The contraceptive patch This is a contraceptive that works like the pill but with the advantage that you don't have to remember to take it every day. This fpa factsheet explains how it works.

In this article

What's the contraceptive patch? How does it work?

How reliable is it? How do you use it?

Where can I get the patch?

It is a small, thin, beige, sticky skin patch that contains the same hormones as the pill - estrogen and progestogen. These are similar to the hormones women produce in their ovaries.

The patch delivers a constant daily dose of hormones into the bloodstream through the skin. This stops the ovaries from releasing an egg (ovulation) each month. The patch also:

• Thickens the mucus in the cervix, making it difficult for sperm to reach an egg
• Makes the lining of the womb thinner so it's less likely to accept a fertilised egg

Effectiveness depends on how carefully it's used. The patch is more than 99 per cent effective when used according to instructions. This means that, using this method, fewer than one woman in 100 will get pregnant in a year. It is less effective in women weighing 90kg (14st) and over.

Myth: The patch is more reliable than the pill
Fact: Not true - the effectiveness of the patch is the same as the pill
Myth: It falls off easily
Fact: Not true - it's very sticky

The patch is used for three weeks out of every four. A new patch is used each week.

The patch can be started up to and including the fifth day of a period. If used at this time it's effective straight away. If started at any other time, additional contraception has to be used for seven days.

After 21 days you have a break of seven days when you have a bleed. This withdrawal bleed is usually shorter and lighter than normal periods.

You can use the patch on most areas of the body as long as the skin is clean, dry and not very hairy. You should not put it on skin that is sore or where it can be rubbed by tight clothing. Don’t put it on your breasts.

Advantages:

• You only need to remember to replace the patch once a week
• It doesn’t interrupt sex
• Unlike the pill, the hormones do not need to be absorbed by the stomach, so the patch is not affected if you vomit or have diarrhoea
• Usually makes your bleeds regular, lighter and less painful
• It may help with premenstrual symptoms
• It may reduce the risk of cancer of the ovary, womb and colon
• It may reduce the risk of fibroids, ovarian cysts and non-cancerous breast disease

Disadvantages:

• It's visible
• It may cause skin irritation in a small number of women
• Like the pill, temporary side-effects at first may include headaches, nausea, breast tenderness and mood changes
• Breakthrough bleeding (unexpected bleeding while using the patch) and spotting can be common

The patch can have some serious side-effects, but these are not common. They may include:

• Raised blood pressure
• A very small number of women may develop a blood clot, which can block a vein (venous thrombosis) or an artery (arterial thrombosis, heart attack or stroke)
• Possible increase in risk of being diagnosed with breast cancer
• Possible increase in risk of cervical cancer if used continuously for more than five years

Can anyone use the patch?

The patch may not be suitable for all women. For most women the benefits of the patch outweigh the possible risks.

It may be unsuitable for you to use the patch if you:

• Think you might be pregnant
• Smoke and are over 35, or are over 35 and stopped smoking less than a year ago
• Are very overweight
• Take certain medicines - always check
• Have had a previous thrombosis
• Have a heart abnormality, circulatory disease or high blood pressure
• Have very severe migraines or migraines with aura
• Have breast cancer now or within the past five years
• Have active liver or gall bladder disease
• Have diabetes with complications, or have had diabetes for more than 20 years

What if the patch comes off?

The patch is very sticky and should stay on in the shower, bath or sauna, during swimming and exercise.

If the patch has been off for fewer than 48 hours, just reapply it as soon as possible or use a new one, then continue as normal.

If it has been off for more than 48 hours, start a whole new patch cycle by applying a new one as soon as possible. Use additional contraception for seven days. Seek advice about emergency contraception if you had sex in the previous few days and were not using a condom.

Other things to consider

• Initially, you'll be given three months' supply of the patch. If there are no problems you will then be given up to a year’s supply
• You don’t need a cervical screening test or an internal examination to have the patch
• The patch does not protect you against sexually transmitted infections

The patch is free on the NHS from contraception clinics, sexual health clinics or general practice.

Advice and support

Call fpa's helpline on 0845 122 8690.

This article was last reviewed in July 2007.