What happens when the contraceptive patch comes off?
If the contraceptive patch has come off less than 48 hours ago, it can be reapplied and changed at the normal time of your cycle. If it is not sticky enough, a new patch can be reapplied in its place. A new patch can then be applied on the usual day of change according to your schedule. If the patch has come off more than 48 hours ago, or if it is not known when the patch came off, then a new patch should be applied as soon as possible. Additional precaution is also necessary such as condoms, or you should avoid having sexual intercourse for the next 7 days. The change day of the subsequent patches is adjusted accordingly as the current patch is considered to be day 1 of week 1 of the patch cycle. Emergency contraception may also be required, especially if unprotected intercourse has occurred in the previous 5 days.
What happens when there is a delay in applying the patch?
If there was a delayed change at the end of week 1 or 2:
If there is a delay of less than 48 hours, a new contraceptive patch should be replaced as soon as possible. The following patch changes should be done as per the original schedule. No additional precaution is required.
If there is a delay of more than 48 hours, a new patch should be applied as soon as possible. The schedule is now different as the current patch is considered to be applied on day 1 of week 1 and the days of change for the following patches needs to be adjusted accordingly. Additional precautions should be used, or sexual intercourse avoided for 7 days. Emergency contraception should be considered if unprotected intercourse has occurred during the last 5 days.
If the patch is not removed at the end of week 3:
The contraceptive patch should be removed as soon as possible. No additional contraception is required. The next patch should be started at the usual time.
If there is a delay in starting a new patch at the end of the cycle (i.e. after the patch-free week):
If there is a delay of less than 48 hours, a new contraceptive patch should be applied as soon as possible. This is now considered day 1 and the patch change day for future patches would subsequently change. No additional contraception is required.
If there is a delay of more than 48 hours, a new patch should be applied as soon as possible. As mentioned, this would be seen as day 1 and future patch change days will need to be adjusted. Additional precautions or abstinence from sexual intercourse is advised for the following 7 days. Emergency contraception should be considered if unprotected intercourse has occurred in the previous 5 days.
What happens when there is no withdrawal bleeding during the patch-free week?
Just like other combined hormonal contraception (CHC) methods, some women may not always have a bleed during their patch-free week. This is not something to worry about if you have used the patch correctly and have not taken any medicines that could interfere with it (these are medicines and herbal remedies that can affect all CHC methods).
If that is not the case and/or you are worried, you should see your doctor or do a pregnancy test to check if you are pregnant. You should also get medical advice if you have missed more than 2 bleeds during each of the patch-free intervals.
If you are interested in finding out more about this type of contraception or other contraceptives, do get in touch with our friendly team of female doctors. They can help you make an informed decision on the right method of contraception, based on your circumstances, medical background and personal choice.
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References
The Faculty of Sexual & Reproductive Healthcare of the Royal College of Obstetricians & Gynaecologists. (2017, Amended 2020). Emergency Contraception. Retrieved from https://www.fsrh.org/standards-and-guidance/documents/ceu-clinical-guidance-emergency-contraception-march-2017/
https://patient.info/doctor/combined-hormonal-contraception-pill-patch-vaginal-ring
Skin patch and vaginal ring versus combined oral contraceptives for contraception. Cochrane Database Syst Rev. 2013 Apr 304:CD003552. doi: 10.1002/14651858.CD003552.pub4.
https://www.singhealth.com.sg/patient-care/medicine/evra-transdermal-patch/
https://www.nhs.uk/conditions/contraception/contraceptive-patch/
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