If it’s been less than 48 extra hours, simply take off the old patch and put on a new one, sticking to your original change day for future swaps.
User Reviews for Xulane
Xulane has an average rating of 5.7 out of 10 from a total of 478 reviews on Drugs.com. 42% of reviewers reported a positive experience, while 33% reported a negative experience.
Reviews for Xulane
Ghen · Taken for less than 1 month · June 29, 2020
For Birth Control “I was on the patch for a month and a half. I don’t even know how to explain my experience. I was on the pill for 4 years so I’ve dealt with hormone changes, etc. but my body started rejecting itself as soon as I started the patch. When I would change the patch every 7 days, that night. I would sleep in the bathroom and throw up for hours. I had migraines everyday that would make me nauseas. And my body overall just did not feel right. I was so fatigued. The day I took the patch off it was 3am and I was sleeping on the floor next to a trash can because it was a “new patch” day. As soon as I took it off I felt so much better. My body never reacted this way with anything before. Now I’m afraid to use any contraceptive ever again. It messed me up bad. It’s been about 2 weeks since I’ve taken it off. I thought I knew my body but there’s something VERY WRONG about this patch.”
1 / 10
Was this helpful? YesNo
Rina · Taken for 1 to 2 years · March 10, 2020
For Birth Control “I’ve currently been on the patch for 1 year now, after switching from the nexplanon implant, and I really like it. No spotting or bleeding in between periods, no weight gain, no mood swings, no problems with the patch falling off, no pregnancy scares, my periods are lighter & more predictable, etc. But I do notice I will get headaches & slight nausea when I change patches, but it is bearable. I definitely don’t plan on changing birth control methods anytime soon, Xulane works pretty good for me.”
8 / 10
Was this helpful? YesNo
Mayhem · January 31, 2020
For Birth Control “I’m 5’2” and weigh 100lbs When I first got on the patch I had all the starting symptoms; nausea, I was tired a lot, headaches – generally feeling like rubbish. However these symptoms gradually went away in about two cycles. I haven’t really had problems using the patch. Yes, when you take the patch off and put it back on the following your patch free week, you’re gonna feel a little off til the hormones regulate again. Similar instances can occur when you go straight to the next patch without a break up on the patch ( which is totally safe, I used to do it all the time ) but go away shortly after. I have only had ONE instance of breakthrough bleeding on this patch. Honestly I feel it was due to a lot of stress in my personal life, as I have NEVER experienced it before in the whole year I’d been on it. The patch is great if you use it correctly. The side effects are generally short term and it’s very effective ( my partner and I never use condoms and I haven’t gotten pregnant on this BC )”
9 / 10
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Frequently asked questions
- Twirla vs Xulane: How do they compare?
- Can you start the Xulane patch anytime?
- Can you get pregnant on the Xulane patch?
- Should I stop using Xulane if I get a rash?
Breeawnah · September 13, 2019
For Birth Control “I’ve been on Xulane specifically for over 6 years, and I must say, it’s the best birth control I’ve taken. I’ve taken many different types of birth control pills before- combination, progestin only, about 8-12 different brand names for the pill, as well as the Depo-Provera shots. I was bleeding the whole 3 months I was on the shot, and the pills were OK but I didn’t like having to take something daily, and I felt like they were taking away my sex drive. On Xulane I’ve had either an increase or no difference in libido, I remember in the beginning my sex drive spiked! Now it’s steady and feels like it’s unaffected by the patch, as well as my weight and anxiety. I’ve been reading horror stories of the patch and the implant for some time now; what affects me in a positive way could be your worst nightmare and vice versa. So keep that in mind while reading reviews- each woman’s experience can vary so much- don’t create a confirmation bias!”
Birth Control Patch
A birth control patch is a small, sticky patch you wear on your skin to prevent pregnancy. You apply a patch once a week for three weeks. You don’t apply a patch on the fourth week, which allows you to get your period.
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What is the birth control patch?
A birth control patch is a type of contraception you stick on your skin. Birth control patches are thin, small, beige squares that look like a bandage. They release hormones through your skin into your bloodstream to prevent pregnancy. You wear a birth control patch for three weeks, then remove it for one week. The birth control patch requires a prescription from a healthcare provider.
How does the patch work to prevent pregnancy?
The patch contains the hormones estrogen and progestin. Your skin absorbs the hormones into your bloodstream through the patch. These hormones prevent ovulation (when your ovary releases an egg). If you don’t ovulate, pregnancy can’t occur because there’s nothing for a sperm to fertilize.
These hormones also help to:
- Thicken your cervical mucus, which makes it hard for sperm to swim through your cervix to your uterus.
- Thin your uterine lining so a fertilized egg is less likely to implant.
Using the birth control patch and when to start
You should start the patch on the same day your provider prescribes it if you’re reasonably sure you aren’t pregnant. These are the criteria to be sure you aren’t pregnant:
- A negative pregnancy test.
- No sexual intercourse since your last period.
- Using a reliable method of birth control consistently.
- If you’re within four weeks of delivering a baby or within seven days of a miscarriage or termination of a pregnancy.
The patch works on a four-week cycle.
- Weeks one, two and three: You put a new patch on every week, on the same day of the week. For example, replace your patch every Sunday for three Sundays in a row. (Although you can start any day!)
- Week four: On the fourth week, you don’t put on a new patch when you remove your old patch. This is your patch-free week.
- During the fourth week (patch-free week), you may get your period. Some people don’t bleed in their patch-free week. This is usually nothing to worry about if you’ve been using the patch correctly. But, if you’re unsure, contact your provider.
- Apply a new patch after one week (or seven days), even if you’re still bleeding.
You need to use backup contraception for the first week you use the patch. After that, you don’t need to worry about a backup method for pregnancy prevention if you’re using the patch correctly. The patch doesn’t prevent sexually transmitted infections (STIs), so it’s still important to use condoms.
If you forget to replace your patch, do it as soon as you remember. If it’s been longer than 48 hours (you’re more than two days late in replacing the patch), use backup birth control for at least one week.
Where do you put the birth control patch?
You can place the birth control patch on your:
- Upper arm.
- Lower back near your butt.
- Abdominal area below your bellybutton and above your pubic area.
- Upper back near your shoulder blades.
Don’t place the patch near your breasts or on any cut, red or damaged skin. Read the packaging closely, as certain birth control patches have different instructions on where to place them.
Removing and replacing the patch
When it’s time to remove and replace your patch, take the following steps:
- Remove the old patch.
- Place a new patch on a different area of your skin.
- Make sure your skin is clean and dry. It sticks better to areas that aren’t very hairy.
- You should only place the patch on one of the four areas listed above.
Don’t attempt to trim or cut the patch, or apply it on top of makeup, lotion or other skin products. This can affect how well your skin absorbs the hormones and impact its effectiveness.
What do I do if I forget to change my patch?
If you forget or are late in changing your patch, apply a new one as soon as possible.
In general, what you do next depends on what week of the cycle you’re on and how late you are in changing it:
- If it’s been less than 48 hours: You should replace the patch as soon as possible. You can use the same patch if it’s been less than 24 hours since it came off. Otherwise, use a new one. No backup protection is necessary.
- If it’s been longer than 48 hours: Put on a new patch as soon as possible. Keep your patch change day the same. Use a backup form of birth control for seven days. If you decide to use emergency contraception, it’s safe to do so. However, certain emergency contraception can interfere with the effectiveness of the patch. So, it’s very important to use a backup method for seven days.
If you’re ever in doubt about what to do, contact your provider and use backup contraception each time you have sex for the next seven days.
How effective is the birth control patch?
The birth control patch is 99% effective with perfect use. However, it’s only about 94% effective with typical use. Perfect use describes a person who follows the instructions “perfectly” every time. Typical use describes a more “normal” use.
What are the side effects of using the patch?
Most side effects from the contraceptive patch are temporary and tend to improve after two months. Some of the most common side effects are:
- Nausea.
- Irregular bleeding.
- Sore breasts.
- Headache (particularly common in the first few weeks after starting the patch but tends to improve over time).
- Mood changes.
Is the patch a good birth control?
Yes. The birth control patch is very effective in preventing pregnancy with perfect use. Like all birth control options, the patch only works when you use it correctly.
What are the advantages of using the birth control patch?
Some of the main advantages of the patch are:
- Easy to apply and replace.
- Convenient and easier to remember than a birth control pill.
- Shorter, lighter periods in people with irregular periods.
- Reversible. This means you can stop using it and become pregnant immediately.
- May improve acne.
- Improves menstrual cramps and other PMS symptoms.
- Doesn’t interrupt sexual spontaneity.
The birth control patch is good for people who experience spotting while taking a daily pill. This is because the patch releases a steady stream of hormones instead of one dose per day (like the pill).
What are the disadvantages of the birth control patch?
There may be disadvantages to using the birth control patch. Some of those are:
- Your skin under and around the patch can become irritated.
- You have to remember to replace it each week.
- It doesn’t protect you against sexually transmitted infections (STIs).
- It requires a prescription.
- It can slightly increase your risk of blood clots (potentially due to more estrogen than other types of birth control).
- It’s less effective in people who have a body mass index (BMI) of 30 or more (have obesity) or who weigh more than 198 pounds.
- You can see it on your body. It’s hard to “hide” it.
There are also risks with using the patch. You may not be able to use the patch if you:
- Smoke cigarettes (especially if you’re over age 35).
- Have certain medical conditions like unmanaged diabetes or high blood pressure.
- Have a history of blood clots, heart attack or stroke.
- Have a history of migraines with aura.
- Have unexplained vaginal bleeding.
- Take certain medications.
Talk to your healthcare provider about the risks of using the patch before you make a decision.
When should I call my provider?
Contact your provider if you experience the following symptoms while using the patch:
- Signs of a blood clot such as redness, swelling or pain in your legs.
- Chest pains.
- Irregular vaginal bleeding.
- Jaundice.
You should also contact your provider if you consistently don’t get your period during the week the patch is off. While this can be OK, it may also mean the patch isn’t working for you.
Do you get periods with the patch?
Yes and no. The patch follows a typical menstrual cycle, which is based on a four-week schedule. When you use the patch correctly, the fourth week (patch-free week) is your period week. However, not all people will get their period. The amount and duration of bleeding can vary. Don’t be alarmed if you don’t get your period. If you’ve been using the patch correctly, it’s OK not to bleed. Contact your provider if you have any questions.
Does the patch hurt?
No, the patch shouldn’t hurt. Some people report that their skin becomes red or irritated while using the patch. If this problem persists, contact your healthcare provider, as you may need another form of birth control.
Can the patch fall off?
The birth control patch is sticky and should stay on your skin. It’s made to withstand showering, swimming and bathing.
However, if it peels up or falls off, read the instructions in the packaging on what to do. What you do next depends on how long the patch has been off. The most important thing to do is put on a new patch right away. Use a backup method of birth control (like a condom) for the next seven days to be sure you’re protected against pregnancy.
Can the patch make you gain weight?
No. Some people report weight gain or bloating from using the patch. However, research has shown that hormones in the birth control patch shouldn’t cause weight gain.
A note from Cleveland Clinic
The birth control patch is a small, square patch that sticks to your skin. It releases a steady stream of hormones to prevent pregnancy. It’s a highly effective form of birth control when you use it correctly. Talk to your healthcare provider about the birth control patch to see if it may be an option for you.
Everything You Need to Know About the Birth Control Patch
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A birth control patch is a square-shaped plastic sticker that looks like a Band-Aid. It’s applied to the skin on certain parts of the body to prevent pregnancy.
Two birth control patch brands are available in the United States: Twirla and Xulane. Both are extremely similar, except Twirla contains a slightly lower level of hormones.
Pros
- Effectiveness. If you follow the instructions perfectly, the birth control patch is 99 percent effective. Even with typical use, the efficacy rate is still relatively high at 91 percent.
- Easy to use. The patch only needs to be applied once per week and replaced weekly. This can make it easier for people who may forget to take a daily pill.
- Can help with period problems. The patch can help regulate the menstrual cycle and make periods lighter and less painful. Premenstrual symptoms may also be positively impacted.
Cons
- Skin irritation. The skin can become irritated, itchy, or sore where the patch is applied. This may particularly affect people with sensitive skin.
- No protection against sexually transmitted infections (STIs). Hormonal birth control is only effective for pregnancy prevention. You’ll need to use a barrier method, like condoms, to protect against STIs.
- Can fall off. It’s possible for the patch to come loose or fall off completely, so it’s a good idea to check it every few days.
- May be visible. While you can apply the patch in a place that’s unlikely to be seen, it does only come in one light color, making it more obvious on darker skin tones.
- Needs to be changed weekly. The patch has to be changed on the same day each week in order to work. Setting reminders can help you remember. But if you’ll have a hard time remembering, longer acting forms of birth control, like the implant or intrauterine device (IUD), may be better.
Each path contains synthetic versions of two hormones: estrogen and progesterone.
When stuck to the skin, the patch releases these hormones and the skin absorbs them into the bloodstream.
The hormones prevent pregnancy by stopping the ovary from releasing an egg each month. They also thicken cervical mucus to block sperm from reaching the egg.
If you first use the patch between days one and five of your period, it’ll be effective immediately. But starting it at any other time means you’ll need a secondary form of contraception, such as condoms, for at least a week.
Some people experience side effects for the first few months of use. These can include:
- headaches
- tender breasts
- nausea
- changes to the timing, heaviness, or frequency of periods
- itchiness, dryness, swelling, or a rash in the area where the patch has been applied
As with other forms of hormonal birth control, there’s also the potential for rare but serious side effects, such as:
- deep vein thrombosis
- stroke
- heart attack
- pulmonary embolism
- blood clots
- gallbladder disease
- high blood pressure
However, not all side effects are negative. Some people specifically use hormonal contraception, like the patch, for some better effects, such as lighter or more regular periods and acne prevention.
There’s also evidence that the patch can help protect against anemia and certain cancers, including ovarian, womb, and bowel cancer.
Introduced in the United States in 2002, the birth control patch is highly effective when used correctly.
With perfect use, it’s 99 percent effective. But the reality is that efficacy rate drops to 91 percent for people who may not follow the directions all the time.
According to Planned Parenthood, that works out to around 9 out of 100 users becoming pregnant every year.
It’s not just how well you use the patch that can affect its effectiveness. Certain medications can affect how well it works, as can a weight of 198 pounds or more.
A health professional can help you decide if the patch is right for you.
Depending on medical history and current lifestyle choices, the patch may not be suitable.
Those who may not be able to use the patch include people who:
- are pregnant or nursing a newborn child
- smoke and are aged 35 or over
- take certain medications, such as HIV medications
- have had blood clots in a vein or artery
- have high blood pressure, migraine with aura, or a heart condition
No form of hormonal birth control can prevent STIs, as they only work to prevent pregnancy.
So you’ll need to use a barrier method, like condoms, during sexual activity to reduce the risk of contracting or transmitting an STI to others.
Both quick to apply and straightforward to use, here’s how you put on the patch and swap it for a new one.
How do you put the birth control patch on?
First, decide where you want to apply the patch. This should be an area of clean, dry skin, such as your:
- stomach
- upper arm
- upper back
- shoulder
- buttocks
Here are places you should avoid placing the patch:
- on your chest
- any areas that are sore or irritated
- areas that might get rubbed with tight clothing
- areas where you might apply lotion, powder, or makeup to help keep the patch sticky
Open the foil pouch so that it lies flat and peel the patch off the foil.
Next, peel half of the plastic off the patch. Be careful not to touch the sticky part.
Stick the patch to your skin, peeling off the rest of the plastic. Push it against the skin for 10 seconds using the palm of your hand.
How long does the birth control patch last?
Each patch is designed to last for a full week. After 7 days, you’ll need to take it off and put on a new one.
It’s a good idea to check your patch is still in place every day. While activities, like short swimming sessions, shouldn’t affect it, the Twirla patch has been known to lose stickiness after 30 minutes in water.
If the patch comes loose less than 24 hours after you first applied it, and it’s still sticky, try to reapply. If it’s not sticky, replace it with a new patch.
If your patch is loose or detaches more than 24 hours after you applied it, throw it away and apply a new one. It’s also recommended that you use a method of backup birth control for the next 7 days.
The day you replace the patch will become your new changeover day.
How do you take the birth control patch off?
On the same day of the following week, it’s time to remove the patch and apply a fresh one.
Simply peel it off and dispose by folding it in half so that it sticks to itself. Place in a sealed plastic bag and throw it away in the trash.
Apply a new patch using the above steps.
Do this for 3 weeks. On the fourth week, you can take a break from using the patch, starting again the week after. During this week, you may have a withdrawal bleed, which is similar to a period.
However, the Xulane patch can be applied during the fourth week to skip this bleed. You may still experience some bleeding or spotting for the first few months.
What if you forget to take it off?
The process differs, depending on how many hours you’ve left the old one on for.
If it’s been less than 48 extra hours, simply take off the old patch and put on a new one, sticking to your original change day for future swaps.
If you’ve kept it on for 10 days or longer, swap it for a new one and stick to your usual change day.
You’ll also need to use a backup form of contraception, like condoms, until you’ve had the same patch on for 7 days in a row.
People who forget to remove the patch after the third week can take it off and apply a new patch on the usual start day. This means a shorter patch-free period.
The patch vs. the pill
Both the patch and combination birth control pills use estrogen and progestin to prevent unwanted pregnancy. But they deliver the hormones differently.
The pill is taken orally each day, whereas the patch is applied to your skin once each week.
Progestin-only pills, also known as minipills, deliver hormones the same way. However, they don’t contain estrogen.
When used correctly, both the pill and patch are equally effective at preventing pregnancy.
The patch vs. the IUD
There are two kinds of IUDs: a progestin type and a non-hormonal, copper type.
Both are small T-shaped devices that prevent fertilization of the egg and need to be inserted into the uterus by a healthcare professional.
The progestin IUD can prevent pregnancy for 3 to 7 years, depending on the type you choose. And it’s highly effective — fewer than 1 in 100 users will become pregnant.
The non-hormonal IUD, known as ParaGard, has the same effectiveness. But it can last up to 10 years.
IUDs are great if you prefer a lower maintenance form of birth control that you don’t need to think about for years.
They can come with some side effects, such as irregular bleeding, for the first few months. The copper IUD can also result in heavier and longer lasting periods compared with other birth control methods.
The patch vs. the vaginal ring
The vaginal ring is inserted into the vagina and left in place for 3 continuous weeks. On the fourth week, it’s removed. A new one is inserted at the start of each new month.
The ring works similarly to the patch, as it contains the same hormones. It’s also highly effective, as fewer than 1 in 100 people will become pregnant when using the ring as directed.
The vaginal ring offers similar benefits. Not only can it stay in place during penetrative sex, but it may also result in lighter periods and less cramping.
The patch vs. the implant
Another form of hormonal birth control, the contraceptive implant, is a tiny plastic rod that’s inserted just under the skin of the upper arm by a doctor or other healthcare professional.
It slowly releases a progestin hormone into the body and lasts up to 5 years before needing to be replaced.
Like the IUD, the implant is more than 99 percent effective at preventing pregnancy, which means it’s more effective than the patch. Plus, you don’t have to think about it each day or week.
The patch vs. the sponge
The contraceptive sponge is a soft, round piece of plastic foam with a loop for removal. It’s available over the counter in many drugstores.
The sponge doesn’t contain any hormones and is instead filled with a spermicide known as nonoxynol-9. This slows sperm down and helps prevent sperm from reaching the egg.
You insert the sponge deep into your vagina up to 24 hours before having penis-in-vagina sex to prevent pregnancy. This means it requires a little more time and preparation than other forms of birth control, including the patch.
You can have sex multiple times with the same sponge inserted. However, it shouldn’t be kept in for more than 30 hours.
The sponge is less effective than the patch. With perfect use in people who haven’t given birth, it’s around 91 percent effective. For people who have given birth, perfect use equates to 80 percent efficacy.
In reality, people don’t tend to use the sponge perfectly. So it’s usually about 88 percent effective for people who haven’t given birth and 76 percent effective for people who have.
A pack of patches, which will last for one month, may be free if you have health insurance or qualify for Medicaid.
If you can’t access the patch through insurance or a government program, it can cost up to $150 per pack, according to Planned Parenthood.
You’ll also need to pay for an appointment with a clinician to get a prescription if you’re not covered by insurance.
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In 2024 our team of doctors and nurses provide a comprehensive range of family planning services. Our doctors have expertise in antenatal care, preconception planning, and STD checks. Contraceptive advice including Mirena and Implanon insertion is available.
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