Should You Use the Ortho Evra Patch?

Your healthcare provider may have recommended the Ortho Evra patch or you may have read about this option for birth control. How does the birth control patch work and what are some of the advantages and disadvantages relative to other methods of contraception? What are the possible side effects?

This article will explore how the Ortho Evra patch is used, how it works, and its advantages and drawbacks.

Woman putting on a contraceptive patch
IAN HOOTON / Science Photo Library / Getty Images

The Ortho Evra patch is the first weekly form of hormonal birth control. It is a discreet and reversible type of prescription contraception that comes in a 4-by-4-centimeter thin, smooth, beige, plastic patch that sticks to a woman’s skin.

How Is It Used and How Does It Work?

The Ortho Evra Patch consists of patches that you place on your skin for seven days in a row for three consecutive weeks each month. In the fourth week, you do not need to put on a patch, because during this time you will usually get your period.

This is similar to many types of combination birth control pills, with the exception that you take pills for 21 days (and possibly a placebo, or dummy pill, for the last seven days) instead of applying a patch each week for those 21 days.

The patch can be worn on one of four different areas of your body, including your:

  • Upper outer arm
  • Abdomen
  • Buttocks
  • Upper torso (front or back, excluding your breasts)

It does not matter which of these locations you choose, but you should wear the patch on a different area of your body each week. You may choose the location to place your patch based on your wardrobe choices and what feels best to you.

How It Works

The Ortho Evra patch is designed to continuously release a steady flow of synthetic estrogen (ethinyl estradiol) and a type of progestin (norelgestromin) through the skin and into the bloodstream to protect against pregnancy for seven days (which is why a woman must replace it after each week). The Ortho Evra patch contains the same types of hormones found in the pill.


There are several advantages of using the Ortho Evra patch relative to the other forms of birth control. These include:

  • The patch is simple, convenient, and safe.
  • With the patch, you don't have to take a daily pill, so it’s one less thing to think about each day.
  • The patch is usually comfortable and discreet.
  • It is reversible and the ability to become pregnant returns quickly after stopping the use.
  • You can do everything you normally do and know that the patch is right there, doing its job.
  • The Ortho Evra patch does not interfere with having sex and can allow for more spontaneity.
  • Many who use the patch report having regular, lighter, and shorter periods
  • Ortho Evra easily adheres to the skin and does not prevent activities such as bathing, showering, swimming, or exercising.
  • You can use your patches to skip your period.

Noncontraceptive Advantages

We now know that there are several noncontraceptive benefits of combination birth control pills, and this likely holds true for the Ortho Evra patch as well. Some of these additional benefits may include protection against:

  • Ovarian cysts
  • Ovarian cancer
  • Hirsutism (excess facial hair)
  • Ectopic pregnancy
  • Premenstrual dysphoric disorder and depression
  • Uterine cancer
  • Noncancerous breast tumors
  • Acne
  • Menstrual migraines
  • Anemia (an iron deficiency that results from heavy periods)
  • Osteoporosis

Disadvantages and Side Effects

Compared with other forms of birth control, the patch may result in:

  • Changes in sexual desire
  • Worsening of depression for those who have a history of depression
  • Skin reactions at the site of patch application

Side Effects

There is a low incidence of side effects for women who choose to use the Ortho Evra patch, but it is important to be familiar with these before starting treatment. Fortunately, many of these side effects will improve or disappear after you have been using the patch for two to three months.

Possible side effects include:

  • Mood changes
  • Headaches
  • Bleeding between periods
  • Breast tenderness
  • Nausea (sometimes with vomiting)

Women who use the birth control patch are exposed to around 60% more estrogen than those who take a typical birth control pill. This increased estrogen exposure may increase the risk of side effects for those using the patch.

Related to this increased estrogen level, the risk of blood clots in the legs (and the subsequent risk of pulmonary embolism that can occur when clots break off and travel to the lungs) may be higher with the patch than with the birth control pill containing 35 micrograms of estrogen. In fact, the risk of blood clots is about twice as high with the patch as with a typical birth control pill. Still, the overall risk of blood clots is relatively low with either method.

There is also a slightly higher risk of breast tenderness on the patch relative to that on the birth control pill.


The Ortho Evra patch is available only by prescription and requires a medical evaluation and blood pressure reading from a healthcare provider. Many healthcare providers also recommend an up-to-date Pap smear (screening procedure for cervical cancer) before prescribing hormonal contraception.

Who Can Use It?

The Ortho Evra patch is a safe method of birth control for many women, though there are times when a different form of birth control is preferred.

The patch is not recommended for women who:

  • Are over the age of 35 and smoke cigarettes
  • Have had a heart attack or stroke
  • Have uncontrolled high blood pressure
  • Have had an abnormal growth or cancer of the breast
  • Have controlled high blood pressure and smoke cigarettes (learn more about birth control pills/patches and high blood pressure)
  • Have had blood clots (venous embolism) or a pulmonary embolism
  • Have liver disease or liver growths
  • Have had serious heart valve problems
  • Have certain inherited blood clotting disorders
  • May be pregnant


Prices vary, but the typical cost for the patch is between $30 and $40 a month (plus the expense of having a medical examination in order to obtain the prescription). State-funded Medicaid health coverage should cover the cost of this contraceptive method. A woman should check with her private health insurance policy as coverage for birth control varies.


The Ortho Evra patch is 92%–99.7% effective in preventing pregnancy. This means that with perfect use, fewer than 1 out of every 100 women who use the patch will become pregnant. With typical use, 8 out of every 100 women who use the patch will become pregnant.

Certain medications can decrease the effectiveness of birth control pills or patches. This includes drugs such as commonly used antibiotics, so it's important to talk to your healthcare provider about any medications you are taking as well as any new medications which you may be prescribed after starting the patch.

The patch might be less effective for women who way more than 198 pounds.

The effectiveness of the Ortho Evra patch can also be lowered due to user error. A woman may be more at risk for pregnancy if:

  • The patch falls off and is not replaced within 24 hours.
  • A woman forgets to change the patch each week.
  • If the patch is not stored at room temperature.
  • If the patch is not kept keep sealed until it is applied.
  • The woman tries to reapply a patch that is no longer sticky, has been stuck to itself or another surface has other material stuck to it, or has become loose and fallen off before.


While many of the pros, cons, and side effects of the Ortho Evra patch are similar to traditional birth control pills, there are a few important differences as well. The hormones that enter the bloodstream via patches are removed from the body differently than those from pills taken by mouth.

A Word From Verywell

The Ortho Evra patch provides yet another form of hormonal contraception in which you only need to think about your birth control once a week. There are several advantages as well as some disadvantages of using hormonal contraception.

Your estrogen levels may be higher when using the patch than with a typical birth control pill. Since the risk of blood clots increases with higher estrogen doses, it's important to be aware of this potential risk.

Like birth control pills, the Ortho Evra patch offers no protection against sexually transmitted infections (STIs). If you may be at risk for STIs, it's important to always use condoms along with your birth control patches.

Frequently Asked Questions

  • What if your Ortho Evra patch falls off?

    In research studies, less than 2% of patches came off and less than 3% of patches loosened. If the patch has been off for less than 24 hours, you can usually reattach it (as long as it is still sticky). If it has been over 24 hours, you will need to use a new patch. You should also use a backup form of birth control for the rest of the month.

    If you forget to change your patch, instructions will vary depending on which patch you are using (for weeks one, two, or three), but it is wise to use a backup form of birth control for the entire month.

  • Can you skip periods?

    One of the advantages of birth control pills is that they can sometimes be used to stop your period, allowing you the freedom to skip your period during an upcoming vacation or for a special event. The Ortho Evra patch works in a similar way to combination birth control pills. Talk to your healthcare provider for the best steps for you to skip your period using this patch.

  • What about showering or swimming?

    You should be able to shower or swim without problems while using the Ortho Evra patch. If your patch does fall off, however, make sure to reapply a patch within 24 hours. When this occurs, it may be preferable to use a new patch (make sure to get a replacement from your pharmacist) rather than reusing the patch that fell off, since it may no longer stick to your skin.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.