Birth Control Patch (Xulane)

Effectiveness: 99 percent effective if used as directed (1 pregnancy per 100 women each year). May be less effective if you weigh more than 198 pounds.

What is it? What is it? The patch, sold under the brand name Xulane, looks like a 1-inch square bandage. You stick it on the skin of your buttocks, stomach, upper outer arm or upper torso once a week for 3 weeks in a row. Synthetic hormones similar to estrogen and progesterone produced by the body are absorbed through the skin.

How does it work? Like birth control pills, the patch releases estrogen and progestin. These hormones keep you from releasing eggs so pregnancy cannot occur. The hormones also thicken your cervical mucus, blocking the sperm from reaching the egg. You apply one patch per week for 3 weeks and then no patch in the fourth week. Then you start the cycle again.

STD protection: No; you will still need to use condoms if you are concerned about STDs.

Benefits: It's simple and convenient and allows women to feel more spontaneous having sex. It may make your periods regular, lighter and shorter. Like other hormonal forms of birth control, the patch may offer some protection against acne; severe menstrual cramps; bone thinning; ectopic pregnancy; endometrial and ovarian cancers; iron deficiency anemia; serious infections in the ovaries, fallopian tubes and uterus; breast and ovarian cysts; pelvic inflammatory disease; and premenstrual symptoms. Your ability to get pregnant returns quickly when you stop using the patch.

Disadvantages: May cause nausea, breast tenderness, stomach pain, skin irritation near patch, fluid secretion from breasts, headache, water retention, weight gain or loss, mood changes, problems wearing contact lenses due to changes in the curvature of the eye, increased blood pressure spotty darkening of the skin or irregular bleeding (especially in the first few months). Because more estrogen is absorbed through the skin with birth control patches than with other hormonal methods of birth control, there is increased risk of venous or pulmonary embolism. There also may be a higher risk of heart attack and stroke. Xulane is not recommended if you are pregnant; are over 35 and smoke; or have certain other health conditions (see Notes below). Certain medicines and supplements may make Xulane less effective, including aromatase inhibitors (such as anastrozole, exemestane), ospemifene, tamoxifen, tizanidine, tranexamic acid, certain combination products used to treat chronic hepatitis C (ombitasvir/paritaprevir/ritonavir with or without dasabuvir). Xulane may also make certain other medicines less effective. Serious complications are rare, but always talk to your health care provider about risks and benefits of any medication.

Disadvantages: Availability: Prescription required.

Cost: About $120 a month, before discounts or insurance.

Notes: Apply the patch the same day of the week and check it daily to make sure it's adhering. Don't use lotion, oil, powder or makeup on the skin around the patch to avoid loosening it. Xulane is not recommended for use during prolonged bed rest or if you are pregnant; have migraine headaches with aura; have blood clots or vein problems; have (or have had) breast or liver cancer; have had a heart attack, stroke, blood clots or angina; have had serious heart valve problems; have certain hereditary blood-clotting disorders; have undiagnosed genital bleeding; have serious diabetes or liver disease; have high cholesterol; or are 35 or older and smoke or have high blood pressure and smoke. Women who use hormonal contraception are strongly advised not to smoke.

* The Affordable Care Act requires insurance companies to cover with no co-pay any FDA-approved contraceptive method prescribed by your doctor, including barrier methods, hormonal methods, implanted methods, emergency contraception, female sterilization and patient education and counseling. These estimated costs apply to women who do not have insurance coverage or who work for a "religious employer," who may be exempt from providing contraceptive coverage. For details about what your insurance covers, contact your benefits coordinator or health insurance provider.