Looks like a band-aid, acts like birth control? Among the many birth control methods available in the United States, a lesser-known one is the birth control patch. Marketed as an alternative to oral contraception for those who don’t want to or have trouble remembering to take a daily pill, the transdermal contraceptive patch was first approved by the FDA in 2001. First commercially produced under the name Ortho Evra, the two generic versions now available in the United States are Xulane and Twirla. The two use different forms of progestin, but the main difference is that Twirla delivers slightly less estrogen each day (an important concern for the patch that will be discussed later on).
It’s difficult to pinpoint how many women actually use the patch, as it tends to be grouped with the birth control ring, and most statistics are several years old. However, like the ring, the patch seems to be a fairly unpopular method of birth control. In 2018, the patch was the chosen method of only 0.5% of contraception users aged 15-49 in the United States. The number of women who have ever used it is significantly higher, hovering between 10 and 11% from 2006 to 2015. One 2014 study reported that over five million women have used Ortho Evra since its creation in 2002 [1].
Putting on the patch
The birth control patch is a small, square piece of hormone-infused adhesive. It can be applied to the skin on the stomach, upper back, upper arm, shoulder, or buttock. Users are instructed to apply a patch on the first day of their period, leave it on for a week, replace it, and repeat that process for a total of three weeks. At that point, the patch is removed to allow a withdrawal bleed (“period”).
How the birth control patch prevents pregnancy
The birth control patch is a form of hormonal birth control; like the combination pill, it contains synthetic forms of both estrogen and progestin that more or less mimic the reproductive hormones naturally produced in varying levels during a woman’s menstrual cycle.
Like the pill, the birth control patch prevents pregnancy primarily by suppressing ovulation. It also thickens cervical mucus, blocking sperm from coming into contact with an egg in case of “breakthrough ovulation,” and thins the endometrium (uterine lining) to prevent an early stage embryo from implanting if fertilization occurs.
The patch isn’t always used for contraception
In addition to preventing pregnancy, the birth control patch may also be prescribed to treat other health conditions, such as “regulating” the menstrual cycle, preventing heavy or painful periods, reducing symptoms of premenstrual syndrome (PMS), or even treating acne. According to the NHS, it “may protect against ovarian, womb and bowel cancer.” However, patch use is associated with an increased risk of breast cancer and cervical cancer.
“Anything you can do I can do…worse?” Birth control patch-specific side effects
While all forms of hormonal birth control come with their share of side effects, the patch carries a significantly higher risk of causing blood clots. Studies have found that women were more than twice as likely to develop blood clots using the patch as compared to the Pill. This is due to the increased level of estrogen the patch delivers, which is 60% more per cycle than the Pill [2]. (Wondering exactly how estrogen can cause blood clots? An article published earlier this year by Natural Womanhood explains the link between estrogen and this life-threatening condition.)
Another side effect unique to the patch is a reaction at the application site, experienced by about 17% of users [3]. Women using the patch were also three times as likely as those on the pill to experience breast pain or swelling. The other most commonly reported side effects occur at comparable rates on the patch and on the pill, and include headaches, nausea, respiratory infection (yes, who knew?), and painful “periods” (remember that these are hormone withdrawal bleeding episodes, not true periods) [4].
Does anyone love the patch?
Unfortunately, women’s concerns about these risks seem to have gone unheeded. The patch has a much lower rate of continued usage compared to other methods, yet it’s still touted as a more convenient form of birth control with similar rates of effectiveness [3].
In 2009, sexually active teenage girls in focus groups shared doubts that a patch on the skin, compared to a pill that you ingest, could actually prevent pregnancy [5]. They also cited concerns about safety, having heard reports of other young women dying from the patch, saying, “You could get blood clots, you can have heart failure from that.” The authors of the report downplayed the young women’s awareness of such risks in the report’s conclusion, writing “It would be unfortunate if these safe and effective options for young women are underutilized because negative attitudes and perceptions about these methods act as barriers to adoption.”
Far from acknowledging the legitimate risks that come with birth control, or even suggesting better education for young women about how birth control methods actually work, the researchers propose that healthcare professionals should be made aware of these apprehensions to “counter recent declines in use of the patch” [5]. In short, researchers seem more intent on helping medical providers convince more women to adopt the patch as birth control than acting in the best interest of women’s health.
This article was updated on 5/31/24 to correct an instance where the imprecise term “fertilized egg” was used, and replaced with the more precise phrase, “early stage embryo.”
Additional Reading:
16-year-old dies of blood clot just weeks after starting birth control
Too much estrogen: The risks women on the birth control patch need to know about
