How do I start using birth control patches?

How to Start Birth Control Patches

Birth control patches can be started at any time during your menstrual cycle as long as you are reasonably certain you are not pregnant, but you may need to use backup contraception for the first 7 days depending on when you start. 1

When to Start the Patch

Starting during your menstrual cycle:

• If started within the first 5 days of your menstrual period, no additional contraceptive protection is needed 1
• If started more than 5 days after the start of menstrual bleeding, use backup contraception (like condoms) or avoid sexual intercourse for the first 7 days of patch use 1

Starting in other situations:

If you have amenorrhea (not having periods):

• You can start the patch at any time if pregnancy has been ruled out 1
• Use backup contraception for the first 7 days 1

If you are postpartum (after childbirth):

• If not breastfeeding: Can start immediately postpartum 1
• If ≥21 days postpartum and your periods haven't returned: Use backup contraception for 7 days 1
• If your periods have returned: Follow the regular timing rules based on your menstrual cycle 1

If you are breastfeeding:

• If fully breastfeeding and less than 6 months postpartum: No additional contraception needed 1
• Otherwise: Use backup contraception for 7 days 1

After abortion or miscarriage:

• Can start immediately after abortion 1
• No backup contraception needed if started immediately 1

When switching from another contraceptive method:

• Can start immediately without waiting for next period 1
• May need backup contraception for 7 days depending on previous method 1

How to Apply the Patch

• Apply one patch to clean, dry skin on your buttock, abdomen, upper outer arm, or upper torso (avoid breasts) 2, 3
• Press firmly for 10 seconds to ensure good contact 3
• Each patch is worn for 7 days (one week) 2
• Apply a new patch every week for three weeks in a row, then have one patch-free week 2, 3
• During the patch-free week, you will likely have withdrawal bleeding 3

Important Usage Tips

• Always apply a new patch on the same day of the week (your "patch change day") 1
• If a patch becomes partially or completely detached for less than 24 hours, try to reapply it or apply a new patch immediately 1
• If a patch is detached for more than 24 hours or if you're unsure how long it's been detached, start a new cycle with a new patch and use backup contraception for 7 days 1
• Rotate application sites to prevent skin irritation 3
• Perfect compliance (21 consecutive days of patch use followed by 7 patch-free days) is associated with optimal effectiveness 3

Effectiveness and Benefits

• The contraceptive patch is highly effective with perfect use, with pregnancy rates similar to oral contraceptives (0.7% overall failure rate in clinical trials) 3
• The weekly application schedule may improve compliance compared to daily pills 3, 4
• Only 1.9% of patches completely detach during normal use 3
• The patch provides regulated menstrual cycles and may decrease dysmenorrhea 5

Common Side Effects

• Breast tenderness (more common with the patch than with oral contraceptives) 4, 6
• Nausea 3
• Application site reactions 3
• Headache 3
• Emotional changes 3

Cautions

• Women over 35 who smoke should avoid hormonal contraceptives containing estrogen, including the patch 5
• The patch contains estrogen which may increase thrombotic risk and should be avoided in women with history of blood clots, stroke, or cardiovascular disease 5
• If you experience severe vomiting or diarrhea while using the patch, the contraceptive effectiveness might be decreased; continue using the patch but use backup contraception until 7 days after recovery 1