Fact Sheet

The Patch

This small plastic patch contains both estrogen and progestin and is worn directly on the skin.

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The birth control patch (sometimes called Evra in Canada) is a small, thin plastic patch containing 2 hormones (estrogen and progestin) that you wear on your skin.

In order to get pregnant, sperm must enter your vagina*, swim up to the uterus and fertilize an egg that has been released from the ovaries during ovulation. The patch works by preventing you from ovulating.
It also thickens the mucus on your cervix (the opening to your uterus), making harder for sperm to reach an egg. This reduces the risk of fertilization.
The patch thins the lining of your uterus (the endometrium), reducing the chance of a fertilized egg from implanting and starting a pregnancy.

The patch is 99% effective. This means that if 100 people used the patch correctly and consistently for one (1) year, only one (1) person would get pregnant.
Because the patch may be used incorrectly, it is closer to 92% – 97% effective with typical use.
If you use the patch incorrectly, your risk of getting pregnant increases.
The patch may be less effective if you weigh more than 198 lbs. Speak with your clinician for more information.

The patch works on a 28-day cycle, using 3 patches per cycle.
Week 1: apply the first patch on clean, dry, lotion-free skin.
Week 2: remove the first patch and apply the second patch on the same day of the week as the first.
Week 3: remove the second patch and apply the third patch on the same day of the week that you applied your second patch.
Week 4: remove the third patch. Do NOT apply a new one. This is your patch-free week (7 days), and you can expect your period sometime during this week.
At the end of the patch-free week (7 days), apply a new patch.
new patch on time, you’re still protected from pregnancy during the patch-free week.·
Some people use the patch continuously (without a patch-free week) to avoid their period. This is called “stacking”. If you’re interested in this, consult your clinician.
If you are late removing or applying your patch, check the instructions in your package, contact your clinician to see if you need an appointment, and/or use a backup barrier birth control method for the next 7 days (such as condoms). Apps like Stay on Schedule (https://www.sexandu.ca/sos/) can be used to help you find out if you need to use backup methods.

If you decide, along with your clinician, that the patch is right for you, they will write you a prescription. You can purchase your patches at a pharmacy (approximately $20/month) or at PPT’s Health Services (approximately $10/month).
If you start the patch within the first 5 days of getting your period, you are protected from pregnancy right away.
If you start the patch 6 or more days after getting your period, you are not protected from pregnancy until you have been using the patch for a full week. To avoid pregnancy during this time, use a back-up method of birth control like condoms or spermicides.
A clinician may recommend that you use a back-up method of birth control for a longer period of time when you start the patch.
Some people like to start the patch on the first Sunday following the start of their period, whether they are still bleeding or not. This can keep you from getting future periods on the weekend.

You can wear the patch on your butt, back, the outside of your arm or on your lower abdomen (stomach). Do not place the patch on or near your breasts*.
You can shower, swim, exercise and do regular activities while wearing the patch. In 98% of cases, the patch does not fall off.

You may experience minor side effects such as nausea, sore breasts, moodiness and/or spotting (a little bit of bleeding that is lighter than your period). These usually go away within the first 3 months of using the patch.
You may experience skin irritation on the spot that you wear your patch. Every time you change the patch, switch sides or apply it to a different area to avoid skin irritation.
If you’re still experiencing side effects after 3 months or if they become severe, consider exploring a different birth control option.
There is a very small risk of getting blood clots, or having a heart attack or stroke while using the patch. Smoking, obesity, and other health conditions increase this risk. Speak to your clinician for more information.
Warning signs of a blood clot include: blurred or loss of vision, chest pain or difficulty breathing, severe unusual headaches, severe abdominal cramps, or severe pain in the leg. If you experience any of these symptoms, get medical help right away.

If you use the patch correctly, your chances of getting pregnant are very low.
You don’t have to do anything before or after you have sex for it to work.
You only need to switch out the patch once a week.
The patch generally causes fewer side effects than the pill.
Your period may become shorter, lighter, less painful, and more regular.
The patch can reduce acne and increase bone strength.
It does not affect your ability to get pregnant in the future.
A partner doesn’t have to be involved.
The patch can help manage symptoms of endometriosis and fibroids, and can lower your chances of developing certain cancers (ovarian and endometrial cancer).

The patch does not protect you from sexually transmitted infections (STIs). Speak to your clinician for ways to protect yourself from STIs while using the patch.
You have to remember to remove and re-apply a new patch every week.
If the patch comes off or starts to peel back, your risk of getting pregnant increases and you may need to use a back-up method of barrier birth control (e.g., internal or external condom) for 7 days (1 week).
The patch comes in only one colour, light beige, which may not match your skin.
You may experience side effects.
If you have certain health conditions, the patch may not be the best option for you. Talk to your clinician for more information.
If you smoke or vape and you use the patch, your risk of getting a blood clot is higher
You need a prescription.
It can be expensive and is not covered by OHIP+ (may be covered by other private insurance). However, PPT’s Health Services sells the patch at a reduced cost.

*We know that these aren’t the words everyone uses for their bodies (e.g. trans folks) and support you using the language that feels best for you.