The Patch – The Contraceptive Patch (Evra)
The Combined Transdermal Contraceptive Patch
Stick on Contraception
The following is a © extract from
Sexplained Two – For Changing Times by Helen J Knox
Used here, with permission.
What is the Contraceptive Patch / The Combined Transdermal Contraceptive Patch and how does it work?
The Patch is a disposable combined hormonal delivery system that is stuck to the skin by a woman once a week, to prevent pregnancy.
In the UK, it is known by the names OrthoEvra® and Evra® and is a ‘combined transdermal (across skin) contraceptive patch’ or CTP.
Here, it is referred to as The Patch.
It is a device that, once stuck to the skin, slowly releases the hormones, oestrogen, as ethinyl estradiol (ethi-nile-eestro-diol) and the
progestogen as norelgestromin (nor-el-jest-ro-min) into the bloodstream.
Once in the blood stream, the hormones work in the same way as the COC Pill to prevent pregnancy:
- the hormones temporarily prevent ovulation (egg release);
- alter the conditions within the uterus (womb) and fallopian tubes;
- form a ‘plug’ of mucus at the cervix (neck of the womb);
- and stop sperm from being able to access an egg to fertilise.
Who can use The Patch?
The Patch is a combined method of contraception, therefore women who are medically safe to use the COC Pill and The Vaginal Ring can use it, too.
The risk of developing blood clots may be slightly greater with the type of progestogen in The Patch (norelgestromen) than with the progestogens used in some low-dose combined oral contraceptive pills.
How effective is The Patch?
The Patch is over 99% effective when used correctly.
In other words, extremely reliable, with less than 1 woman in 100 who use it becoming pregnant each year.
How do I use The Patch?
The total cycle is 28 days, as with The Pill.
The Patch cycle consists of 21 days of active hormonal treatment, carried through three sticky patches, worn consecutively, for seven days each — followed by one week without a Patch, during which a withdrawal bleed can be expected.
It should be applied on Day 1 of the first cycle to obtain full protection immediately but can be applied up to Day 5 of a regular 28-day cycle.
If your cycle is shorter than 24 days, and if it is applied between Days 2 and 5, protection is not sufficient until the 8th day.
In this case you should either avoid sex in that time or carefully use a condom, to prevent pregnancy.
Where is The Patch worn?
The Patch can be worn on most areas of the body, but should not be applied to:
— the breasts; or
— broken or irritated skin.
What if I forget to put a new Patch on?
The same ‘rules’ apply as with forgotten or missed COC Pills.
If you are late with your next Patch, for more than 48 hours, protection is lost.
Replace the Patch and, to avoid pregnancy, use extra protection or avoid having sex for the next 7 days.
What are the advantages of The Patch?
The Patch provides:
- a discreet way to use hormonal contraception;
- a weekly option, rather than a daily method so you only have to
- remember to do something once a week to maintain your contraceptive protection;
- you don’t have to worry if you vomit or have diarrhoea as it doesn’t have to be swollowed;
- as with most other methods, it use doesn’t interfere with sex; and
- withdrawal bleeds are regular, usually lighter and less painful than natural periods.
What are the disadvantages of The Patch?
- can be seen;
- does not offer any protection against sexual infections; and
- as with other hormonal methods, there may be spotting (bleeding at unexpected times) and other side effects during the first few months.
The Patch is pink in colour, so can I colour it or draw a design on it?
No. Do not alter The Patch.
There could be an interaction between the dyes in your ink and the hormones in The Patch.
What if The Patch falls off?
The same guidance applies as with forgotten COC Pills.
Will The Patch fall off when I have a shower or a bath?
The Patch is very sticky and does not generally fall off, either in the bath, shower or with general wear.
If it does, follow the guidance for forgotten Patch and missed COC Pills.
Is using The Patch like using a ‘stick on’ form of The Pill?
Yes. In many ways The Patch is a ‘stick on pill’, but for many women, it is easier to use and to remember.
When can I use The Patch after I have a baby, a miscarriage or have an abortion?
See this question in relation to the COC Pill because the answer is the same (page 88).
NOTE: your prescriber should ensure that you understand how to use it correctly before issuing you with The Patch..
However,if you decide to use it, excellent instructions and answers to many more questions are provided by the manufacturer.
Keep their leaflet for reference.