The patch is a highly effective contraceptive method when used correctly. In fact, the patch is just as effective as birth control pills and is a good alternative, reversible, hormonal contraceptive. Research suggests that the patch may even offer additional advantages to the pill, including:
- Because the hormones in the patch go through the skin, directly into the bloodstream (and don’t have to be ingested), its therapeutic effects can be achieved at lower dosages.
- Hormone levels do not fluctuate as much because there is a steady stream of hormones being released (this could lead to fewer side effects).
- The patch only needs to be re-applied once a week, so it doesn’t require you to remember to use it everyday. This can improve effectiveness and compliance.
- The patch offers reliable pregnancy protection for women who have trouble swallowing pills.
Even though the patch offers excellent protection against becoming pregnant, this effectiveness can be compromised if it is not used properly.
Applying the Patch: You must stick the patch on your upper torso (but not your breasts), stomach, buttocks or upper arm. It is suggested that you use a different site every time you put on a new patch.
If The Patch Falls Off: The rule of thumb in this scenario depends on how long the patch has been partially or totally detached. If it has been less than 24 hours, you can just reattach the same patch in the same location (as long as it is still sticky). You can also replace it with a new patch. If your patch has fallen off for more than 24 hours, you MUST apply a new patch (throw out the one that has fallen off). The day that you replace the patch will then become the new day of the week that you change your patch (so if you replace a fallen off patch on a Tuesday, then you will change it on Tuesday of the following week). You should also use a back-up birth control method for the first seven days after you have applied a new patch, because it had been more than 24 hours since the previous patch fell off.
It seems, though, that it is rare that a patch will fall off. To find out more about the incidence of patch detachment, I researched an article on UpToDate -- an electronic reference used by many doctors and patients looking for in-depth medical information. According to UpToDate,
“In various trials, 1.8 percent of transdermal patches required replacement for complete detachment and 2.9 percent became partially detached. Living in warm, humid climate did not increase the risk of detachment. The quality of adherence was illustrated in a study in which 30 women were subjected to various conditions over several seven-day time periods during transdermal patch use. The conditions included normal activity, use of a sauna, immersion in a whirlpool bath, use of a treadmill followed by showering, cool water immersion, and a combination of these activities. Only one patch became detached during the 87 cycles that were evaluated, suggesting that skin adherence is not adversely affected by a vigorous, athletic lifestyle.”
This research suggests that the adhesion reliability of the patch is excellent. The results show that only a small percentage of contraceptive patches either partially fall off (2.9%) or completely come off (1.8%). Also, keep in mind that the women in these studies were subjected to dynamic conditions -- most likely participating in these activities for longer durations than typical women do. It appears, then, that the patch sticks... regardless of heat, humidity, exercise, whirlpools, swimming and bathing/showering. So even though it is important to know what to do if your patch falls off, chances are very high that it won’t.
Forgetting to Change the Patch: To be most effective, you need to replace the patch (on the same day) once a week for three weeks. Then, you go one week without it. If you want to change the day you apply the patch, you can choose a new day to put it on during the patch-free week (week 4).
The following are guidelines to help you know what to do if you forget to apply your patch (depending on which week in your cycle you are in):
- First Patch (Week 1) - if you forget to put the patch on past your scheduled start day, stick on a new patch as soon as you remember (this day will become your new day each week to change the patch). To avoid pregnancy, make sure you use back-up birth control (condoms, spermicide, the sponge) for seven days.
- Second or Third Patch (Weeks 2 or 3) - because there is about a two-day amount of continued release of ample hormones, you have a two-day late-window to change the patch at the beginning of Week 2 or 3. If you have left on the patch for up to two additional days, you can just apply your new patch at this time. You do not need to switch your "patch change day," and you don’t need additional contraception. If it has been more than two days when you realize that you forgot to change the patch, you are at a greater risk for birth control failure. If you have had sex in this time frame (three or more days past the start of Week 2 or 3), it may be wise to use emergency contraception. Also, you will need to use back-up birth control for seven days (beginning with the day you change the patch) and will have to switch your patch change day to the day you remember to change your patch.
- Forgetting to Take Off Your Third Patch - if you forget to take off the patch at the beginning of Week 4 (your patch-free week), this is okay. Just remove it whenever you remember. You can still begin your new cycle (Week 1) on your regular scheduled patch change day.
Want to learn more? See UpToDate's topic, "Transdermal contraceptive patch," for additional in-depth medical information on the patch.
Burkman, Ronald T. “Transdermal contraceptive patch.” UpToDate. Accessed: October 2011.