Talking to your kids about sex can be daunting, no matter how
close you are. But discussing issues like abstinence,
sexually transmitted diseases (STDs)
, and birth control can help lower teens' risk of an
or contracting an STD.
The American Academy of Pediatrics (AAP) supports sex education
that includes information about both abstinence and birth control.
Research has shown that this information doesn't increase
kids' level of sexual activity, but actually promotes and
increases the proper use of birth control methods among sexually
How and when you discuss sex and birth control is up to you.
Providing the facts is vital, but it's also wise to tell your
kids where you stand. Remember, by approaching these issues
like any other health topics, not as something dirty or
embarrassing, you increase the odds that your kids will
feel comfortable coming to you with any questions and
problems. As awkward as it might feel, answer questions honestly.
And if you don't know the answers, it's OK to say so, then
find out and report back.
If you have questions about how to talk with your son or
daughter about sex, consider consulting your doctor. Lots of
parents find this tough to tackle, and a doctor may offer some
What Is the Birth Control Patch?
The birth control patch is a thin, beige, 13/4-inch
(41/2-centimeter) square patch that sticks to the skin. It releases
hormones through the skin into the bloodstream to prevent
How Does the Patch Work?
The combination of the hormones progesterone and estrogen in the
patch prevents ovulation (the release of an egg from the ovaries
during a girl's monthly cycle). If an egg isn't released, a
woman can't get pregnant because there's nothing for the
male's sperm to fertilize.
The hormones in the patch also thicken the cervical mucus (the
mucus produced by cells in the cervix). The cervix is the part of
the uterus that sits within the vagina and acts as the opening to
the uterus. This makes it difficult for sperm to enter the uterus
and reach any eggs that may have been released. The hormones in the
patch can also sometimes affect the lining of the uterus so that if
the egg is fertilized it will have a hard time attaching to the
wall of the uterus.
Like other birth control methods that use hormones, such as the
birth control pill or ring, the birth control patch is used based
on a young woman's monthly menstrual cycle. She puts on the
patch on the first day of her menstrual cycle or the first Sunday
after her menstrual cycle begins. She will place the patch on her
skin once a week for 3 weeks in a row. (The patch should be applied
to one of four areas: the abdomen, buttocks, upper arm, or upper
torso - except for the breasts). On the fourth week, no patch is
worn, and the menstrual period should start during this time. It is
important to use an additional form of contraception during the
first 7 days on the patch to prevent pregnancy.
A new patch should be applied on the same day every week to
ensure that it keeps working effectively. For example, if the
first patch is applied on a Monday, patches should always be
applied on a Monday. When it's time to change the patch, the
old one should be pulled off first, before applying a new patch.
The new patch should be placed on a different area from the old
patch (but still on one of the four recommended areas listed above)
to avoid skin irritation. And any patch of skin that is red,
irritated, or cut should be avoided.
If a patch becomes loose and falls off or if a
woman forgets to apply a new patch on the right day, she
should consult the labeling information or a doctor about what
to do. A backup method of birth control may be necessary for a
while, such as condoms, or she might need to stop having sex for a
while to protect against pregnancy. Also, if a young woman stops
using the patch for any reason, she will need to begin using
another method of birth control, usually after 24 hours of removing
the last patch.
It's OK to participate in regular activities like swimming
and exercise while wearing the patch. It can also get wet in the
shower or in the bath. However, the patch should not be moved or
removed until the week is over (pulling the patch off to reposition
or move it may cause it to lose some of its stickiness and it might
fall off easily). A girl wearing a patch shouldn't try to
change its size by trimming it or try to attach it with tape.
The patch should not be applied over makeup, creams, lotions,
powder, or other skin products as these may prevent it from
sticking well. (Skin products may also affect how hormones are
absorbed by the skin.)
How Well Does the Patch Work?
Ongoing studies suggest the birth control patch may be as
effective as the
birth control pill
. That means that about 5-8 out of 100 couples will have an
unintended pregnancy during the first year of use. Of course, a
woman's chance of getting pregnant depends on whether she uses
the patch correctly. Delaying or missing a weekly application or
removing a patch too early reduces its effectiveness and increases
the chance of pregnancy.
For young women who weigh more than 198 pounds (90 kilograms),
the contraceptive patch may be less effective in preventing
pregnancy. If a young woman has any health conditions or is taking
any medications, that might interfere with the patch. How effective
the patch is at preventing pregnancy also depends on whether the
girl finds it convenient to use, and whether she remembers to wear
it correctly all the time.
Protection Against STDs
The birth control patch does not protect against STDs. Couples
having sex must always use
along with the birth control patch to protect against
Abstinence (not having sex) is the only method that always
prevents pregnancy and STDs.
Possible Side Effects
The birth control patch is a safe and effective method of birth
control. Most young women who use the patch have no side effects.
Smoking cigarettes while using the patch can increase a girl's
risk of certain side effects, which is why health professionals
advise those who use the patch not to smoke.
The side effects that some women have while using the patch are
similar to those experienced with the birth control pill. These may
- irregular menstrual bleeding
- nausea, weight gain, headaches, dizziness, and breast
- mood changes
- blood clots (rare in women under 35 who do not smoke, but
there may be a higher risk with the patch than with the
Other possible side effects seen in patch users include:
- skin reactions at the site of application of the patch
- problems with contact lens use, such as a change in vision or
inability to wear the lenses
- menstrual cramps
These side effects are usually mild and tend to disappear after
2 or 3 months.
Who Uses the Patch?
The birth control patch may be a good choice for sexually active
young women who weigh less than 198 pounds (90 kilograms) and find
it difficult to remember to take a pill every day or who have
difficulty swallowing pills.
Not all women can - or should - use the birth control patch. In
some cases, medical or other conditions make the use of the patch
less effective or more risky. For example, it is not recommended
for women who have had blood clots, severe high blood pressure,
certain types of cancers, certain types of migraine headaches, or
diabetes with certain complications. It's recommended that
girls who have had unexplained vaginal bleeding (bleeding that is
not during their periods) or who suspect they may be pregnant
should talk to their doctors, discontinue using the patch, and use
another form of birth control in the meantime.
Girls who are interested in learning more about the possible
health benefits and risks of different types of birth control,
including the patch, should talk to a doctor or other health
Where Is the Patch Available?
A doctor or a nurse practitioner must prescribe the patch. He or
she will ask about a girl's health and family medical history,
and may also do a complete physical exam, including a blood
pressure measurement and a pelvic exam. If the patch is prescribed,
the doctor or nurse will also provide instructions on how to use
it. Girls who use the patch may be asked to return within a few
months for a blood pressure measurement and to ensure that there
are no problems. After that, a doctor may recommend routine exams
once or twice a year or as needed.
How Much Does the Patch Cost?
The patch usually costs between $30-$35 a month, although health
and family planning clinics (such as Planned Parenthood) might sell
them for less. In addition, the birth control patch and
doctor's visits are covered by many health insurance plans.
Larissa Hirsch, MD
Date reviewed: January 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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