Patch

Pregnancy can occur if sperm reaches and fertilises an egg. Contraception helps prevent this by keeping sperm and eggs apart, or by stopping egg production. One method of contraception is the patch. 

What is the Patch? 

The contraceptive patch is a sticky patch, similar to a nicotine patch, measuring 5x5 cm. It delivers hormones into the body through the skin. In the UK, the brand name is Evra. 

It contains the same hormones as the combined pill and works in the same way. It prevents ovulation (the release of an egg), thickens cervical mucus (making it harder for sperm to travel through the cervix), and thins the lining of the womb, making it less likely a fertilised egg will implant. 

How to use the patch 

The patch can be applied to most areas of the body, as long as the skin is clean, dry, and not very hairy. 

Apply a new patch once a week for three weeks. Then take a seven-day break (your patch-free week). During this time, you may have a withdrawal bleed, similar to a period. This may not always happen. 

After seven patch-free days, apply a new patch and begin the four-week cycle again—even if bleeding hasn’t stopped. 

Avoid placing the patch on: 

• sore or irritated skin 
• areas where it may rub off due to tight clothing 
• the chest or breast area 

To avoid irritation, change the placement of the patch each week. 

When the patch starts to work 

If the patch is started on the first day of your period, it works straight away. You won’t need additional contraception. 

According to the Faculty of Sexual and Reproductive Healthcare, if the patch is started within the first five days of the menstrual cycle, no extra contraception is needed. 

If it’s started any other time, use additional contraception (like condoms) for seven days. 

You can speak to a doctor or nurse for more advice on when it starts working and whether you need backup protection. 

If the patch falls off 

The patch is designed to stay on through showers, baths, swimming, or exercise. If it does come off, what to do depends on how long it’s been off and how long you had it on before. 

If the patch has been off for less than 48 hours: 

• Reapply the same patch if it's still sticky 
• If not, apply a new one (don’t use plasters or bandages) 
• Continue as usual and change it on your normal day 
• You’re still protected if it was worn properly for the previous seven days 
• If it was worn for fewer than seven days, use extra contraception for the next seven days 

If the patch has been off for 48 hours or more (or you’re unsure): 

• Apply a new patch immediately and start a new cycle (this becomes day 1) 

• Use condoms or another form of contraception for the next seven days 
• If you’ve had unprotected sex recently, consider emergency contraception. Contact your GP or local sexual health clinic for advice. 

If you forget to remove the patch

If you forget to remove the patch after week one or two: 

If it has been on for 8–9 days: 

• Remove it and apply a new one 
• Continue as normal with your change day 
• You’re still protected 

If it has been on for 10+ days: 

• Start a new cycle immediately with a new patch 
• This becomes your new change day 
• Use additional contraception for seven days 
• Contact a healthcare provider if you’ve had unprotected sex 

If you forget to take off the patch after week three: 

• Remove it as soon as possible 
• Start your patch-free break 
• Begin the next cycle on your usual start day, even if you’re bleeding 
• You will still be protected 

If you forget to put a patch on, after the patch-free week 

There’s no specific research on extending the patch-free interval. Advice is based on similar methods like the combined pill. 

If you apply the new patch within 9 days of removing the last one: 

• You’re still protected, as long as the previous cycle was followed correctly 

If more than 10 days have passed: 

• You may not be protected 
• Use another form of contraception for the next seven days 
• Consider emergency contraception if you've had unprotected sex 

Bleeding during the patch-free week 

Some people don’t bleed during their patch-free week. This isn’t usually a concern if the patch was used correctly. 

If you're worried, take a pregnancy test or speak to your GP or sexual health clinic. If you miss more than two bleeds, seek medical advice. 

Who can use the patch

The contraceptive patch isn’t suitable for everyone. A doctor or nurse will ask about your health and medical history to see if it's right for you. Mention any medications, past conditions, or operations. 

You may not be able to use the patch if you: 

• are pregnant or think you might be 
• are breastfeeding 
• smoke and are 35 or older 
• recently quit smoking and are 35 or older 
• are significantly overweight 
• take certain medications (e.g. for epilepsy, TB, HIV, or certain herbal supplements like St John’s Wort) 

You should also avoid using the patch if you have or have had: 

• blood clots 
• heart problems or circulatory issues (including high blood pressure) 
• migraines with aura 
• breast cancer 
• liver or gallbladder disease 
• diabetes with complications or long-term diabetes (20+ years) 

Risks 

Like all hormonal contraception, the patch carries small risks of serious side effects. 

Blood clots

There is a slightly increased risk of blood clots, especially in the first year of use. Your risk may be higher if: 

• you smoke 
• you are very overweight 
• you are immobile or use a wheelchair 
• you have severe varicose veins 
• a close relative had a blood clot before age 45 

Risk of arterial clots (heart attack/stroke) increases with: 

• smoking 
• diabetes 
• high blood pressure 
• being very overweight 
• migraines with aura 
• family history of early heart attack/stroke 

Cancer

There may be a slight increase in the risk of breast or cervical cancer with long-term hormonal contraception. Research is ongoing. 

For most people, the benefits outweigh the risks, but discuss this with a healthcare provider. 

Where to get the patch

Contraception is free on the NHS. You’ll usually be given a three-month supply to start with, followed by longer prescriptions if there are no issues. 

You can get it from: 

• Some GP surgeries – talk to your GP or practice nurse 
• Find your nearest sexual health clinic in Bexley

If you’re under 16

Contraceptive services are confidential and free, even if you're under 16. 

Healthcare professionals won’t tell your parents or carers if they believe you understand the information and can make informed choices. They’ll encourage you to speak with a trusted adult but won’t force you to. 

They’ll only break confidentiality if they believe you're at risk of serious harm, and they'll try to talk to you about it first.