Center for Young Women's Health

The Hormone Patch (Ortho-Evra)



  • The patch is placed on the upper arm, lower stomach, buttocks, or back.
  • Showering, swimming, exercising, and sweating should not loosen the patch.
  • The patch needs to be changed every week.
  • The patch doesn't protect against STIs.

What is the patch?

hormone patch

The patch looks like a square Band-Aid (less than 2" x 2") and is worn on the skin. It contains hormone medicine similar to birth control pills, but the dose absorbed through the skin is 60% higher than the birth control pills with 35ug of estrogen. This may increase the risks of side-effects such as blood clots and makes it particularly important that patch users not smoke. When used correctly, the patch is as effective as birth control pills in preventing pregnancy. Like birth control pills, your health care provider may also prescribe the patch for irregular periods, menstrual cramps, or endometriosis.


Out of 100 women using the patch
Average use: 9 women become pregnant 9 Pregnant Women
Perfect use: 1 or less women become pregnant 1 Pregnant Woman

How does the patch work?

There are two different hormones (estrogen and progestin) in the patch. When you place the patch on your skin, the hormones are absorbed through your skin and enter your bloodstream. The hormones suppress your pituitary gland which stops your ovaries from releasing eggs. Without these eggs, pregnancy can't happen. The patch also changes the lining of your uterus and the mucus in your cervix. The change in your cervical mucus makes it more difficult for sperm to reach the egg.


Is the patch as effective as the Pill in preventing pregnancy?

Yes, when used correctly. Health care providers and researchers studied over 3000 women and found that the patch was 91-99% effective in preventing pregnancy. However, the patch is less effective for women who weigh more than 198 pounds, so check with your health care provider to see if the patch is right for you.


Where on my body do I wear the patch?

The patch can be worn on the skin of your lower abdomen, buttocks, back, or upper arm. Wherever you decide to put it, you must leave it there for 7 days. You should change the location of the patch each week.


Location of the Hormonal Patch (Ortho-Evra) on the Female Body

How do I put on my patch?

You can apply the patch like you would a Band-Aid. You must apply a new patch each week. Be sure that the spot where you have decided to wear your patch is clean and dry. Lotions on this area will cause the patch not to stick.

When should I start wearing my patch?

This depends on what your doctor recommends for you. The patch is usually started on the 1st day of your menstrual cycle or the 1st Sunday after your period (the same way you would start the pill). Your doctor may tell you to start the day you are seen in clinic.


How often do I change my patch?

Cyclic Use (3 weeks on, 1 week off): You'll need to change your patch once a week. For example, if you start the patch on day 1 of your cycle, the next time you'll change it is on cycle day 8 (week 2), then on cycle day 15 (week 3). On the 22nd day of your cycle (week 4) you remove the patch, and you don't wear a patch on week 4. Your period should start during this week.


Cyclic Use of the Hormonal Patch


Continuous Use: If you're using the patch continuously, it means that you'll always be wearing a patch. You'll need to change your patch once a week. Instead of going without a patch on the 4th week of your menstrual cycle, you'll apply a new patch. You probably won't have a period, or you may have an irregular period.


Continuous Use of the Hormonal Patch


Remember: You simply change the patch on the same day of the week. For example, if you start Sunday, then you change the patch every Sunday. If you start on Monday, then you change the patch every Monday, and so on.


How do I take off my patch?

Now that I've been using my patch... What if I'm more that 1 day late applying the patch on week 1?

If you forgot to restart your patch on time after your week off, apply it as soon as you remember. You MUST use another method of birth control such as condoms for at least 1 week. The first day that you apply your patch is considered Day 1 of your new patch cycle.


What if I forget to change my patch on week 2 or 3?

You can take the used patch off and apply a new patch right away if you are only 1-2 days late changing your patch. The next patch should be applied on your regular patch change day. Using a backup birth control method (such as condoms) for 7 days is recommended.


What if my patch falls off?

If you have noticed that your patch is off or almost off for less than 24 hours, try to put it back on or replace it with a new one. In research studies, less than 2% of patches came off and less than 3% of patches loosened.


If you don't know how long your patch has been off or you know that it's been more than 24 hours, you'll need to apply a new patch as soon as possible to prevent pregnancy. You must start a new 4-week cycle with a new patch change day. It's very important to use another method of contraception for at least a week to prevent pregnancy.


What if my hormone patch loosens?

If your patch loosens, press down firmly along the edges of the patch with your finger for about 10 seconds. If your patch still doesn't stick, remove and apply a new patch.


Can I still shower, take baths, exercise and swim?

Yes. Showering, bathing, exercise, swimming, or even sweating shouldn't loosen your hormone patch. If for some reason your patch does loosen or fall off, follow the steps listed above.


Will I get a menstrual period every month?

If you're using the patch for 3 weeks with 1 week off, you should expect your period sometime during the 4th week of your patch cycle. This is the "patch free" week. If you're using the patch continuously you most likely won't have a period since you won't have a "patch free" week.


What if I forget to take my patch off on the 4th week?

Take your patch off as soon as you remember. Apply a new patch on your regular patch change day.


Are there any side effects with the patch?

Some women and young women have reported side effects such as spotting or irregular bleeding, breast tenderness, headaches, nausea, cramps, and/or skin irritation or change in skin pigment (color) where the patch is worn. Not all teens can take hormonal medicine, especially if they're at serious risk for blood clots. Because the patch gives 60% more estrogen than the birth control pill, a person is more likely to get blood clots.


The patch contains the same medicine in birth control pills (the hormones estrogen and progestin), so it may not be safe for you if you have a history of certain medical problems such as blood clots, high blood pressure, or serious migraine headaches. Routine check-ups and measurement of your blood pressure are important.


Although the patch is easy to use, you must follow the directions for it to be effective. If you're using the patch for birth control, remember that it doesn't prevent the spread of STIs. Be sure to always use a condom, and talk to your health care provider to make sure that the patch is the right choice for you.


Written by the CYWH Staff at Children's Hospital Boston


Updated: 1/16/2013


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