The Contraceptive Patch

The contraceptive patch, also known as the Evra® patch, is a birth control patch that is worn on the skin and changed weekly to prevent pregnancy. The Evra® patch contains two types of female hormones - estrogen and progestin - that are absorbed through the skin and then distributed in the blood. The Evra® patch is up to 99 per cent effective if used the right way.

How does Evra® patch work?
The Evra® patch prevents the ovaries from releasing an egg each month (ovulation). If there is no egg to meet the sperm, pregnancy will not occur. The Evra® patch also changes the lining of the uterus making it difficult for the egg to attach itself. Finally, the Evra® patch changes the mucus in the cervix making it harder for sperm to enter the uterus.
Who can use Evra® patch?
Women seeking a reliable and reversible method of birth control that does not require daily attention can use the contraceptive patch.
How do I use the Evra® patch?
Apply a new patch on the same day of the week for three weeks in a row. The fourth week is patch-free; your period should begin during the patch-free week.

First day start: Apply your first patch during the first 24 hours of your period. This is day one, your "patch change day". If the patch is not applied within the first 24 hours, use a backup method of birth control if you have sex in the next seven days.

Sunday start: Apply your first patch on the first Sunday after your period starts. This is Day one, your "patch change day". Use a backup method of birth control if you have sex in the next seven days.

Application method
  • Apply to clean, dry, intact healthy skin. To ensure that the patch sticks well on the skin, avoid using make-up, creams, lotions, shower gels, body washes, powders or other skin products on or around the patch area
  • To avoid skin irritation, apply the patch to a new area each time you change it. Ensure the patch is not worn in an area where it can be rubbed by tight clothing
  • The patch is placed on one of four areas: the buttocks, the lower abdomen, the upper outer arm and upper back (shoulder blade). Do not place on the breasts or skin that is red, irritated or cut (Insert Picture DEMO of locations)
  • Check patch daily to ensure well in place
  • The patch can be worn during all daily activities (bathing, swimming, etc.). For your health, avoid spending a lot of time in saunas or hot tubs as you may be exposed to more estrogen
  • Do not cut, write on or change the patch in any way
  • Do not use other tapes or wraps to hold EVRA® in place, even if the edges start to peel away from the skin
Backup
During the first month on the patch you may be at risk of pregnancy. For the first seven days you are on the patch, use a backup method of birth control such as condoms or do not have sex during this time.
What to do if the Evra® patch partially or fully comes off?
  • Less than one day (24 hours): re-apply it right away or apply a new patch, NO backup method of birth control is needed and your "patch change day" remains the same
  • More than 24 hours: STOP the current cycle. Start a new cycle right away by applying a new patch and this is now Day one of your cycle and your new "patch change day". Use a back-up method of birth control if you have sex in the next seven days.
What to do if you forget to change the your Evra® patch?

Week 1: More than 1 day late applying your first patch at the start of any cycle.

Apply the first patch as soon as you remember

You will now have a new Day 1 and a new "patch change day"

You must use a backup method of birth control for 7 days

Week 2 or 3 : Up to 48 hours late.

Remove the used patch and apply a new patch right away

The next patch should be applied on your normal "patch change day"

No backup method of birth control is needed

Week 2 or 3: More than 48 hours late.

Remove the used patch and apply a new patch right away to start a new cycle

You will now have a new Day 1 and a new "patch change day"

You must use a backup method of birth control for 7 days

Week 4: If you forget to take your patch off during week 4.

Take the patch off as soon as you remember

Start your next cycle on your normal "patch change day"

No backup method of birth control is required

What are the advantages, possible side effects or possible complications of the Evra® patch?
Advantages
  • Convenient (once a week)
  • Decreased cramping and menstrual bleeding
  • Improved cycle control
  • Reduced risk of ovarian and endometrial cancer
  • Can reduce acne

Possible side effects

Minor possibility of (will likely resolve within the first three months)

  • Irregular bleeding
  • Nausea
  • Headaches
  • Sore breasts
  • Local skin reaction: redness or itchiness on or around the patch area

Possible complications

The warning signs of a blood clot spell out the acronym ACHES:

Abdominal pain (severe pain or lump in the abdomen)

Chest pain or shortness of breath

Headache (severe) with dizziness, weakness or numbness

Eye problems (vision loss or blurred vision) or speech problems

Severe leg pain or numbness (calf or thigh)

Women who have any of these symptoms while on the Evra® patch should go to the hospital.

Remember

  • The Evra® patch is less effective in a woman with a body weight equal to or greater than 90kg than in women with lower body weights
  • The Evra® patch does not protect you against STBBIs or HIV; use condoms to lower your risk
  • For additional information or assistance contact the province wide Aids and Sexual Health Infoline at Toll free: 1 (800) 668-2437
  • For more information on the transdermal contraceptive patch, please consult the janssen website:

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