Birth control patches come in a few hormone and dose types that give weekly, skin-based contraception.
Birth control patches appeal to people who want strong pregnancy protection without a daily pill. You place a thin adhesive square on the skin, leave it on for a week, and switch to a fresh patch on the same day each week for three weeks, followed by one patch-free week. Within that routine, different types of birth control patches offer slightly different hormone mixes, dose levels, and body-size limits. This article explains how the patch works, compares the main patch types in use, and shares questions you can bring to a health care professional when you decide which option fits your body and your routine. It is general education only and cannot replace personal medical advice.
What Is A Birth Control Patch?
A birth control patch is an adhesive square that sticks to clean, dry skin on areas such as the upper arm, back, belly, or buttock. The patch steadily releases two hormones, estrogen and progestin, through the skin and into the bloodstream to prevent ovulation and thicken cervical mucus.
Current patches are combined hormonal methods. Each contains ethinyl estradiol (a form of estrogen) plus either norelgestromin or levonorgestrel as the progestin. There is no progestin-only patch on the market. MedlinePlus notes that these patches prevent pregnancy in the same basic way as many combined pills.
| Feature | Norelgestromin / Ethinyl Estradiol Patch | Levonorgestrel / Ethinyl Estradiol Patch |
|---|---|---|
| Example brand | Xulane and regional generics | Twirla |
| Hormone mix | Norelgestromin (progestin) plus ethinyl estradiol | Levonorgestrel (progestin) plus ethinyl estradiol |
| Estrogen level | Mid-range estrogen; higher exposure than many pills | Designed as a lower estrogen dose than older patches |
| Labeled BMI range | Labeled for BMI under 30 kg/m²; less reliable over 90 kg | Labeled for BMI under 30 kg/m²; effectiveness drops near 30 kg/m² |
| Wear schedule | One patch weekly for three weeks, then one week off | Same weekly pattern: three weeks on, one week off |
| Patch style | Square, slightly larger, beige backing | Round, fabric-like backing, a bit smaller |
| Typical user | Prefers a long-used patch and a standard estrogen dose | Prefers a lower-dose patch and meets BMI limits |
Exact doses, contraindications, and warnings appear in each product’s prescribing information. Brand materials list those details, but your clinician still needs to help you decide whether any combined hormonal patch is suitable for you.
How Effective Are Birth Control Patches?
When used exactly as directed, the birth control patch prevents pregnancy in more than 99 out of 100 users per year. Real-life use often includes late changes or missing a patch week, and that brings effectiveness down. The Centers for Disease Control and Prevention lists typical use of the patch at around 91% effective, which means about nine pregnancies each year among 100 users.
Birth control patches do not protect against sexually transmitted infections. Adding condoms cuts the chance of infections and also adds backup pregnancy protection. For a broad comparison of contraception effectiveness, the CDC guidance on birth control methods shows how the patch compares with pills, implants, IUDs, shots, and barrier methods.
Effectiveness also depends on factors such as body weight and medicines that interact with hormones. Anti-seizure drugs, some HIV medicines, and some herbal products can change hormone levels and make any combined hormonal method less reliable.
Different Types of Birth Control Patches And How They Compare
In most countries, different types of birth control patches fall into two main groups: norelgestromin-based patches and levonorgestrel-based patches. Both groups contain ethinyl estradiol, both follow a weekly routine, and both work as combined hormonal contraception.
Norelgestromin And Ethinyl Estradiol Patches
Norelgestromin patches were the first modern contraceptive patches to reach a wide audience. They deliver norelgestromin as the progestin plus ethinyl estradiol at a dose similar to many mid-range combined pills. Brand names include Evra, Ortho Evra, Xulane, and several generics. Product information notes that these patches are intended for people with a body mass index under 30 kg/m² and may work less well for those who weigh more than 90 kilograms, which is why clot risk and weight are reviewed together before starting them.
Levonorgestrel And Ethinyl Estradiol Patches
Levonorgestrel patches belong to a newer group of combined hormonal patches. The Twirla patch is the best-known example. It follows the same weekly pattern as norelgestromin patches, has a round cloth-like backing, and is labeled for people with a BMI under 30 kg/m². It is designed as a lower estrogen dose than older patch designs, and effectiveness drops as BMI approaches 30 kg/m².
Regional Brand Differences
Outside the United States, similar hormone combinations may appear under other brand names, and local regulators may set slightly different rules around weight limits or warnings. Labels and packaging can change, but pharmacists can tell you whether a new box is equivalent to the patch you used before.
Birth Control Patch Types For Different Needs
When someone asks about different types of birth control patches, the real question is usually, “Which patch fits my body and my day-to-day life?” Routine and body size matter a lot here. If you like a weekly rhythm and usually remember calendar events, any combined patch can work well, while people who forget weekly tasks may prefer an implant or IUD. Both main patch types carry upper BMI limits and warnings about lower effectiveness at higher weights.
| Your Situation | Patch Features To Look For | Question To Ask |
|---|---|---|
| BMI close to or above 25 kg/m² | Clear data on performance at your weight; backup guidance | How well does this patch work at my BMI? |
| Past clot, stroke, or strong family history | Non-estrogen methods instead of a patch | Is a combined hormonal patch safe for me at all? |
| Sensitive skin or adhesive reactions | Softer backing, smaller patch, tips on rotating sites | What should I do if my skin reacts under the patch? |
| Heavy or painful periods | Patches with data on lighter bleeding and steadier cycles | Which patch is most likely to ease my cramps and flow? |
| Strong nausea on standard pills | Lower estrogen dose or a non-estrogen method | How does this patch’s hormone exposure compare with my pill? |
For a clear summary of common side effects, precautions, and drug interactions, the MedlinePlus page on estrogen and progestin contraceptive patches offers plain-language information similar to what many clinicians explain during visits.
Side Effects And Safety Of Birth Control Patches
Common side effects for both main patch types include breast soreness, mild nausea, headaches, spotting between periods, and skin irritation where the patch sits. These symptoms often appear in the first few cycles and then fade, but if they stay strong past three months a different patch type or another contraceptive method may feel better.
The main safety concern with any combined hormonal patch is clot risk. Estrogen raises the chance of a blood clot, especially in users who smoke, have certain clotting disorders, or live with other risk factors such as long periods of immobility. Some research suggests that estrogen exposure from patches is higher than from many pills, so clot risk may also rise slightly. Sudden leg pain, chest pain, or shortness of breath after starting a patch warrant urgent medical care.
Certain conditions call for a different method altogether. People with migraine with aura, some heart or liver disease, certain cancers, or very high blood pressure are often advised to avoid any combined hormonal method. In those cases, a progestin-only option or a non-hormonal method such as a copper IUD usually works better than a birth control patch.
How To Use A Birth Control Patch Step By Step
Every brand supplies detailed instructions, and you should follow those first. Most combined patches still share a simple weekly pattern.
Starting Your Patch Cycle
Many users start the patch on the first day of a period or on the first Sunday after bleeding begins. Starting on day one usually gives immediate protection, while starting later in the week may require condoms for the first seven days. Before you apply the first patch, wash and dry your skin, skip lotion on that area, peel the patch from its liner, and press it firmly on the chosen spot so the edges stick well.
Weekly Patch Changes
Pick a patch change day you can remember, such as Monday or Friday, and keep that same day each week. Replace the patch on that day for three weeks in a row, then go patch-free in week four for a withdrawal bleed. Rotate sites so you are not placing a fresh patch on the exact same square of skin each week, and check that it stays firmly attached after showers, swims, or tough workouts. If it falls off, follow the brand’s instructions, since you may need a new patch and backup contraception for several days.
If You Miss Or Delay A Patch
Patch changes sometimes run late. Each product insert includes a chart for missed or late patches, and many users save a photo of that chart on their phone. Follow those steps or your clinician’s advice if you run late, and use backup contraception whenever the instructions say it is needed.
Whichever method you choose now, you can change it later if it stops working for your body or your life. You can always talk with your clinician again if your plans or health change.