The Birth Control Patch

Currently there is only one company that makes the birth control patch. The company, Ortho-McNeil Pharmaceuticals, has the philosophy of attaching the Ortho company name to every one of their women’s products. In this case, the patch is called Evra®, therefore, the full name of the product is the Ortho Evra® patch.

Norelgestromin is the active progestin in the patch, while the active estrogen is ethinyl estradiol. These 2 hormones are the same components found in Ortho’s most popular birth control pills, OrthoCyclen® and Ortho Tri-Cyclen®

The Ortho Evra® patch is ideal for the woman who has difficulty remembering to take a birth control pill on a daily basis. With the patch, one only needs to remember to change it on a weekly basis.

You can wear ORTHO EVRA® on one of four areas of the body: upper outer arm, upper torso (front and back, excluding the breasts), abdomen, or buttocks. The birth control patch should not be worn on any other areas of the body.

To ensure the effectiveness of ORTHO EVRA®, do not place the birth control patch on areas of your skin where make-up, lotions, creams, powders, or other products are or will be applied. In addition, do not place ORTHO EVRA® on skin that is red, irritated, or cut.


The Ortho Evra® patch is considered as effective as the Pill and is the first weekly form of reversible contraception. It is considered 99 percent effective when used correctly.

The patch is also thought to limit hormone fluctuations, like those that occur with the Pill. Instead of having rising and falling hormone levels each day as a woman takes her birth control pill, the Ortho Patch causes a steady release of hormones that remain constant throughout the week.

When is contraception effective using the Sunday Start method: You must use back-up contraception, such as a condom, spermicide or a diaphragm, for the first week of your first cycle.

Can you wear ORTHO EVRA in the shower or while swimming or exercising? Yes. The Patch adheres well to the skin, allowing you to perform your daily activities such as bathing, showering, swimming, and exercising without interruption. If the sticky surface of the Patch becomes wet, discard it and apply a new patch.

How do you use the Ortho Evra Patch?

The Patch Calendar Graphic

Apply the patch on the 1st Sunday after your period begins. You will wear this patch all week until Sunday. At that time, discard your current patch and apply a new patch in a different area for the next week. On Sunday you will again discard your current patch and apply a new one. On the following Sunday, you will leave the patch off for 1 week, to let your body have a period.

If your are breastfeeding, can you use the Ortho Evra patch? No, you should not use the patch until you have weaned your child completely, because the estrogen hormones in the patch can enter your breast milk and be passed to the baby. Also, the patch may decrease the amount and quality of your breast milk).

Side Effects of the Patch

The contraceptive patch contains hormones similar to those in birth control pills. And, hormonal contraceptives are not for everybody. Most side effects of the contraceptive patch are not serious and those that are, occur infrequently.

Serious risks, which can be life threatening, include blood clots, stroke or heart attacks and are increased if you smoke cigarettes. Cigarette smoking increases the risk of serious cardiovascular side effects, especially if you are over 35. Women who use hormonal contraceptives are strongly advised not to smoke. Some women should not use the contraceptive patch, including women who have blood clots, certain cancers, a history of heart attack or stroke, as well as those who are or may be pregnant.

The contraceptive patch does not protect against HIV or other sexually transmitted diseases.

A common adverse reaction associated with the patch, is a skin rash. Most notably, the patch sometimes causes a skin hypersensitivity reaction because of the glue used to make it stick to a woman’s skin. The reaction is usually a red welt, that lasts for several days after the patch is removed. If this reaction occurs with you, then it is recommended that you find an alternate form of contraception.

Secondly, since the patch is worn for seven days at a time, lint will accumulate along the edge of the patch, just as occurs with a band aid that has been in place for several days. This black ring is unsightly and will be a deterrent for some women.

Side effects thought to be due to the patch:

  • Nausea
  • Vomiting
  • Gastrointestinal symptoms (such as abdominal cramps and bloating)
  • Breakthrough bleeding
  • Spotting
  • Change in menstrual flow
  • Amenorrhea
  • Temporary infertility after discontinuation of treatment
  • Edema
  • Melasma which may persist
  • Breast changes: tenderness, enlargement, secretion
  • Change in weight (increase or decrease)
  • Change in cervical erosion and secretion
  • Diminution in lactation when given immediately postpartum
  • Cholestatic jaundice
  • Migraine

Will it fall off?

According to the Ortho company, the Ortho Evra® patch adheres well to the skin. In a special study conducted in warm and humid conditions—including swimming, bathing, sitting in a sauna, working out on a treadmill, and soaking in a whirlpool—the birth control patch showed excellent sticking power.

If it should fall off or come lose, do not try to re-apply it if it is no longer sticky; if it has been stuck to itself or another surface; if it has other material stuck to it; or if it has become loose or has fallen off before.

What do you do if you discover that a patch has fallen off?

If your patch has been off for less than 24 hours:Try to re-apply your patch or apply a new patch immediately. No back-up contraception is needed and your “Patch Change Day” will remain the same.

If your patch has been off for more than 24 hours, or if you are not sure for how long: Start a new four-week cycle immediately by applying a new patch. You now have a new Day 1 and a new “Patch Change Day”. You must use back-up contraception, such as a condom, spermicide or a diaphragm, for the first week of your new cycle because you may become pregnant during this time.

Re-apply the Patch by following these instructions:

  • Press down firmly on the patch with the palm of your hand for 10 seconds, making sure that the edges stick well. Then run your fingers around the edge of the patch. Do not use tapes or wraps to keep the birth control patch in place.
  • If the birth control patch does not stick well, remove it and then apply a replacement birth control patch. This patch should be replaced on the original “Patch Change Day.” Single replacement patches are available. Call our office for a replacement if you don’t already have one.

Missed Period While Using the Patch

  1. If you miss your menstrual period and you haven’t followed the patch directions as you should have, then you should consider the possibility of being pregnant, and you should have a pregnancy test done. You may call our office for a blood pregnancy test (most accurate) or you may perform a home pregnancy test. If either test is positive, then stop the Ortho Patch
  2. If you miss your menstrual period and you have followed all of the patch directions, then you should continue using your patch just as you have been. If you miss a second consecutive period then you should have a pregnancy test done. You may call our office for a blood pregnancy test (most accurate) or you may perform a home pregnancy test. If either test is positive, then stop the Ortho Patch