Birth Control Bingo: the Contraceptive Patch
The birth control patch was first approved for use in the United States in 2002. It's an adhesive square that, when placed on the body, transdermally (through the skin) administers a combination of hormones, including estrogen, to prevent pregnancy. Those hormones suppress ovulation (keep your body from releasing an egg each month), thicken cervical mucus to interfere with sperm mobility, and also thin the lining of the uterus, making it less hospitable for a fertilized egg to implant in. It works in all three of those ways to basically provide backup in case one of its mechanisms doesn't work at a given time.
The first commercially available transdermal patch was approved by the U.S. Food and Drug Administration in December 1979: it administered scopolamine, for motion sickness.
The Contraceptive Patch is:
- 99% effective in one year of perfect use; less than one out of every 100 people will become pregnant
- 92% effective in one year of typical use: 8 out of every 100 people will become pregnant
Additional Sources for Effectiveness Ratings and Use:
- 91% typical use/99+% perfect use: Contraceptive Technology, 20th Revised Edition; Hatcher, Trussell, Stewart, Nelson, Cates, Guest, Kowal: Ardent Media, 2011.
- 92% typical use/over 99+% perfect use: Planned Parenthood
The What, the Why, the Where, the When, and the How-to: You use a patch by opening a new patch and putting it, like a band-aid, on a clean part of your body where it's most likely to stay (you want to choose places that don't rub up against the edges of clothing a lot, for instance), and where you feel most comfortable having it. One place it should NOT be put is on your breasts: that could create breast health problems. And if you use body lotions, be sure to put the patch on before you put on any lotion: lotions or oils can keep it from sticking and staying on properly.
Every week -- every seven days -- around the same time, you're going to take off your old patch, and put on a new one in at least a slightly different spot. You'll do that for three weeks in a row, then have one week where you don't have a patch on, but you will still be protected against pregnancy for that week. After that off-week, you go back to putting a patch on once a week for three weeks.
Certain people should not use the patch, such as smokers, those over 35, and people who are breastfeeding, diabetic or have a history of high blood pressure, any cardiovascular disorders or high cholesterol. This is true for all methods with estrogen, but is even more so for the patch as it contains substantially more estrogen than other methods: around 60% more than low-estrogen combination pills. People who are over 198 pounds should also be aware that the patch may not be as effective for them. Be sure to discuss your health history and any current health issues with your healthcare provider so that they can be sure the pill is safe and likely to be effective for you.
Too, people who are looking for a hormonal method to suppress periods should probably not use the patch to do that: it has not been studied yet for continuous use, and with the higher dose of estrogens, could pose serious health problems used continuously. If you are looking to suppress periods, first talk to your doctor (particularly if you are in your teens, as doing so may pose extra health risks for you; teens have not been studied for suppression), then if your doc gives you the green light to suppress, consider other hormonal methods such as the pill, the implant or the Mirena IUD to safely do so with.
Some typical effects -- pro and con -- of the patch include lighter periods (though technically, people on hormonal methods have withdrawal bleeds, not actual periods), less cramping, decreased PMS symptoms, skin changes, a more regular schedule of monthly bleeding, bloating, nausea, more frequent or more severe headaches, breast tenderness, mood changes or increased depression or anxiety, a decrease in sexual desire, vaginal dryness, weight gain, skin irritation and/or more frequent yeast infections. Rare but more serious side effects can include allergic reactions, blood clots, embolism or stroke, heart attack, gallbladder disease, thrombosis or eye problems.
To get the patch, you'll need to visit your sexual healthcare provider (who may also be your regular doctor) to obtain a prescription to fill at your pharmacy. Patches tend to cost a bit more than birth control pills, usually around $35 - $50 a month.
Also be aware that certain medications and substances may interfere with the effectiveness of the patch, or the patch may interfere with the effectiveness of other medications. If you are using or have, in your current patch cycle (that being the four-week period of three patch weeks and the off-week), used, any of the following it's best to use a backup method of birth control (like a condom) until your next new cycle:
- Anti-Migraine medications
- Seizure/Epilepsy medications
What will/might you need to discuss or negotiate with a partner?
- If you or they are or are not okay with ejaculation inside the vagina
- Possible semen allergies or sensitivities (it is currently estimated as many as around 10% of people may have them), if not being combined with condom use
- STI status and history, especially if not being combined with condom use
Some questions and answers about the patch:
- How does estrogen dose effect protection against pregnancy?
- How do I actually get birth control?
- He isn't okay with condoms, so I'm starting the patch. Is that safe enough?
- Scarleteen Message Board users talk about their experiences using the patch
Or, click on the tag for patch for a larger list.
When Good Birth Control Does Bad Things: The birth control patch may fail if it is not replaced every week as required or if the seven-day off period is extended longer than seven days, if it is not used with a backup method within the first seven days to one month, if taken in conjunction with other drugs or substances which may interfere with it, or if the patch slips off and is not replaced within 24 hours. If and when a patch slips off, you can try and put it back on, but if it isn't sticking, you'll need a new patch. Don't try and MacGyver it by using tape or glue to stick an old patch on.
Other methods which can be used as a backup method with the Contraceptive Patch:
- Cervical Barriers (Diaphragms, Lea's Shield and Cervical Caps)
- Emergency Contraception (Plan B or the Morning-After-Pill)
- the Sponge
Other methods you might like if you like the Contraceptive Patch:
- the Contraceptive Implant (Implanon)
- Depo-Provera (The Shot)
- Intrauterine Devices (IUD, IUC or IUS)
- the Vaginal Ring (Nuvaring)
Why would the patch be a good option for me? If any of the following are true:
- You want a method which is highly effective when used properly
- You want some of the possible benefits the patch may offer, like the reduction of some kinds of acne, shorter, lighter periods, decreased PMS symptoms and help in preventing certain reproductive cancers
- You are looking for a method which you are completely in charge of yourself, where you don't have to rely on a partner to help with birth control
- You do not have sensitive skin
- You were a perfect pill user but still had a failure, and suspect you might need a method with more estrogen in it
- You have an erratic schedule, or are looking for a hormonal method but cannot or do not want to remember to take pills daily
- You don't want a method you have to think about at the time you're going to have sex
Don't forget: Statistically, sexually active young adults are as, if not more, likely to acquire a sexually transmitted infection (STI) as you are to become pregnant. Although 15-24-year-olds represent only one-quarter of the sexually active population, they account for nearly half of all new STIs each year, and of the 18.9 million new cases of STIs each year, 9.1 million (48%) occur among 15-24-year-olds (AGI). Often people have some funny ideas about who is most likely to get an STI, but the fact of the matter is that younger people -- of any sexual orientation, any economic class, any kind of relationship -- have been the highest risk group for some time now.
Condoms are the only method of birth control which also provide protection against STIs. It's pretty typical for younger people to ditch condoms if they have another method of birth control, so just remember that STIs are still a risk if you're using another method. You can read all about safer sex here -- Safe, Sound & Sexy: A Safer Sex How-To -- but the rule of thumb most medical experts and prevention organizations suggest, which we also encourage at Scarleteen is six months of safer sex, six months of sexual monogamy, and then TWO full STI screenings for each partner -- once at the start of that six months, once at the end -- before ditching latex barriers.
Illustrations copyright 2014, Isabella Rotman