The Contraceptive Patch

What is the contraceptive patch?

The contraceptive patch, also known as the Evra® patch, is a birth control patch changed weekly and worn on the skin to prevent pregnancy. The Evra® patch contains two types of hormones, estrogen and progestin, which are taken in through the skin. The Evra® patch is 91% effective with typical use.

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. It also changes the lining of the uterus making it difficult for an egg to attach itself. Finally, the patch changes the mucus in the cervix making it harder for sperm to enter the uterus.

Who can use Evra® patch?

All individuals seeking a reliable and reversible method of birth control that does not require daily attention. It is important to consult a health care provider, as the patch should not be used if you have certain health conditions.

How do I use the Evra® patch?

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. The fourth week is patch-free; your period should begin during the patch-free week.

• Apply to clean, dry and intact skin. To ensure that the patch sticks well on the skin, avoid using creams, lotions or other skin products around the patch area.
• To avoid skin irritation, apply the patch to a different area every time it is changed.
• Place the patch in one of four areas: the buttocks, the lower abdomen, the upper outer arm and upper back (shoulder blade area). Do not place on the breasts.
• Check patch daily to ensure it is well in place.
• The patch can be worn during all daily activities, including bathing and swimming.
• 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.
• Note: Avoid spending a lot of time in saunas or hot tubs, as this could increase your exposure to estrogen.

Backup for 7 days

It takes 7 days for the patch to start taking effect and prevent a pregnancy. Use a backup method of birth control during this time to prevent a pregnancy, such as condoms or abstinence. If this is the first time you start the patch, it is best to use a back-up method for the first month, as you adjust to the routine of changing the patch weekly.

What to do if the Evra® Patch partially or fully comes off

Less than 24 hours: re-apply it right away or apply a new patch, no backup method of birth control 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 are the advantages, possible side effects or 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:

Slight possibility of:

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

*Side effects will likely resolve within the first three months.

Possible complications:

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

• 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).
  
  To find out if this birth control method is right for you, click here for an interactive quiz!  

I forgot to change my patch. What should I do?

Which week of your cycle did you forget to change the patch?

Week 1 - If you are less than one day (24h) late applying your first patch.

Your contraception is still effective.

Apply the first patch as soon as you remember. No backup method of birth control needed.

Your “patch change day” remains the same.

Week 1 - If you are more than one day (24h) late applying your first patch.

Your contraception may not be effective.

Step 1: Apply the first patch as soon as you remember. You will now have a new day one and a new “patch change day”.

Step 2: If you had unprotected sex in the last 5 days, consider using emergency contraception.

Step 3: Use a back-up method such as condoms for the next 7 days.

Week 2 or 3 - If you are less than two days (48h) late changing your patch.

Your contraception is still effective.

Remove the used patch and apply a new patch right away.

Apply the next patch on your normal “patch change day”.

No backup method of birth control is required.

Week 2 or 3 - If you are more than two day (48h) late changing your patch.

Your contraception may not be effective.

Step 1: Remove the used patch. A new 4-week cycle should be started immediately by applying a new patch. You will now have a new “patch change day”.

Step 2: If you had unprotected sex in the last 5 days, consider using emergency contraception.

Step 3: You must use a backup method of birth control for seven days.

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

Your contraception is still effective.

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.

Remember:

• The Evra® patch is less effective in individual with a body weight of equal to or greater than 90kg than in women with lower body weights.
• The Evra® patch does not protect you against sexually transmitted and blood borne infections (STBBIs) including HIV; use condoms to lower your risk.

Call the Sexual Health Infoline Ontario at 613-563-2437 if you have questions or need help.

For more information on the transdermal contraceptive patch, please visit: www.sexandu.ca