Birth control

The birth control patch

A new form of birth control, the birth control patch, has been available in Canada since January 2004. A 4-centimetre (1 1/2-inch) square that sticks to a woman's skin (usually on the buttocks, stomach, back, or upper arms but never on the breasts), the patch continuously releases the hormones estrogen and progestin into a woman's bloodstream.

When used properly, the Patch is more than 99% effective in preventing pregnancy. For women who have trouble remembering to take their pill every day, the Patch may be more effective than the Pill. It may, however, be less effective in women weighing more than 90 kilograms (198 pounds).

How does the Patch work?

The patch works in a manner very similar to the Pill: hormones that prevent a woman's ovaries from releasing eggs are released into her bloodstream. Naturally, if an egg isn't released, it cannot become fertilized and pregnancy cannot occur. In addition, the Patch also causes other physical changes in a woman's body that make it difficult for male sperm to reach an unfertilized egg.

Both the Patch and the Pill thicken the mucus of the cervix, thereby making it more difficult for sperm to travel into the uterus and up into the fallopian tubes. Oral contraceptives also alter the lining of the uterus, making it thinner and therefore more difficult for an egg to implant itself in the endometrium.

The only main difference between the patch and the Pill is that the Pill is taken by mouth whereas the Patch provides hormones through the skin.

If you cannot take estrogen because of an underlying medical condition, you should not use the Patch. Only your doctor can determine whether the Patch is right for you.

How do I wear it?

Typically, you should apply the first patch on the first day of your menstrual period. If you apply the Patch more than 24 hours after the start of your period, it will not offer protection from unwanted pregnancy during the first week. If switching from the Pill to the Patch, you should also start the Patch on the first day of menstrual bleeding rather than on the day you would have started your next pack of pills.

The Patch is worn on the skin for 7 days, with a new patch worn each week for 3 weeks. The Patch should be changed on the same day each week. Try to change the location of the Patch each week and be sure to apply it to clean, dry skin. No patch is worn the fourth week. It's during this week that you should have your menstrual period. The Patch should never be off for more than 7 days in a row. Then, following a patch-free 7 days, you begin a new cycle when you apply a new patch on the day you normally change your Patch.

Avoid using cream or lotion near a patch you're already wearing or where you plan to apply a new one. Some women worry that the Patch may come off. For most, that's not a problem: they can still shower, exercise, swim, or enter a jacuzzi or hot tub. You should, nonetheless, check each day to make sure the Patch is still well applied. If the edges have lifted, try to smooth the Patch back on by pressing it with your hand for 10 seconds. If it doesn't stick or if it comes off completely, apply a new one. You would still change it on your normal patch change day and don't worry —you're still protected against pregnancy.

If your patch falls off for more than 24 hours, apply a new one right away and begin a new four-week cycle. You should use a backup method of birth control for the next week. You will also have a new patch change day.

If you forget to change your patch for 1 or 2 days, remove it when you remember and apply a new one. You will still change your patch on your next patch change day and you are still protected against pregnancy.

If you are more than 2 days late changing a patch, start a new four-week cycle with the application of a new patch. You will need to use a backup method of birth control for the next week.

If you forget to remove your patch at the start of your patch-free week, take it off as soon as you remember and start your next four-week cycle on the day you'd normally start. You may find that your menstrual period is shorter or that you are still bleeding when you put on the next patch at the start of your next four-week cycle.

If you forget to put on your patch at the end of your patch-free week, (meaning that you've had more than 7 days without a patch), put it on as soon as you remember. You will need to use a backup method of birth control for the first week of your new cycle, and your patch change day will be different.

Are there any health benefits?

The benefits of the Patch mirror those of the Pill. The Patch can help regulate a woman's menstrual cycles and may reduce premenstrual symptoms, menstrual flow, and cramps. The Patch is also believed to reduce the risk of endometrial and ovarian cancers and to help prevent benign ovarian cysts. The Patch is also completely reversible: once you stop taking it, your body resumes its normal menstrual cycle.

Are there any side effects

When first starting the Patch and as your body grows accustomed to the hormones, you may experience such side effects as bleeding between periods, breast tenderness, headaches, or nausea. These symptoms usually disappear after the first three months. If they do not, consult your doctor or healthcare provider.

Does the Patch offer any protection from STIs?

The Patch cannot protect against sexually transmitted infections. It's important to use both condoms and the Patch in order to safeguard against pregnancy and sexually transmitted infections. Knowing your partner or believing you're in a monogamous relationship is not enough. You may have chosen to have sex only with your partner, but do not assume your partner feels the same way. Do not assume you're in a monogamous relationship. If you wish to stop using condoms, be sure to see your doctor for regular HIV testing and tests for sexually transmitted infections. Following that, talk with your partner and make sure you both agree to be strictly monogamous.