If 100 people who could get pregnant don’t use any contraception, 80 to 90 will get pregnant in a year.

If the patch is:

• Not always used perfectly, according to instructions, it’s about 93% effective. This means about 7 in 100 patch users will get pregnant in 1 year. Most people don’t use the patch perfectly all the time.

• Always used perfectly, it’s over 99% effective. This means fewer than 1 in 100 people who use the patch perfectly will get pregnant in 1 year

If you weigh 90kg (14 stone) or more, the patch may not be so effective. It’s advised to use another method of contraception.

The most effective methods of contraception are those you don’t have to remember, such as the implant, the hormonal IUD (hormonal coil) or copper IUD (copper coil). These are known as long-acting reversible contraceptives (LARC). For more information, ask your healthcare professional or see FPA’s Your Guide to LARC.

The hormones in the patch:

• stop the ovaries from releasing an egg each month (ovulation)
• thicken the mucus in your cervix so it’s difficult for sperm to move through it and reach an egg
• make the lining of the uterus (womb) thinner so a fertilised egg is less likely to implant

You can get the patch for free from:

• a contraception or sexual health clinic
• some GP surgeries
• some young people’s services

In some areas of the UK, you can order the patch for free from an online sexual health service. They can send it by post and may offer a click and collect service. You usually need to be 16 or over and be able to give a recent blood pressure measurement.

All advice and treatment from these services is free and confidential.

You can also buy the patch from some online pharmacies, private online services or private clinics.

You don’t need a vaginal or breast examination or cervical screening (smear test) before you start using the patch.

Not everyone can use the patch. Your healthcare professional or online service will ask about your own and your family’s medical history to make sure the patch is suitable for you. Do mention any illnesses or operations you’ve had and any medicines you’re taking.

The patch may not be suitable for you if:

• you think you might be pregnant
• you smoke and are aged 35 or over
• you’re aged 35 or over and stopped smoking less than a year ago
• you’re very overweight, with a body mass index (BMI) of 35 or more
• you take certain medicines
• you’re breastfeeding a baby less than 6 weeks old – also see below for I’ve just had a baby – can I use the patch?

The patch may not be suitable for you if you have now, or had in the past:

• thrombosis (a blood clot) in any vein or artery, including your lungs
• an immediate family member who had a blood clot before the age of 45
• heart disease or a stroke
• systemic lupus erythematosus with positive antiphospholipid antibodies
• a heart abnormality or circulatory disease, including high blood pressure
• migraine with aura
• breast cancer or a gene mutation that’s associated with breast cancer
• active disease of the gallbladder or liver
• diabetes with complications

The patch may not be suitable if you’re:

• immobile for a long period of time or use a wheelchair
• at high altitude (more than 4,500m) for more than a week

If you’re healthy, don’t smoke and there are no medical reasons for you not to use the patch, you can use it until you’re aged 50. You’ll then need to change to another method of contraception until after the menopause.

Some of the advantages of the patch are:

• It usually makes your bleeds regular, lighter and less painful
• You can choose not to have a monthly bleed
• You don’t have to think about it every day – you change it once a week
• It may help with premenstrual symptoms
• It’s not affected if you vomit or have diarrhoea
• It reduces the risk of cancer of the ovary, uterus and colon
• It improves acne in some people
• It may reduce menopausal symptoms
• It may reduce the risk of recurrent endometriosis after surgery
• It helps with problems associated with polycystic ovary syndrome (PCOS)

There are some serious possible side effects – see below for are there any risks?

In addition:

• You may get temporary side effects at first, including headaches, nausea, breast tenderness and mood changes
• Breakthrough bleeding and spotting (unexpected vaginal bleeding on days you’re using the patch) are common in the first few months of use
• It can be seen
• It may cause skin irritation
• It doesn’t protect you from sexually transmitted infections, so you may want to use condoms too

The patch can have some serious side effects. These aren’t common but can happen to anyone.

For most people, the benefits of the patch outweigh the possible risks. Your patch provider will ask some questions to check whether you could be at higher risk.

• A very small number of patch users may develop a blood clot in a vein, a blood clot in an artery, pulmonary embolism (a blood clot in a lung), heart attack or stroke. If you’ve ever had a blood clot, don’t use the patch.

• The risk of a blood clot in a vein is greatest if any of these apply: you smoke, are very overweight, have a thrombophilia (an increased risk of blood clots), are immobile for a long period of time or use a wheelchair, or an immediate family member had a blood clot in a vein before the age of 45.

• The risk of a blood clot in an artery is greatest if any of these apply: you smoke, have high blood pressure, are very overweight, have migraine with aura, or you’re diabetic.

• Research suggests that patch users appear to have a small increased risk of being diagnosed with breast cancer compared to non-users of hormonal contraception. This risk reduces with time after stopping the patch and is undetectable 10 years later.

• Research suggests there’s a small increase in the risk of developing cervical cancer with longer use of the patch. This risk reduces over time after stopping the patch and is undetectable 10 years later.

See a doctor straight away if you have any of the following:

• pain in the chest, including any sharp pain which is worse when you breathe in, breathlessness or coughing up blood
• painful swelling in your leg(s)
• weakness, numbness or bad ‘pins and needles’ in an arm or leg
• an unusual headache or migraine that’s worse than usual
• sudden problems with your speech or eyesight

If you develop any new conditions, tell your healthcare professional so they can check it’s still safe for you to use the patch.

If you go into hospital for an operation or have an accident which affects the movement of your legs, tell the doctor you’re using the patch. You may need to change to a different method of contraception or need treatment to reduce the risk of a blood clot.

If you’re given medicine by a healthcare professional, always tell them if you’re using the patch.

Commonly used antibiotics don’t affect the patch.

Medicines called enzyme-inducers may make the patch less effective. These include some medicines used to treat epilepsy, migraine, HIV and TB. It also includes the herbal medicine St John’s Wort.

If you take any medicines that may affect the patch, talk to your healthcare professional. Consider changing to contraception that won’t be affected by the medicines you’re taking.

You won’t have your usual periods. The patch stops you from releasing an egg each month. It also stops the lining of the womb getting thicker each month. So your body doesn’t need periods while you’re using the patch.

The patch is designed to give you a 7-day hormone-free break each month. If you choose to have this break, you’ll usually still get some period-like bleeding. This is called a withdrawal bleed. It’s caused by a drop in your hormone levels after a few days without hormones from the patch. This causes your body to shed some blood from the womb lining.

Because the patch keeps the womb lining thin, a withdrawal bleed is often lighter, shorter and less painful than your usual periods.

You don’t need to have a 7-day break each month. You can choose a shorter 4-day break or miss the break completely and not have a withdrawal bleed. There are no known benefits of hormone-free breaks and no known risks to missing out a break and withdrawal bleed.

You can miss out the hormone-free break and withdrawal bleed every month or just occasionally.

Missing or shortening the hormone-free break:

• Could help if you get heavy or painful bleeding, headaches or mood swings during the break
• Could reduce your risk of pregnancy. This is because if you forget your patch just before or just after a break, you’re more at risk of pregnancy than at other times

Research hasn’t shown that the patch causes weight gain. Your weight may change throughout your cycle due to fluid retention or other reasons not related to the patch.

Bleeding is very common at first and isn’t usually anything to worry about. It may take up to 3 months to settle down.

It’s important to keep using the patch according to instructions, even if the bleeding is as heavy as a withdrawal bleed.

If you’re using the patch continuously it’s normal to get some bleeding – also see How do I use the patch?

Bleeding may also be due to other causes, such as not using the patch correctly or a sexually transmitted infection.

If bleeding doesn’t settle down or starts after you’ve used the patch for some time, seek advice.

If you’ve used the patch correctly and haven’t taken any medicines that might affect the patch, then it’s very unlikely you’re pregnant.

Keep using the patch as usual. If you’re worried, ask your healthcare professional for advice or do a pregnancy test. Using the patch won’t affect a pregnancy test. If you are pregnant, using the patch won’t end the pregnancy and won’t harm the fetus.

If you miss more than 1 expected bleed, always do a test or speak to a healthcare professional.

You can usually start using the patch from 21 days after you give birth if you’re not breastfeeding and if a healthcare professional has checked your risk of blood clots.

Starting on day 21, you’ll be protected from pregnancy straight away. If you start later than day 21, use additional contraception or avoid sex for the first 7 days of using the patch.

If you’re breastfeeding a baby less than 6 weeks old, using the patch may affect your milk production. It’s usually recommended to use a different method of contraception until 6 weeks after the birth.

Yes. If you start the patch on or before day 5 after a miscarriage or abortion, you’ll be protected from pregnancy straight away.

If you start later than day 5, use additional contraception or avoid sex for the first 7 days.

When you stop using the patch, your fertility will go back to whatever’s normal for you.

It’s possible to get pregnant before having your first period after stopping.

If you don’t want to get pregnant, it’s best to make sure you’ve used the patch continuously without any breaks for at least 21 days before stopping.

If you don’t want to wait, ask your healthcare professional for advice because you can risk getting pregnant if you’ve had sex recently.

Use another method of contraception as soon as you stop the patch.

If you want to get pregnant, aim to start pre-pregnancy care – such as taking folic acid and vitamin D, and stopping smoking and drinking alcohol – before you stop using the patch. Ask your healthcare professional for advice or see www.tommys.org/pregnancy-information

You can stop the patch at any time and try to get pregnant straight away. You can also wait until you’ve had your first period after stopping so it’s easier to work out when you got pregnant.

Don’t worry if your periods don’t start straight away. For some people it can take a few months after stopping the patch.

It’s easy to change from the patch to a different method.

Talk to your healthcare professional. You may need to miss out a patch-free break or use other contraception for a short time.

When you first start using the patch or you get new supplies, you’ll be advised when to get your next review. You can be given up to 12 months’ supply of the method at a time, but some people may need a review earlier than this.

Your medical history, blood pressure and weight need to be checked at least once a year while you’re using the patch.

A review may be done face to face or may be done online or by phone for some people.

For online and phone reviews, you’ll need to give recent height, weight and blood pressure measurements. Your blood pressure could be taken by a healthcare professional (for example at a pharmacy or GP surgery), at a self-testing station (for example at a GP surgery or sexual health clinic) or using a home blood pressure machine (check with your healthcare professional which machines are OK to use).

It’s important to get advice as soon as possible if you have any problems or concerns, develop new health problems or want to change to a different method of contraception. You don’t need to wait until your next review.

No. You don’t need a break and the hormones do not build up.

There are no known benefits to your health or fertility from taking a break.

You can start the patch any time in your menstrual cycle if you’re sure you’re not pregnant.

If you start the patch:

• on the first day of your period, you’ll be protected from pregnancy immediately
• up to and including the fifth day of your period, you’ll be protected from pregnancy immediately; if you have a very short cycle or a cycle that changes, talk to your patch provider about whether you may need additional contraception at first
• at any other time in your menstrual cycle, use additional contraception, such as condoms, or avoid sex for the first 7 days of using the patch.

You can stick the patch on to most areas of your body as long as your skin’s clean, dry and not very hairy.

Don’t put it on skin that’s sore or irritated or anywhere that can be rubbed by tight clothing.

Don’t put it on your breasts.

Changing the position of each new patch can help reduce the chance of any skin irritation.

Only ever use one patch at a time. Try to check the patch every day to make sure it’s on.

Avoid covering the patch with cream or lotion, as it may become loose.

No. This is not recommended.

You wear each patch for 1 week (7 days) then take it off and put on a new one.

You always change the patch on the same day of the week. So if you put on a patch on a Monday, you take it off and put on a new one on the next Monday.

After using the patch for 21 days (3 patches), patch instructions tell you to take a 7-day break with no patches. The patch-free break is not needed. You can have it if you want to, or you can have a shorter 4-day break or miss out the break.

Having no break or a shorter break can help lower your risk of getting pregnant. This is because if you forget a patch just before or just after a break, you’re more at risk of pregnancy than at other times.

If you have a break, you’ll usually have a withdrawal bleed. If you don’t have a break, you won’t usually have a withdrawal bleed – also see Will my periods change?

Having no break or a shorter break can help if you get heavy or painful bleeding, headaches, or mood swings during the break.

There are different ways to use the patch, so you can choose a bleeding pattern that works for you.

• Apply a new patch once a week, every week for 21 days (1 pack of patches) then no patch for the next 4 or 7 days.

• You’ll usually have a withdrawal bleed during the patch-free break. Put on a new patch on the fifth or eighth day even if you’re still bleeding. You can miss out a patch-free break at any time, if you don’t want a withdrawal bleed that month.

• Apply a new patch once a week, every week for 9 weeks (3 packs of patches) then no patch for the next 4 or 7 days.

• This is called extended use or tricycling. You’ll usually have a withdrawal bleed during the patch-free break. Put on a new patch on the fifth or eighth day even if you’re still bleeding. Using the patch this way means you’ll only have a bleed once every 10 weeks.

• Apply a new patch once a week, every week. Continue to do this with no break.

• This is called continuous patch use. You won’t have a withdrawal bleed but you may still get some bleeding. This may be occasional or more frequent. Any bleeding you get is likely to reduce over time if you keep using the patch continuously.

• Apply a new patch once a week, every week for at least 21 days. Continue to apply a new patch every week. If you get bleeding that’s unacceptable to you for 3 to 4 days then have a 4-day patch-free break.

• This is called flexible extended use. Put on a new patch on the fifth day even if you’re still bleeding.This can help manage the bleeding. Apply a new patch once a week, every week, for at least 21 days before taking your next break.

You can use the patch continuously without a break for as long as you like, as long as your healthcare professional doesn’t advise you to stop.

Yes. You’re protected if:

• • • you used the previous 3 patches correctly and
    • you start the next patch cycle on time and
    • you’re not taking medicines that will affect the patch – also see do other medicines affect the patch?

See below – What if I haven’t used the patch correctly?

The patch is very sticky and should stay on.

If a patch does come off, throw it away and apply a new patch. Do not try to hold the old patch in place with a plaster, bandage or anything else.

What to do next, depends on how long the patch came off for. See below – What if I haven’t used the patch correctly?

Put used patches in the bag provided and put them in the bin. Do not flush them down the toilet.

I’m late restarting after a patch-free break

If it’s LESS THAN 8 full days since you removed your last patch:

• Apply a new patch now
• Continue using the patch as normal

If it’s 8 OR MORE full days since you removed your last patch:

• Apply a new patch now
• Keep the new patch on until the day you usually change it
• Use condoms or avoid sex for the next 7 days
• You may need emergency contraception and a follow-up pregnancy test if you had unprotected sex in or after the patch-free break. Talk to a doctor, nurse or pharmacist as soon as possible.

It’s up to 48 hours since the patch came off OR the patch was left on for up to 48 hours too long

• Apply a new patch as soon as possible
• Keep the new patch on until the day you usually change it

• And:

• If you’re in the first week after a patch-free break, you don’t need additional or emergency contraception, as long as you’ve used the patch correctly every day so far this week and in the week before the patch-free break.

• If you’re in any other week, you don’t need additional contraception or emergency contraception as long as you’ve used the patch correctly for the previous 7 days.

It’s up to 48 hours since the patch came off OR the patch was left on for up to 48 hours too long

• Apply a new patch as soon as possible
• Keep the new patch on until the day you usually change it
• Use condoms or avoid sex until a patch has been worn for 7 days in a row
• If you’re due to start a patch-free break in the next 7 days, don’t take the break

• You might need now and a pregnancy test in 3 weeks if:

• you’re in the first week after a patch-free break and
• you had unprotected sex this week OR in the patch-free break

• If you’re in any other week, you don’t need emergency contraception as long as you’ve used the patch correctly for the previous 7 days.

Important: If you think you might forget more patches, talk to your doctor or nurse about contraception you don’t have to remember – also see our guide to LARC (Long-Acting Reversible Contraception)