The Contraceptive Patch

How does the contraceptive patch work?

The contraceptive patch prevents pregnancy through the following ways:

Stops ovulation.
Thickens cervical mucus making it difficult for sperm to pass.
Changes the endometrium which decreases the possibility of egg implantation.

When can a woman start the contraceptive patch?

If amenorrhoeic or certain she is not pregnant, she may start at any time (use a back up method during the next 7 days).
If menstruating, start within the first 5 days of menses.
If she wants to switch to a different method, start anytime if she is certain she is not pregnant.
If after miscarriage or childbirth but is not breastfeeding, start after 4 weeks.

How does a woman use the contraceptive patch?

Women may place the patch on her abdomen, buttock, or arm (not on the chest, breast, or anywhere else).
Apply the patch on the first starting day (woman had to memorize that day)
Use one Patch per week for three weeks in a row (change the patch on the same day of each week).
On the same day of the fourth week; take out the third patch and don’t replace with another one, it is the patch-free week, menstruation will occur.
After the patch-free week, apply a new patch.
Continue in the same way, placing a weekly patch for three weeks, followed by a patch free week.

What if I forget to replace the patch?

If you forget to replace the patch:

During week 1: apply a new patch as soon as you remember and use a back up method for the next 7 days; now you will have a new “patch change day”
During week 2 or 3:
if 1-2 days have lapsed, apply a new patch as soon as you remember and apply the next patch on the normal “patch change day”; there is no need for a back up method.
if more than 2 days have lapsed, start a new four-week cycle as soon as you remember; now you will have a different “patch change day”.
During week 4: if you forgot to remove the patch at any time during this week, remove it and start the next cycle on the normal “patch change day”.

Are there side effects attributed with patch use?

The contraceptive patch is expected to cause minor some side effects that are usually easily tolerated by women, especially during the first few cycles. Side effects include changes in menstrual bleeding (spotting or bleeding in between periods), breast tenderness, nausea, local skin irritation (this can be avoided by rotating the placement of the patch each time it is replaced). However, if she experiences any of the following warning signs, she should seek medical assistance immediately:

Severe pain in abdomen, chest, or leg.
Severe headache, dizziness, weakness, or numbness.
Vision loss or blurred vision.
Speech problems.
Yellowing of the skin or eyes (Jaundice).

Can any woman use the patch?

As the patch consists of two hormones, a clinical check up is needed before starting the patch. Your service provider will ask you some questions regarding your health, review your family medical history, and may do a physical check up if necessary. In general, a woman can't use the patch under the following circumstances:
Thinks she might be pregnant.
Over 35 years old and a heavy smoker (more than 10 cigarettes a day).
Over 35 years old and was a heavy smoker the preceding year.
Woman is very overweight (more than 90Kg, as effectiveness decreases with increasing weight).
Have certain illnesses such as thrombosis (shall we define this?), heart abnormality or circulatory disease including high blood pressure, breast cancer, migraine, liver or gall bladder disease, or diabetes with complications.

What if the patch falls off?

The patch is very sticky and should stay on. It should not come off in the shower, bath, hot tub or sauna, or during swimming or exercise. However, if it does come off, what you need to do will depends on the amount of time it has been off:

If less than 48 hours: Reapply it as soon as possible if it is still sticky. If it will not stick, apply a new patch. Don't use a bandaid or bandage to hold it in place. There is no need for any back up method.
If 48 hours or more: Start a new patch cycle by applying a new patch as soon as possible; now you will have a new “patch change day”. Use a back up method for the next 7 days. If you have sexual intercourse during the preceding days, you may need to use an emergency contraceptive.

If I didn’t bleed in the patch-free week, what does that mean?

If you were using the patch correctly and didn't use any medication that may affect efficacy, it is unlikely that you are pregnant. However, to be sure you should visit your health care provider and take a pregnancy test. If you are pregnant, the patch does not harm your pregnancy.

Should I give my body a break from using the patch every few years or so?

No, this is not necessary as the hormones do not build up in your body. There are no health benefits of taking a break. However, if you stop using the patch without switching to another effective method, you may become pregnant.