Can I use the contraceptive patch (hormonal patch) without the withdrawal bleeding?

Using the Contraceptive Patch Without Withdrawal Bleeding

Yes, you can use the contraceptive patch continuously without the withdrawal bleeding by applying a new patch every week without taking the patch-free week. 1

How to Use the Patch Continuously

The standard use of the transdermal contraceptive patch involves:

• Applying 1 patch for each of 3 weeks in a row
• Taking 1 week off the patch (patch-free week), during which withdrawal bleeding usually occurs 1

To eliminate withdrawal bleeding:

1. Skip the patch-free week
2. Apply a new patch immediately after removing the third patch
3. Continue this pattern of replacing the patch weekly without breaks

Efficacy and Safety Considerations

When using the patch continuously:

• Contraceptive efficacy: The patch maintains its high effectiveness when used continuously, similar to its typical use failure rate of 9% (and perfect use failure rate of <1%) 1

• Breakthrough bleeding:

  • You may experience some unscheduled bleeding, especially in the first few months
  • This bleeding typically improves over time with continued use 2
  • If breakthrough bleeding becomes bothersome, you can take a short 3-4 day patch-free interval after at least 21 days of continuous use, but not more than once monthly to maintain effectiveness 2

• Safety concerns:

  • The FDA has identified increased estrogen exposure (1.6 times higher than with a low-dose combined oral contraceptive) with the patch 1
  • There is a potential increased risk of venous thromboembolism compared to standard combined oral contraceptives 1
  • Regular monitoring of blood pressure is recommended 2

Benefits of Continuous Patch Use

Using the patch continuously offers several advantages:

• Elimination of withdrawal bleeding
• Management of conditions that can be exacerbated cyclically (migraines without aura, epilepsy, irritable bowel syndrome, etc.) 1
• Potential improvement in conditions like anemia, acne, severe dysmenorrhea, and endometriosis 1
• Better compliance compared to daily oral contraceptives (88.2% perfect compliance with patch vs. 77.7% with oral contraceptives) 3

Practical Tips

• Placement: Apply the patch on the abdomen, upper torso, upper outer arm, or buttocks 1
• Replacement schedule: Mark your calendar or set phone reminders for weekly patch changes
• Weight considerations: The risk of pregnancy with perfect use of the patch is slightly higher for women who weigh more than 198 pounds (0.9% vs 0.3% in first 12 months of use) 1
• Adhesion: Only about 1.8% of patches completely detach during use 3, but check daily to ensure proper adhesion

When to Consider Alternative Methods

Consider alternative contraceptive methods if you:

• Are aged 40 years or older
• Have hypertension or cardiovascular risk factors
• Have a history of venous thromboembolism
• Smoke and are over 35 years old 2
• Weigh more than 198 pounds (consider higher-efficacy methods) 1

The contraceptive patch offers a convenient and effective option for those who prefer to eliminate withdrawal bleeding, with the added benefit of simpler adherence compared to daily methods.