Patch
How does it work?
Read the sections below for details about Patch, including how well it works and how to use it.
Compare this method with others, or view the full list of birth control methods using the links below.
More about Patch
The patch has two types of hormones in it: estrogen and progestin. Because hormones can affect the growth of breast cancer cells, we generally recommend against using the patch and other hormonal birth control after a breast cancer diagnosis.
Unfortunately, there is limited high-quality research on the safety of hormones after breast cancer. Because of this uncertainty (and because hormone exposure may increase the risk of breast cancer coming back), we and most medical experts recommend avoiding birth control with hormones after breast cancer - especially for those with hormone receptor (HR) positive breast cancer.
For those who are within 5 years of a breast cancer diagnosis, hormonal birth control, including the patch, should not be used. During this time, the risk of breast cancer coming back is higher, and being exposed to hormones can increase that risk.
For those who are more than 5 years out from diagnosis and in remission, hormonal birth control is still generally discouraged. While the risk of breast cancer coming back decreases over time, it does not go away completely. There is also not enough evidence to confirm that hormonal birth control is safe – even for people whose cancer was not hormone-receptor positive.
In some situations, birth control that contains hormones, including the patch, may be considered to treat severe bleeding or pain when options without hormones have not worked. In these cases, decisions should be made carefully and in collaboration with your oncology and primary care teams. These decisions should also be revisited over time as your health and priorities change.
There are 3 birth control patches approved for use in the United States. Xulane and Zafemy are two generic brands that have the same type and amount of estrogen and progestin hormones.
Twirla is a brand name with a slightly lower dose of estrogen and a different progestin than Xulane and Zafemy.
For Xulane or Zafemy:
With perfect use, fewer than 1 out of 100 people will get pregnant over a year. Perfect use means that you never go more than 7 days without a patch.
Most people forget to use the patch as it should be used. This is called typical use. With typical use, 7 out of 100 people will get pregnant over a year.
For Twirla:
With perfect use, 5 out of 100 people will get pregnant over a year. With typical use 7 out of 100 people will get pregnant over a year.
For all 3 patches: If your body mass index is more than 30, these patches may not work as well to prevent pregnancy. Talk to your provider about the pros and cons for you.
You can use the patch and another birth control method at the time of sex. We call this a Method Boost
because it prevents pregnancy better than the patch alone.
Method Boost options include the outer condom (penile), the inner condom (vaginal), pull out, spermicides, the vaginal gel (Phexxi), the cervical cap and the diaphragm. You can also use these as a Method Backup when you forget to put a new patch and it has been 7 days or more since the last patch.
The patch releases estrogen and progestin hormones. The hormones stop an egg from being released (ovulation) and make the mucus of the cervix thicker (blocking sperm).
Pick a day of the week to be your “patch change” day. HINT: Your start day does not have to be Sunday. (Your body does not care what day it is!)
Put a new patch on clean, dry skin. You can put it on your upper outer arms, belly, buttocks, or back. You can do all your normal activities with the patch on, including shower and exercise.
The next week on your “patch change day”, take off the patch, and throw it out In the pouch it came in. Put a new patch on a different spot than you used last week. This way your skin is less likely to get red or irritated.
The patch releases hormones that keep the lining of the uterus thin, so it does not build up and shed each month. If you want to bleed each month, put on a new patch on your skin each week for 3 weeks. For Week 4, skip the patch. With no patch on your skin, the hormone levels drop. This causes a withdrawal bleed.
Some people want to skip the withdrawal bleed for one or more cycles. We call this No Bleed Months. This is very safe and can improve conditions that get worse with periods like migraines, anemia, or mood problems.
To have a No Bleed Month, just skip the patch free week and go straight to the next patch. This means you use a new patch every week. For example, if you want to have a withdrawal bleed every 3 months, use a patch every week for 12 weeks straight and then skip the patch in week 13.
Typically, while you wear the patch, you may not have a period. Instead, you have your period during the "patch-free" week. Periods may be lighter and more predictable. You can use the patch to skip your period.
Because the patch and birth control pill both have estrogen and progestin hormones, the patch is expected to have the same pros as the pill:
- Help acne, bad periods, and ovarian cysts
- Help menstrual migraines, anemia, premenstrual symptoms (PMS)
- Help hot flashes in early menopause
- Lower the change of getting cancer of the uterus or ovaries in the future
When you first start the patch, you can have nausea, tender breasts, and irregular bleeding. These are annoying but not serious. They usually go away after 1-3 months.
Some people worry that the patch will affect their weight, mood, or sex drive. Studies do not link the patch with these side effects. But if you ever have concerns about side effects, you should tell your health care provider. Your concerns should be taken seriously.
Beyond the breast cancer concerns discussed in the section "Special considerations for breast cancer survivors and thrivers," the patch is very safe. In fact, pregnancy carries a higher risk of health problems than the patch does.
Rarely, birth control with hormones have been linked with blood clots, strokes, heart attacks, or liver tumors. The chance is about 5 out of 10,000 people over a year. This chance goes up if you have other risk factors, such as being older than 35, a cigarette smoker, or having diabetes.
No. However, correct use of condoms can prevent HIV and STIs.
You can get a prescription from your health care provider.
The patch can cost up to $100-$150 for a one month supply.
If your insurance covers the patch, you may pay $0-$20
There are also online birth control services. A licensed health care provider will review your health history. The patch box can then be mailed to you.
For more info about the patch, click here: Planned Parenthood:Patch