This is a thin, beige patch about the size of a matchbox, which can be applied to any part of the body except the breasts. There is only one patch available at this time, called the Evra Patch.
How does it work?
The Patch releases progestogen and oestrogen, the same hormones used in the combined contraceptive pill, into the bloodstream through the skin.
A new patch is applied every week for three weeks. On the fourth week no patch is applied, to allow for a period bleed after which the cycle begins again. Full instructions of how to apply the patch correctly are available from the prescribing doctor and also with the accompanying instructions.
How effective is it?
As with any contraceptive it’s effectiveness depends on how well the instructions are followed. With perfect use the patch is over 99% effective meaning that less than 1 woman in 100 will become pregnant in a year.
Pregnancy can happen if an error is made in using the patch — especially if
- it becomes loose or falls off for more than 24 hours
- the same patch is left on the skin for more than one week
Where do you get the contraceptive patch?
This method of contraception requires a prescription from your family doctor or family planning centre. It is available on the GMS (Medical Card Scheme).
What are the advantages?
- It is a very effective method when used correctly
- It is easy to use
- It does not interfere with sex
- It helps to reduce heavy or painful periods
- It may prevent pre-menstrual syndrome
- Its contraceptive effects are totally reversible
- Unlike the pill, it is not affected by vomiting or diarrhoea
- It may protect against cancer of the ovary and cancer of the body of the uterus (womb)
What are the disadvantages?
- It is visible on the skin
- It is less widely available than the contraceptive pill
- It is more expensive than the contraceptive pill
- It does not protect against Sexually Transmitted Infections
- It may fall off without you noticing
- It can be affected by some prescription drugs and complementary drugs (see below).
Who is it suitable for?
Not everyone can use the patch so your doctor or nurse will need to ask you about your own and your family’s medical history to make sure the patch is suitable. Do mention any illnesses or operations you have had.
Some of the conditions which may mean you should not use the patch are:
- you smoke and are 35 or over
- you are 35 or over and stopped smoking less than a year ago
- you are breastfeeding
- you are very overweight.
You have now or have had in the past:
- thrombosis (blood clots) in any vein or artery
- a heart abnormality or circulatory disease, including raised blood pressure (hypertension)
- current breast cancer or breast cancer within the last 5 years
- migraines with aura
- disease of the liver or gall bladder
- diabetes with complications.
If you are healthy, don’t smoke and there are no medical reasons for you not to use the patch, you can use it until your menopause. At the age of 50 if you are still having periods, you may be advised to change your method.
Are there any side-effects?
When starting the patch some women may experience: breast tenderness, skin irritation, mild headaches, a bloated feeling, or have some breakthrough bleeding (bleeding between periods).
Although these can be a nuisance, they are not dangerous and should disappear within the first few months using this contraceptive.
However, a woman should see her doctor immediately if while using the patch she develops:
- Pain or swelling in her legs.
- Severe chest pain.
- Breathlessness or coughing up blood.
- A bad fainting attack or collapse.
- Unusual headaches or difficulty with speech or sight.
- Numbness or weakness of a limb.
What about other medications I am taking?
A small number of medications, including the “natural” remedy St. John’s Wort, may affect the patch and put you at risk of pregnancy. Always ask any doctor prescribing medications for you if it will interfere with your contraception.
What if it comes off?
The contraceptive patch is very sticky and should not come away from the skin even in the shower or during exercise. If it does come off, you should try and reapply it immediately, but if the patch is no longer adhesive do not try and reapply with a bandage or sticky tape, instead apply a new patch.
If the patch has been off for less than 24 hours no additional contraception is required. If it has been off for longer than 24 hours then another method of contraception is needed for the next 7 days and emergency contraception should be considered if appropriate.
What if I am late putting on a new patch?
If you are less than twenty four hours late, simply apply patch when you remember and carry on with rest of pack as normal. No extra precautions are needed.
If you are more than twenty four hours late, apply patch when you remember, avoid sex or use condoms for the next seven days and if you have unprotected sex during this time you may need emergency contraception.
Can I decorate the patch?
No. This is not recommended. You should also avoid covering the patch with body cream or lotions, such as sun tan lotion. This may cause the patch to become loose.
Pregnancy and the patch
If I become pregnant
There is a very slight chance you will become pregnant even if you use the patch. However, a missed period does not always mean you are pregnant, especially if you have used the patch correctly. But see your doctor if you miss a second period. It is unlikely that using the patch during early pregnancy will increase the risk of defects in the fetus.
Want to become pregnant?
If you want to become pregnant, stop using the patch. If you want to plan the timing of your pregnancy, use another form of contraception until your period becomes regular. It usually takes about one to three months for your period to return to the cycle you had before using the patch.
After childbirth
You can start using the patch three weeks (21 days) after you gave birth. Starting on day 21 you will be protected against pregnancy straight away. If you start later than day 21, you will need to use an extra method of contraception for seven days.
If you are breastfeeding, using the patch may reduce your flow of milk. It is usually recommended that you use a different method of contraception.
After an abortion
You can start using the patch immediately after having an abortion.
Special precautions
Ask your doctor for advice about your patch use if you are planning to have surgery, are immobilised for a prolonged time, are taking a high altitude holiday or a long-haul flight.