Evra

The EVRA patch is a weekly contraceptive skin patch that delivers a combination of two synthetic hormones — oestrogen (ethinylestradiol) and progestogen (norelgestromin) — directly through the skin into the bloodstream. It works in the same way as the combined oral contraceptive pill, but instead of taking a tablet every day, you simply apply a new patch once a week. The hormones work in three ways to prevent pregnancy — they stop the ovaries from releasing an egg, thicken the cervical mucus to make it harder for sperm to reach an egg, and thin the lining of the womb to reduce the chance of a fertilised egg implanting. When used correctly, the EVRA patch is 99% effective at preventing pregnancy. Because the hormones are absorbed through the skin rather than the digestive system, the patch continues to work even if you vomit or have diarrhoea — which is not the case with oral contraceptive pills. A consultation with one of our clinicians at Access Doctor is required before it can be prescribed.

When used correctly and consistently, the EVRA patch is 99% effective at preventing pregnancy — making it as reliable as the combined pill when used properly. If the patch is not always used as directed — for example, if it falls off unnoticed or is not changed on time — around 9 in 100 women may become pregnant over a year of use. The patch may be less effective in women weighing 90kg or more, as higher body weight can affect how well the hormones are absorbed through the skin. If you weigh 90kg or over, speak to your GP for advice on the most appropriate contraceptive option for you.

Apply one patch to clean, dry, hairless skin on the buttock, abdomen, upper outer arm, or upper back — avoid areas where clothing might rub it off. Press it firmly in place for at least 10 seconds. Wear one patch for 7 days, then remove it and apply a new patch to a different area of skin on the same day each week — this is your patch change day. Do not apply two consecutive patches to the same area of skin. After three weeks of wearing a patch, have a 7-day patch-free break — during which you will usually have a withdrawal bleed. Then start a new pack the following week, even if the bleed hasn't fully finished. The patch-free break must not exceed 7 days — if it does, use additional contraception such as condoms for the next 7 days. Never cut or alter the patch in any way.

If your patch has been detached for less than 24 hours, try to reapply it to the same spot or replace it with a new patch immediately — you do not need additional contraception and your patch change day stays the same. If your patch has been off for 24 hours or more, or you are unsure how long it has been off, apply a new patch immediately and use additional contraception such as condoms for the next 7 days. Your patch change day will now be different — note the new day. If you forget to change your patch on your change day, replace it as soon as you remember, but if it has been more than 24 hours, treat it in the same way as a detached patch and use back-up contraception for 7 days. If you are ever unsure, speak to your clinician at Access Doctor for advice.

Most women tolerate the EVRA patch very well. The most commonly reported side effects include headaches, nausea, breast tenderness, skin irritation or redness at the patch application site, and mood changes. Some women also experience light, irregular bleeding or spotting in the first few months of use — this usually settles after 2 to 3 cycles. Because the EVRA patch delivers a slightly higher level of oestrogen than many combined pills, some women find it causes more breast tenderness or nausea than they experienced on the pill. If these effects are persistent or troublesome, speak to your GP, who can discuss whether an alternative contraceptive might suit you better.

Like all combined hormonal contraceptives, the EVRA patch carries a slightly increased risk of blood clots (venous thromboembolism or VTE) compared to not using hormonal contraception. The overall risk is still small, but it is worth being aware of. The risk is highest during the first year of use or when restarting after a break of 4 weeks or more. Signs of a blood clot include sudden swelling, pain or redness in the calf, sudden chest pain, difficulty breathing, or sudden severe headache. If you experience any of these symptoms while using the EVRA patch, remove it immediately and call 999 or go to your nearest A&E. To minimise your risk, stay active, stay well hydrated, and always inform your clinician at Access Doctor of any personal or family history of blood clots before starting the patch.

Yes — the EVRA patch is designed to stay in place during normal daily activities including swimming, showering, bathing, exercising, and using a sauna or hot tub. However, it is a good idea to check that the patch is still firmly in place after these activities, particularly after swimming or intense exercise. If the patch has partially lifted at the edges, press it back down firmly. Never use tape or other adhesives to hold the patch in place — if it will not stick properly, replace it with a new one and follow the guidance for a detached patch if it has been off for more than 24 hours.

Yes — certain medications can reduce the effectiveness of the EVRA patch and increase the risk of an unplanned pregnancy. These include some epilepsy drugs (such as carbamazepine, phenytoin, and lamotrigine), the antibiotic rifampicin, some HIV medications, and the herbal supplement St John's Wort. If you are prescribed any new medication while using the EVRA patch, always tell the prescribing doctor or your clinician at Access Doctor, so they can advise on whether additional contraception is needed. The EVRA patch does not protect against sexually transmitted infections — if you need protection against STIs, always use a condom as well.

The EVRA patch is not suitable for everyone. It should not be used by women who smoke and are aged 35 or over, as this significantly increases the risk of serious cardiovascular problems. It is also not suitable for women with a history of blood clots, stroke, heart attack, migraine with aura, severe liver disease, certain cancers, undiagnosed vaginal bleeding, or high blood pressure that is not well controlled. It has not been studied in women under 18 and is not recommended for this age group. If you have any of these conditions or risk factors, speak to your GP, who can recommend a more suitable contraceptive option for you.