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Birth control methods

What is a condom?

A condom (rubber, prophylactic) is a sheath worn over the penis. Condoms originally were designed to block the escape of sperm, but now have been shown to be effective in blocking entry and exit of bacteria and some viruses. Most condoms are made of latex but some, called "skin condoms," are made of sheep intestine. Only the latex condom should be used for disease protection because the AIDS virus, and possibly other disease agents, are able to penetrate the larger pores in the skin condom.

What are vaginal spermicides?

Vaginal spermicides are products such as foam, jelly, cream, suppositories or film that are inserted deep into the vagina on or near the cervix shortly before sexual intercourse.  Most of these products contain nonoxynol-9, a chemical that kills sperm on contact.  To be effective, a spermicide must be used every time intercourse occurs.

We recommend that vaginal spermicides always be used with condoms.

What is emergency contraception?

Emergency contraception (also known as EC or the morning after pill) works to prevent pregnancy in the case of unprotected intercourse. For maximum effec­tiveness, EC should be taken as soon as possible after unprotected sex. However, EC may be taken within 72 hours (3 days) of unpro­tected intercourse.

What is Ortho Evra?

Ortho Evra or "the patch" is a birth-control patch. It contains the hor­mones norelgestromin and ethinyl estradiol, hormones similar to those used in birth control pills. Each contraceptive patch, which is thin, beige, flexible, and square, is worn on the body for 1 week at a time.

How does the contraceptive patch work?

Once applied to the body, the hormones are absorbed through the skin into the blood stream. Like the birth control pill, the patch works by suppressing ovulation.  It also causes changes to the cervical mucus and to the endometrium (lining of the uterus) that further reduce the chances of becoming pregnant.

How effective is the contraceptive patch?

Like the pill, the contraceptive patch is 99% effective when used correctly.

When do I start wearing the patch?

You may apply your first patch during the first 24 hours of your menstrual period.  No back-up birth control method is needed.

Or you may wait until the first Sunday after your period be­gins.  A non-hormonal method of birth control (such as con­doms or a diaphragm) is needed for the first 7 days. 

Where should the contraceptive patch be applied?

You can apply the patch to your abdomen, buttock, upper outer arm, or upper torso (but not the breasts).  You can wear it in the same location each week.  However, you should apply each new patch to a new spot on the skin.  To ensure effective­ness, you should not write on the patch or alter it in any way.

How should the contraceptive patch be applied?

You should apply the patch to clean, dry skin with no redness, irritation, or cuts. To make sure that the patch sticks properly, you should avoid using creams, lotions, oils, powder, or makeup on or near the site where the patch is to be applied.

Please refer to the patient package insert for specific instruc­tions in applying the patch.

Check the contraceptive patch every day to make sure that it is still sticking firmly.

How is the contraceptive patch removed?

To remove a used patch, simply lift one corner and quickly peel back. Because a used patch still contains some active hormones, you should fold the patch in half so that it sticks to itself before you throw it away.  If a small ring of adhesive is left on your skin (which may occur if certain clothing has rubbed against the patch), you can remove it by rubbing a small amount of baby oil on the area.

Will I be able to do all of the same activities I was doing before I began wearing the contraceptive patch?

Yes.  There is no need to alter daily activities while using the patch. Bathing, showering, swimming, exercising, or moisture due to wet or humid weather should not affect your contracep­tive patch.

What if I forget to change the contraceptive patch?

If you are more than one day late in putting on your first patch:

  • Apply the first patch of your new cycle as soon as you remember.
  • You will now have a new start day and a new Patch Change Day.
  • You must use backup birth control for one week to avoid becoming pregnant.

If you forget to change your patch during week 2 or 3:

  • And you are 1 or 2 days late, remove the used patch and apply a new one.
  • Apply your next patch on your normal Patch Change Day.
  • No back up birth control is needed.

If it has been more than 2 days past your last Patch Change Day:

  • Remove the used patch and apply a new patch as soon as you remember.
  • You will have a new Day 1 and a new Patch Change Day.
  • You must use back up birth control for 1 week to avoid becoming pregnant.

If you forget to take your patch off during week 4:

  • Take the patch off as soon as you remember.
  • Start your next cycle on your normal Patch Change Day.
  • No backup birth control is needed.

Can I change my Patch Change Day?

Yes. If you wish to alter the Patch Change Day,  follow these instructions:

  • Complete the current cycle.
  • Remove the third patch on the correct day.
  • Select a new Patch Change Day by applying a new patch on the desired day during the patch-free week.
  • Do not let more than 7 consecutive days go by without a new contraceptive patch.

Does the contraceptive patch cause side effects?

Except for possible minor skin reactions when the patch is placed, adverse events are similar to those associated with oral contraceptives.  The most common side effects are breast symptoms, headache, application-site reactions, nausea, cramps, and abdominal pain.  The patch is not associated with significant changes in weight.

Are there any risks associated with use of the contraceptive patch?

The patch contains hormones similar to those in birth-control pills.  Most side effects associated with the patch are not seri­ous, and those that are serious occur infrequently.  Serious risks, which can be life–threatening, include blood clots, stroke, and heart attack, and are increased if you smoke ciga­rettes. Cigarette smoking increases the risk of serious cardio­vascular side effects, especially if you are older than 35 years. Women who use hormonal contraceptives are strongly advised not to smoke. Some women should not use the patch, includ­ing those who have had blood clots (this does not mean blood clots in your menstrual flow), certain cancers, or a history of heart attack or stroke, as well as those who are or may become pregnant.

In November 2005, Ortho Women’s Health updated the information it provides to clinicians and patients.  The current patient information/warning states: “Hormones from patches applied to the skin get into the blood stream and are removed from the body differently than hormones from birth control pills taken by mouth. You will be exposed to about 60% more estrogen if you use ORTHO EVRA than if you use a typical birth control pill containing 35 micrograms of estrogen. In general increased estrogen exposure may increase the risk of side effects.  However, it is not known if there are differences in the risk of serious side effects based on the differences between ORTHO EVRA and a birth control pill containing 35 micrograms of estrogen.”

NOTE: The patch does not protect against HIV infection or AIDS or other sexually transmitted diseases.

What are the danger signs?

Call the clinic immediately or consult your private doctor or local Emergency Room if you experience ANY of the follow­ing:

  • Severe headache
  • Visual changes (flashing lights in the eyes, blurring and/ or partial loss of vision)
  • Numbness or tingling in the face, an arm, leg, hand or foot
  • Pain in the chest, shortness of breath, or coughing up blood (these symptoms may indicate possible clots in the lungs)
  • Severe leg pain (possible clot in the leg)
  • Crushing chest pain or heaviness
  • Severe abdominal pain

These symptoms may be warning signs of a blood clot, heart attack or stroke.

Who needs to know I am using Ortho Evra?

There are some drugs that may interact with Ortho Evra (and other hormonal birth control methods) possibly making the birth control method less effective in preventing pregnancy or causing an increase in breakthrough bleeding. If you are ill or need medical care, tell your health care practitioner that you are using Ortho Evra. If surgery is anticipated, it may be advisable to discontinue Ortho Evra one month before the surgery. Please discuss this with your surgeon and clinician.

Please note also that women who are using a hormonal method of birth control and also use some form of St. John’s Wort have reported pregnancies and breakthrough bleeding.

What if I want to become pregnant?

The contraceptive patch is a reversible form of birth control.  As with other forms of hormonal contraception, you may experience a delay in becoming pregnant after you stop using the patch, especially if you had irregular menstrual cycles before you used it.  Your clinician may advise you to postpone trying to get pregnant until you begin menstruating regularly on your own.

Other important information

Be sure you have available at all times a non-hormonal method of birth control such as condoms, diaphragm or spermicides.

If you do not know what to do about mistakes in using your patch, use a backup birth control method every time you have sex and contact your health care provider.

Individual replacement patches are available from your pharmacist.

For detailed information, read carefully the information sheet that is included with your prescription for Ortho Evra or you may access the web site for Ortho Evra at

Additional resources

If you have any questions and are a UW student or established Hall Health patient, you may call one of our Consulting Nurses for further information.


Authored by: Hall Health Center Women's Health Clinic staff

Reviewed by: Hall Health Center Women's Health Clinic staff, January 2014

What is a diaphragm?

The diaphragm is a round silicone cup that holds spermicidal jelly or cream against the cervix. Although it may prevent some sperm from entering the cervix, it does not and cannot fit snugly enough to protect against pregnancy by itself. Therefore, spermicide is essential for the diaphragm to work.

What isIUC.jpg an IUD?

An IUD (an acronym which stands for intrauterine device) is a small plastic device that is inserted into a woman's uterus by a clinician.  It provides highly effective, safe, and convenient birth control.

What is Nexplanon™?

Nexplanon (which has replaced Implanon, an older version of the device) is a small, thin, implantable type of birth control that releases hormones.  It is a flexible plastic rod the size of a matchstick that is put under the skin of your arm and is effective for up to three years. 

What is Depo Provera?

Depo Provera, also known as "the birth control shot" or just "Depo," is a synthetic hormone that is injected into the hip muscle every 12 weeks. Depo Provera prevents ovulation. It also alters the lining of the uterus making it much less likely for pregnancy to occur.

How effective is Depo Provera?

When used correctly, Depo Provera is 99.7% effective in preventing pregnancy over 12 weeks.

What is the NuvaRing?

NuvaRing is a flexible, colorless, odorless ring that contains the same hormones used in birth control pills. The hormones are absorbed through the vagina into the blood stream to prevent pregnancy. The ring is inserted into the vagina and left in place for 21 days. It is then removed for seven days to allow for a period.

large_opened pack of pills jpeg.JPGWhat is the progestin-only birth control pill?

The mini-pill is a type of birth control pill that contains about half the amount of the hormone pro­gestin found in most combined oral contra­ceptives.  There is no estrogen in mini-pills.

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