What is the Evra Patch?
Evra is a convenient transdermal contraceptive patch used as a birth control method to prevent pregnancy and was introduced in the UK in 2002. Evra patch contains both artificial oestrogen and progestogen (norelgestromin and ethinylestradiol), and works in a very similar way to combined oral contraceptives (the pill) except that only one patch is required per week.
Also known as Ortho Evra, the patch releases a steady dose of hormones into your bloodstream through your skin, for the entire duration of your cycle. Similar to the vaginal contraceptive ring, it is easy to use and low maintenance contraception, providing an alternative for those who may be unable to take the traditional pills.
How does the Evra Patch work?
Ortho Evra's contraceptive hormones are released into the bloodstream through your skin, and once they are in your system, they work in the same way as regular combination contraceptives. It prevents ovulation from occurring, so that an egg doesn't get released when it's supposed to. This happens because the hormones in Evra patches, norelgestromin and ethinylestradiol, make the body think that ovulation has already happened.
As an additional measure, the transdermal birth control patch prevents sperm from entering the womb by changing the consistency of the cervical mucous, and it also doesn't allow the womb lining to thicken enough for an egg to grow there.
The three-part process can be summarised as follows:
- It delivers a dose of oestrogen and progestogen, which prevents an egg from reaching the ovaries stopping the ovulation
- Secondly, it thickens the cervix wall, making it more difficult for sperm to enter and reach the womb
- Thirdly, it thins the lining of the womb so that, in the unlikely event of an egg getting released and fertilised, it will not be able to implant itself in the wall
As with any birth control method, if you do not use the contraceptive patch in time or keep it on for too long, its effectiveness will be compromised. More information regarding this, and what you should do, is detailed below. The patch is also effective if you happen to vomit or have diarrhoea as, unlike the contraceptive pills it is absorbed straight into the skin. Please ensure you speak to your health care provider regarding the best method suited to you before using this hormonal contraceptive.
What are the benefits of Ortho-Evra?
The Evra contraceptive patch provides women with a convenient alternative to the pill. All you have to do is use a patch every seven days to enjoy complete protection. Similarly to the pill, the Evra patch can provide the following benefits:
- High contraceptive efficacy – more than 99% effective when used correctly
- Ease menstrual symptoms - can help to reduce irregular periods, menstrual cramps, or chance of endometriosis
- Low-maintenance – One patch is applied once a week, instead of taking one pill a day
- Easy to use – The patch is simply applied to a smooth area of the skin
- Non-invasive – Unlike a diaphragm or other similar methods, it doesn't need to be inserted in the vagina
- Minimal gastrointestinal side effects – Some women find taking a pill can upset their tummy (nausea and diarrhoea for example). This is not the case with the contraceptive patch
- Can reduce the risk of other condition – Including fibroids, ovarian cysts and breast disease (not associated with cancer)
How to use Evra Patches
The patch is thin and beige in appearance at roughly 5cm x 5cm in size, working in the same way as a nicotine patch by releasing hormones into your bloodstream through the skin, rather than through ingestion.
Evra transdermal patches are used for three weeks (21 days) of your cycle, followed by a seven-day break period, during which you will still be completely protected. You should change your patch every seven days, so apply a new patch on day eight meaning there are three patches in every 1-month supply. If you start using the patches within the first 24 hours of your period, you should be fully protected, but if you take use the patch later than that you should wait seven days before having sex or use extra barrier contraceptive methods.
- Apply the patch to clean, dry and smooth skin. Do not use any lotions or creams on that area
- The patch should stay on for the following week. Check daily to make sure it is still in place
- On the 8th day, remove 'Patch One' and apply the new patch immediately. You can change the location of each of your patch, remembering to always place on dry, clean and hair-free skin
- 'Patch Two' stays on for the next week. Check daily to make sure it is still in place
- On the 15th day, remove 'Patch Two' and apply 'Patch Three' immediately. Again, you can change the location
- 'Patch Three' stays on for the next week. Check daily to make sure it is still in place
- On the 22nd day, remove 'Patch Three'. Do not apply another patch.
- The next seven days is your patch-free week where you may experience a withdrawal bleed similar to your period
- Apply the next patch on the 29th day, regardless of whether you're still bleeding or not, and continue the cycle again
As mentioned, the patch will be of maximum effectiveness immediately if applied with the first to fifth day of your period. If not, use barrier protection or avoid sex for the next week.
What if I forget an Evra Patch?
There is not any research specific to the contraceptive patch if you've forgotten to take either patch one, two or three off or forgot to apply a new patch after the 7-day break, however we can look at the effects of the combined pill and the ring as they work in a very similar way.
If I forget to apply the new patch after the 7-day break
- Up to nine days after the last patch (48 hours after the 7-day break) – you will still be protected providing you wore the previous three patches correctly. Apply your first patch of the month as soon as possible. This means your usual change dates have been altered slightly.
- After nine days after the last Evra patch – you will NOT be protected and will need to use additional barrier contraception for a further seven days. Your usual change dates are now altered, and continue the three contraceptive patches as usual.
If you don't use further protection, you will need to consider buying the morning after pill. For further help on obtaining one of two emergency pills, head to our Morning After Pill page.
What to do if it falls off
The contraceptive patch is a sticky blighter that should stay on come rain or shine. This includes washing, swimming, exercising and all those under this umbrella. However, here's what you can do if it comes off:
Less than 48 hours – Stick your patch back on as soon as possible if it is still sticky. If it's lost it's stickiness, throw away and apply a new patch. Don't try to salvage with a plaster or tape. Change your patch on the normal day.
More than 48 hours – You may not be protected against pregnancy during this period so you will need to use additional barrier protection such as condoms for seven days after. Still apply a new patch as soon as possible. This will alter your usual change dates.
What dosages are available for Evra?
There is just one dosage for Evra and this has been clinically tested so you're effectively protected against pregnancy whilst posing minimal risk on your health.Ortho Evra contains the active ingredients ethinylestradiol and norelgestromin, synthetic oestrogen and progestogen respectively. The dosage levels are 203mcg for ethinylestradiol and 34mcg for norelgestromin. We supply both 3-month and 6-month supplies at HealthExpress.
What are the side effects of Evra Patch?
Some women experience side effects whilst taking the contraceptive patch. Like all contraception, side effects are rare and tend to be temporary, especially when starting a new medication. Common side effects that may be experienced when first using the treatment include:
- Headaches, breast tenderness, nausea, mood changes or light irregular bleeding
Rare sides effects of the contraceptive patch include:
- Vision or speech impairment, jaundice, breathlessness and chest pain
Contrary to popular belief, the patch will not make you gain weight. but you must ensure that the change in hormones do not affect eating habits negatively. If you do experience any of adverse symptoms, you should always seek further medical advice from your GP.
It is also very essential that you inform your doctor or health care provider before using the Evra patch, as research as shown it to slightly increase the risk of blood clots in women compared to the the combined pill. For this reason, the FDA have provided a warning on the label to ensure those using it understand the risks and take the correct precautions.
What are the interactions/precautions when using Evra?
For most women the Evra patch is a safe contraceptive, however, there are some scenarios that make it unsuitable. These include if you are:
- Obese or morbidly obese
- Pregnant or breastfeeding
- Allergic to norelgestromin or ethinylestradiol ingredients
- Over the age of 35 (in particular, smokers or recently ex-smokers)
- A smoker
- Prone to severe migraines
Other women who need to exercise caution with the contraceptive patch include if you have:
- Heart or circulatory problems (high blood pressure for example)
- Thrombosis (blood clots)
- Had breast cancer in the last five years
- Severe migraines
- Liver or gallbladder disease
Although the Evra patch is generally well tolerated, caution is usually advised when taking it alongside certain other medication. Usually most antibiotics do not have an adverse reaction when used at the same time as the Evra path, but certain medication may make it less effective such as:
- Epilepsy medication
- Topamax (topiramate)
- HIV or tuberculosis medication
- St John's Wort
It is always advised to visit your GP before starting a new form of contraception so that they can assess whether this contraceptive option is the best, or if an alternative may be more suitable.
Can I use the contraceptive patch during pregnancy and/or breastfeeding
If you think you could be pregnant, it is advised to stop using the contraceptive patch immediately. The patch is also not recommended if breastfeeding as it can reduce the amount of breast milk. Because of this, doctors seldom offer the contraceptive patch to new mums before the 6-month mark.
How do I come off the patch or try to get pregnant after?
It is usually advised to wait till the cycle of the patch is complete, then you can stop using it at this point. You should be aaware though that your normal periods may not come back
immediate and may take some months in certain women to regulate.If you decide to remove the patch before the end of the cycle, then you increase the risk of becoming pregnant, therefore it is essential that you tell your doctor before you do so. It is recommended that you use an alternative contraceptive method if you have decided against using the transdermal contraceptive patch.
If you are looking to try and have a baby, it is advised for you to wait for at least one standard period after stopping the use of the Evra patch before trying. This is to ensure that your body has reworked to its standard cycle and that you can take the right steps towards pre and mid-pregnancy care.
Dealing with unexpected pregnancy
If in the off chance you do manage to become pregnant before using or after coming off Evra transdermal patch, you can use emergency contraception. This should be done as soon as possible after unprotected sex. The main options available are usually ellaOne (works within five days of intercourse) and Levonelle (works within three days of intercourse). These are also available to order online here.
Will the patch protect against STIs?
The only contraception that will protect against STIs is barrier methods such as condoms, which are 98% effective when used correctly. This contraceptive patch will protect against pregnancy, but not STIs (sexually transmitted infections).
How can I buy Evra patch online safely?
Evra contraceptive patches are available online at HealthExpress in both a 3 month and 6 month supply. With every prescription medication in the UK, you are required to answer a few questions in your consultation just to make sure the medication is right for you. One of our registered ensure the patch is safe for you to buy and it can be dispatched for delivery within 24 hours.