What Should I Know Before Starting the Birth Control Patch?

Written by Kristen Miranda, MD, MPH

Helpful things to know before starting your patches.

Basic information about the birth control patch

Birth control patches contain two hormones: estrogen and progestin. These hormones work in unison to prevent pregnancy in a variety of ways: they block ovulation (when the ovaries release an egg); they thicken the cervical mucus which makes it harder for sperm to get into the uterus; and they thin the lining of the uterus making it harder for a pregnancy to implant. These hormones are not only excellent at preventing pregnancy, though; they also have many non-contraceptive benefits.

The patch is a small sticker placed on the skin for a week. At the end of the week, you remove the patch and put on a new one. You repeat this cycle for three weeks, take a week off, which is known as the hormone-free interval, and then you repeat this four-week cycle. You can find more information on the patch here.

When should I start my first patch?

You can start your first patch at any time, but be sure to use backup protection (i.e., using condoms or practicing abstinence) for the first seven days to avoid pregnancy.

If you start the patch in the middle of the month, you may have some irregular bleeding or bleed twice during the first month. Don’t worry; this bleeding is normal and will go away with time as your body adjusts to the hormones. Just make sure you keep placing the patch at the same time every week, even if you are spotting or bleeding. Here is a good article about it. Breakthrough bleeding on the patch is managed the same as on the pill.

What if I miss a patch?

If you forget to put on a new patch, don’t panic! Once you realize you forgot to replace the previous week’s patch, change it as soon as you can, and then continue on the same weekly schedule you were on before (i.e., if you normally change your patch on Sunday, but on Tuesday you realize you never put on the new one, put it on that Tuesday but still change it again on Sunday). If your patch falls off early, put on a new one as soon as you realize it, and then start your weekly cycle on the day you replace it. In any scenario where you miss a patch, be sure to use condoms or practice abstinence as backup for seven days to avoid pregnancy. If you have unprotected sex during this seven-day period, you may want to consider emergency contraception methods.

Nervous or confused about what to do when you miss a patch? This quiz from Planned Parenthood can help you decide what to do, based on which patch you missed (1st, 2nd, or 3rd week) and how long it has been.

What will happen with my period?

Overall, your period will be lighter and likely shorter when you use the patch. Your body will eventually adjust to a pattern where you have no bleeding during the three weeks you have the patch on, and then in the “hormone free” week where you do not wear the patch, you will have a “withdrawal bleed” similar to what you experience during your period. If you prefer not to have a period at all, you can skip it.

The first few months you are on the patch, you may get some spotting or bleeding, known as “breakthrough bleeding,” which will go away over time. The more consistently you wear the patch and replace it on the same weekly schedule, the faster the bleeding should resolve. If the breakthrough bleeding becomes bothersome, reach out to your healthcare provider to discuss your options. For some women using the patch, your period will go away completely. That is normal and not dangerous, and your period will come back once you stop using the patch.

How effective is the patch?

The patch is highly effective at preventing pregnancy. With perfect use, they are 99.7% effective, and with typical use (how most women use them), they are still 93% effective.

How expensive are the patches?

Prices for the patch vary by pharmacy, but they are usually reasonable. You can check out various pricing options at GoodRx, our partner website.

The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of HeyDoctor, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.

Check out the HeyDoctor app

With over 1,000 5-star reviews, we're one of the highest rated medical apps. See for yourself!