Island Sexual Health Society Be informed, not surprised!

Ortho Evra birth control patch

2006 May 16

The birth control patch is similar to a band-aid that is worn on the body and changed weekly. It releases hormones that are absorbed through the skin to prevent pregnancy.

The patch does not protect against “sexually transmitted infections”:/infections.

“Make an appointment”:/about/appointments/ at any of our sexual health clinics in Greater Victoria to get a prescription for the patch, or drop in to pick up refills.

h3. The patch in detail

* “How the patch works”:#works
* “Advantages, side-effects and risks”:#pro-con
* “Using the patch”:#using
** “Starting the patch”:#start
** “Switching from other methods”:#switching
** “Missed or removed patches”:#missed

h3(#works). 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”:/birthcontrol/birth-control-pills/:

* Prevents the ovaries from releasing an egg (ovulation)
* Thins out 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 period.

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.

h3(#pro-con). Birth control patch advantages, side-effects and risks

h4. Possible side-effects are usually minor

For most women, the contraceptive patch is safe, effective and convenient. Some women 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”:/about/appointments/ 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 women who may not be able to use the pill because of their health history. Our doctors can suggest alternative methods of birth control.

h4. Advantages of the birth control patch

* decreased cramping and bleeding during periods
* regulates periods
* reliable, 99% effective
* convenient
* reduces the risk of ovarian cysts, benign breast disease, endometriosis, ectopic pregnancy, ovarian and endometrial cancer

h3(#using). How to use the birth control patch

h4. The patch uses a four week cycle

Like the “birth control pill”:/birthcontrol/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. Your period should come 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 should 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.

* A patch change reminder service is available through “the Ortho Evra patch website”:http://www.evra.ca

h4. 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 eighth 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 properly.

h3(#start). 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 the patch is not applied during the first day of your period, you will need to use a back-up method for birth control, such as “condoms”:/birthcontrol/condom/, for one week.

h3(#switching). How to switch from the pill or Depo Provera

* When switching from the birth control pill to Evra, be sure to take all 21 of the hormone pills in the pack. You will apply the patch on the first day of bleeding during the hormone-free week (or during “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.

h3(#missed). Missed patch guidelines

h4. 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 become pregnant and need to “consider emergency contraception”:/emergency (ECP). Then apply a new patch and start a new 4 week cycle. This will mean you will have a new Patch Change Day. You must use a back-up method of birth control for 7 days.

If you have concerns about possible pregnancy, please “contact the clinic”:/about/contact/ as soon as possible.

h4. If you forget to change your patch

Week 1 patch:

* If you are late applying your first week patch, take “emergency contraception (ECP)”:/ec/ 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”:/birthcontrol/condom/ 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”:/emergency contraception (ECP), use back up 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.