What is the Birth Control Patch?

Written by Giuliana Castellucci, medically reviewed by Sophia Yen, MD, MPH.

The birth control patch is a small, flexible square or round patch that sticks to your skin to prevent pregnancy. Roughly the size of a mini-sticky note, the patch releases hormones (estrogen and progestin) into your bloodstream through your skin. These hormones stop ovulation (the release of an egg from the ovaries), thicken cervical mucus, and thin the uterine lining—making it harder for sperm to reach an egg or for a fertilized egg to implant.

Brands like Xulane and Twirla are commonly prescribed patches in the U.S., and they’re FDA-approved, discreet, and easy to use.

How Does the Birth Control Patch Work?

The patch works similarly to combination birth control pills, delivering a steady dose of estrogen and progestin. These hormones:

• Prevent ovulation, no egg is released.
• Thicken cervical mucus, making it harder for sperm to swim to an egg.
• Thin the uterine lining, reducing the chance of a fertilized egg implanting.

You apply a new patch once a week for 3 weeks, then go patch-free for the fourth week. During this patch-free week, you’ll likely get a withdrawal bleed. Some people call this a “period” but it’s not a “real period” because the lining is not as thick as usual and it’s arbitrary.

Birth Control Patch Effectiveness

When used perfectly, the patch is about 99% effective. With typical use (i.e., missing a patch change or not applying it correctly), it’s around 91% effective in preventing pregnancy.
Factors that may reduce its effectiveness:

• Forgetting to change the patch on time. You should change it every week on the same day of the week, ideally at the same time.
• Weighing over 198 pounds (effectiveness is reduced for patches because they were formulated assuming an average weight. Also Twirla is NOT to be used by anyone with a BMI of 30 kg/m2 or more because it won’t work to prevent pregnancy reliably).
• Using certain medications that interfere with hormones (like some antibiotics, seizure medications, pseudoephedrine [over the counter cold medicine]).

Does the Birth Control Patch Have Side Effects?

Like all hormonal birth control, the patch can come with side effects—most temporary and will go away in 3 months, others less common.

Common side effects include:

• Breast tenderness (which should get better after 3 months).
• Nausea (if this happens, put the patch on right before you go to bed and see if that helps).
• Headaches (if this happens, tell your doctor, you may need to stop estrogen containing methods, or at least the patch).
• Spotting or irregular bleeding ( should get better after 3 months). Check to see if you started any new medications or over the counter medications that may be revving up your liver and eating up the hormones, causing this spotting. Ask your doctor and make sure you tell her/him all the medications and over the counter meds and supplements you are taking.
• Skin irritation at the patch site

Less common but serious risks:

• Increased risk of blood clots, especially in people who smoke and are over 35.
• Elevated blood pressure (which will go away when you stop the medication).
• Mood changes (which will go away when you stop the medication).

Always talk to a doctor about your personal health history before starting the patch.

Is the Birth Control Patch Right for Me?

The patch might be a great option if you:

• Don’t want to take a daily pill.
• Want a discreet method you only change weekly.
• Are under 35 and don’t smoke.
• Prefer a hormonal method without wanting an implant, shot or IUD.

The patch might not be right for you if:

• You’re over 35 and smoke (NOT safe to be on estrogen containing birth control with both of these because of increased risk of blood clots and death from the clots).
• You have a history of blood clots, stroke, or certain cancers (increased risk of clots or reactivating/aggravating the cancer).
• You prefer a non-hormonal method.
• You have sensitivity to estrogen or progesterone.

Birth Control Patch Advanges Vs Disadvantages

Advantages	Disadvantages
Only apply once a week	Skin irritation where the patch is placed
Discreet and easy to use	Must remember weekly change
Regulates periods and reduces cramps	Slightly higher risk of blood clots vs the pill
No daily pill to remember	Less/ineffective if you weigh over 198 lbs or BMI 30 kg/m2 or greater
Can be used to skip periods (but only for 12 weeks in a row.)	Cannot be used to skip periods more than 12 weeks at a time. Have to bleed every 12 weeks or else risk estrogen level getting high in blood and increasing the risk of blood clots
Helps improve acne	Not suitable for everyone

Where to Get the Birth Control Patch

You need a prescription to get the birth control patch in the U.S.—but you don’t have to wait for an in-person doctor’s visit.

Pandia Health makes it simple. We’re a female-founded, doctor-led telehealth company that specializes in birth control and hormonal care.

For just $35, you can use one of our expert doctors online to get the patch—or decide if another method (the pill or birth control ring) may work better for your unique body. Once prescribed, your refills arrive to your mailbox with FREE delivery, so you never have to worry about wasting time and running back and forth to the pharmacy.

➡️ Get your birth control today with Pandia Health

Disclaimer: This article is for informational purposes only and does not substitute professional medical advice. Always consult with a healthcare provider for personalized medical guidance.