • Do not place the patch on skin that is red, irritated or cut
  • Apply to clean, dry skin only. The skin should be free from lotions, oils, cosmetics, powders, etc.

Remove the patch from the foil packet being careful not to accidentally remove the clear liner. Peel off half of the clear liner and avoid touching the sticky side. Position it on the site you have chosen and remove the other half of the clear liner. Press firmly to skin for 10 seconds, making sure that the edges stick. Wear the patch continuously for 7 days. On the 8th day (Patch Change Day), remove the patch, fold it in half and discard it. Apply a new patch immediately on a different area of the body to avoid irritating the skin. Be sure to check your patch daily to make sure it is sticking.

Some medication and herbs may reduce the effectiveness of the patch, check with your doctor, nurse or pharmacist if this applies to you.

Start the first patch on the first day of your period

Apply your first patch anytime during the first day of your period. Take note of this day, this is your Patch Change Day.

If you start the pill on the first day of your period, you do not need to use a back up method of birth control such as condoms because you will have immediate protection vs pregnancy.

If the patch is not applied during the first day of your period or is quick started (meaning as soon as you get your prescription, you will need to use a back-up method for birth control, such as condoms, for one week.

How to switch from the pill or Depo Provera

  • When switching from the birth control pill to Evra, be sure to take all of the hormone (or active) pills in the pack. You will apply the patch on the first day of bleeding during the hormone-free week (or during your sugar pills). This will be your Patch Change Day, then follow the directions as given above. If you start the patch at any other time be sure to use a back-method of birth control for 7 days.
  • When switching from Depo Provera to Evra, you will apply your patch 2 days before your next shot is due and then follow the directions given above. Again, if you start Evra at any other time you will need to use a back-up method of birth control for 7 days.

Missed patch guidelines

If your patch becomes loose or detaches

If the edges of your patch lift up try to reapply by pressing down firmly with the palm of your hand for 10-20 seconds. Then run your fingertip around the edges. If it still doesn’t stick remove it and apply a new patch immediately (be sure to use a different location).

If your patch has come off either partially or completely and it has been less than 24 hours, try to reapply it or apply a new patch. No back-up method of birth control is needed.

If your patch has been partially or completely detached for more than 24 hours or you are unsure how long it has been, you may need  emergency contraception. Apply a new patch and start a new 4 week cycle. This will n you will have a new Patch Change Day. You must also use a back-up method of birth control for 7 days.

If you have concerns, please contact the clinic as soon as possible.

If you forget to change your patch

Week 1 patch:

  • If you are late applying your first week patch, take emergency contraception (if you’ve had sex in the past 5 days) and apply the patch immediately (you will now have a new patch change day). Use a back-up method of birth control such as condoms for 7 days.

Week 2 or 3 patch:

  • If you are 1 or 2 days late apply new patch immediately. No ECP or back-up is needed.
  • If you are more than 2 days late: Take emergency contraception (if you’ve have sex in the past 5 days), use back up a method of birth control for 7 days, and apply patch immediately (you will now have a new patch change day)

Week 4:

  • If you forget to take your patch off during week 4 just remove the patch as soon as you remember and start your next cycle on your regular Patch Change Day. No back-up form of birth control is necessary.