Contraception
Contraceptive Methods
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Contraceptive Patch
The contraceptive patch (Evra®) is a new method of birth control that has been available in Canada since January 2004. It is a 4 x 4 cm beige patch that sticks to a woman's skin and continuously releases estrogen and a progestin (two female hormones) into the bloodstream.
How it works
The patch prevents pregnancy primarily by stopping the ovaries from releasing an egg, but it may also thicken the cervical mucus (making it harder for sperm to get into the uterus) and make the uterine lining thin. Its method of action is very similar to the Pill.
How to use it
Unlike the Pill, which has to be taken every day, each patch is worn on the skin for seven days. One patch is worn each week for 3 weeks. The patch should be changed on the same day each week (called the "Patch Change Day"). The fourth week is patch-free, allowing a period to occur. The patch should never be off for more than seven days. Following the seven patch-free days, a new cycle is started when you apply a new patch on your Patch Change Day.
Where to wear the patch
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The patch can be worn on the buttocks, stomach, back or upper arms, but not on the breasts. It may help to change the location a bit each week. The patch should be applied to clean, dry skin. You should not use any creams or lotions near a patch you're already wearing, or where you'll be applying a new one. The patch is very "sticky". You can exercise, shower, swim or go in a sauna or hot tub and it still sticks 98% of the time! (Read below for what to do if it comes off.)
How to start
You'll need to visit your doctor or health clinic to see if this is a good choice for you, and to get a prescription. Ideally, you should apply the first patch on the first day of your period. If you apply the patch more than 24 hours after the start of your period, you will not be protected from pregnancy for the first week. Women switching from a birth control pill should also start the patch on their first day of bleeding (not when you would have started the next pack of pills).
Effectiveness
Like the Pill, the patch is also more than 99% effective at preventing pregnancy when used perfectly, with about a 3% failure rate for typical users. For women who have trouble remembering to take a pill every day, the patch may work better than the Pill. It may be a bit less effective in women who weigh more than 90 kg (198 pounds).
Other Benefits
Other benefits to being on the patch include a regular, lighter period, often with less PMS and cramping. It is believed to reduce the risk of endometrial and ovarian cancers and help prevent benign ovarian cysts like the birth control pill because it works in a similar way. It is completely reversible. Once you stop the patch, your body resumes its natural cycle.
Disadvantages
The patch does not protect against sexually transmitted infections.
When starting the patch, you may notice side effects such as breakthrough bleeding (between periods), breast tenderness, headaches, or nausea as your body gets used to the hormones. These symptoms usually go away in the first three months. You may also notice some skin irritation.
Women who cannot take estrogen due to a medical condition cannot use the patch or the Pill. See your doctor to decide if the patch is a good choice for you.
It may not be covered by all drug plans.
Troubleshooting
Check each day to make sure the patch is still well applied. If the edges come loose try to smooth it back on by pressing with your hand for 10 seconds. If it does not stick back on, or comes off completely, apply a new patch. You would still change it on your same Patch Change Day and you are still protected against pregnancy.
If the patch falls off for more than 24 hours put a new patch right away, and start a new four-week cycle. You will need to use a back up method of birth control for the next week and you will have a new Patch Change Day.
If you forget to change your patch for 1 or 2 days, remove the patch when you remember and apply a new patch. You will still change it on your next Patch Change Day - you are still protected against pregnancy. If you are more than 2 days late changing the patch, you start a new four-week cycle with the new patch. You will need to use a back up method of birth control (like condoms) for the next week.
If you forget to take off your patch at the start of the Patch-free week, take it off when you remember and start the next cycle at the usual time. Your period may be shorter, or you may still be bleeding when you put on the next patch.
If you forget to put on your patch after your patch-free week (so you have had more than 7 days with no patch) put it on as soon as you remember. You need to use back up birth control for the first week of the new cycle, and your Patch Change Day will be different.
If you are not sure, talk to your doctor or pharmacist.
Last Modified: September 5, 2006
