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revised Tuesday May 16 2017
healthy sexuality
Birth Control Methods

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The Contraceptive Patch (EVRA)

EVRA, the contraceptive patch, is a 1 ¾ inch square patch worn on your skin that slowly releases the hormones estrogen and progestin through the skin and into the bloodstream. The patch prevents pregnancy by stopping an egg from being released each month (ovulation) and by changing the cervical mucous to make it difficult for sperm to enter the uterus.

The patch is only available by a prescription from a doctor.

How to Use the Patch

Things to Note Beforehand

  • The patch is latex free and is intended to be worn on the buttock, abdomen, upper body (except for the breasts) or on the outside of the upper arm.
  • You should put the patch on a different place (buttock, abdomen, upper body, and upper arm) each week. You can wear it on the same location but not in the exact same spot.
  • The patch will stay attached while bathing, swimming, exercising or even when it’s very humid.
  • If you’ve had any difficulty using the Patch and think you may be at risk of pregnancy, you might be able to take the emergency contraceptive pill (morning after pill) to help prevent pregnancy. Speak to your health care provider if you have any questions or concerns.
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Starting the Patch for the First Time

 

What to Do

Step 1

  • Read and follow the instructions that come with the patch package.
  • Apply a patch to your buttock, abdomen, upper body (except for the breasts) or on the outside of your upper arm on the first day of your period. (If you want to start your patch on a Sunday, but this was not the first day of your period, use a back up method such as condoms for the next 7 days.)
  • Press the patch firmly with the palm of the hand to be sure edges are sticking well.
  • Don’t put the patch on a cut or on red or irritated skin.
  • Don’t put the patch on areas of skin where you’ll also apply oil, creams, lotions or powders.

Step 2

  • Replace with a new patch once a week on the same day of the week for 3 weeks in a row. (For example, if you started your first patch on Monday, then you will change your patch every Monday for 3 weeks.)

Step 3

  • On week 4 remove your patch. Your period should start during this “patch-free” week.

Step 4

  • Apply the first patch from a new package at the beginning of your next 4 week cycle on your normal patch-change day, no matter when your period begins or ends.
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If You Forget to Apply or Change A Patch

If you forget during...

What to Do

Week 1

Apply a patch as soon as you remember.
This is now your new patch change day.
Use a back-up method for 7 days.

Week 2 or 3

If less than 2 days (48 hours) from usual change day:

  • Remove your “used” patch.
  • Apply a new patch immediately.
  • Apply your next patch on your usual day.

If more than 2 days (48 hours) from usual change day:

  • Remove your “used” patch.
  • Apply a new patch immediately.
  • This is now your new patch change day and you now start a new 4-week cycle.
  • You may or may not have a period this cycle.
  • Use back-up for 7 days then apply a new patch.

Week 4
(patch free week)

  • Remove the patch when you remember. (Your period may start late.)
  • Apply a new patch on your usual patch change day.

(You should never be “patch free” for more than 7 days.)

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If Your Patch Becomes Loose or Falls Off:

If your patch becomes loose or falls off before the end of a 24-hour period:

  • Try to re-stick the patch or put a new patch on immediately.
  • Keep your patch change day the same.

If your patch stays loose for more than 24 hours:

  • Remove the entire patch
  • Put a new patch on immediately - this starts a new 4-week cycle.
  • Going forward, use the day that you added the new patch as your new “patch change day”.
  • Use a back-up birth control method for the next 7 days.
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When to Use Backup Protection

You should also use a back up birth control method - such as condoms - for 7 days if:

  • You start the patch on a Sunday, but this isn’t the first day of your period.
  • You start the patch more than 24 hours after your period starts.
  • You are changing from the Pill to the patch on a day that isn’t the first day of your period.
  • You’re switching from a Depo injection to the patch and more than 13 weeks have passed since your last injection.
  • You’re taking other prescription drugs that might make the patch not work as well. Check with your health care provider.
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Effectiveness

The patch is 98% effective in preventing pregnancy when used correctly. In other words, 2 in 100 women who use the patch for one year will get pregnant.*

The patch may be less effective for women who weigh over 90kg (198 lbs).

* source: The Mayo Clinic

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Advantages & Disadvantages

Advantages

Disadvantages

  • You need to only remember the patch once a week.
  • Regular, lighter periods with less cramping.
  • Reversible: won't affect your future fertility.
  • Allows for spontaneity with sexual activity.
  • Doesn't protect against sexually transmitted infections including HIV/AIDS.
  • Can cause some side effects when you first start using the patch, like breakthrough bleeding, breast tenderness, headaches or nausea.
  • Can cause skin irritation where the patch is placed.
  • Might not be as effective for if you weigh more than 198 pounds.
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Cautions & Things to Consider

The Contraceptive Patch Doesn’t Protect Against STIs

The patch won’t protect you or your partner from STIs including HIV/AIDS. Using the patch and condoms at the same time can reduce your chances of getting an STI, including HIV/AIDS.

Smoking, Being Overweight/Obese and the Patch

A warning from the manufacturer recommends that the women should not use the Patch if they are:

  • smokers (especially heavy smokers - more than 15 cigarettes per day)
  • overweight or obese

Women who have one or more of the above characteristics have a higher chance of developing a blood clot because of the higher exposure to estrogen compared to the Pill.

Speak with your doctor or health care professional if you’re thinking about using the patch and smoke and/or are overweight/obese.

Storing and Switching Your Patches

  • Be sure to keep a supply of extra patches in case your patch loosens or falls off and you need to replace it.
  • Remember to pack extra patches if you’re going on vacation or you’ll be away from home for an extended period of time.
  • Store your patches at room temperature.
  • Don’t write on your patch or change it in any way.
  • Don’t move the patch once it’s applied.
  • Removing your patch while bathing might be easier.
  • If you’re switching from Depo to EVRA, start the patch on the day the next injection is due.
  • If you’re switching from birth control pills to EVRA, start the patch the first day you start bleeding, not on your regular pill start day.

Side Effects

When you first start the patch, and for some months after, you might:

  • Feel nauseous.
  • Have headaches.
  • Have some breast tenderness.
  • Have some breakthrough bleeding.
  • Have some skin irritation or redness where the patch is applied.
Don’t smoke if you use the patch. Women who use the patch and smoke have a higher chance of developing a blood clot.
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Revised: Tuesday May 16 2017

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