The Xulane patch, formerly known as ‘Ortho Evra’, is an FDA-approved hormonal birth control that has been available since 2014. Also referred to as the ‘transdermal patch’, it is applied to the skin to release synthetic oestrogen and progestin into the bloodstream. If used correctly, Xulane is around 98 percent effective in preventing pregnancy.
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Reviewed by Dr Yasmin Aghajan, MD
Information last reviewed 07/04/19
Xulane is a contraceptive patch, similar to a Band-Aid, which is applied to the skin to effectively prevent pregnancy. It contains a synthetic combination of the female hormones progestin (norelgestromin) and estrogen (ethinyl estradiol) that are absorbed into the bloodstream through the skin to prevent ovulation. Xulane contains hormone medication similar to birth control pills but with a dose that is around 60 percent higher. The patch can also be prescribed for irregular periods, menstrual cramps or endometriosis.
Xulane works in numerous ways to help protect against an unwanted pregnancy. Its main function is to stop the release of an egg from the ovaries during the menstrual cycle (ovulation). In cases where an egg has been released, it thickens the vaginal mucus to prevent the sperm from reaching the egg (fertilization), as well as changing the lining of the uterus to prevent a fertilized egg from attaching to the womb (implantation).
When used correctly, Xulane patches are just as effective as birth control pills in preventing pregnancy. Research shows that 9 out of 100 women fell pregnant in one year with ‘typical use’ of Xulane whereas 3 out of 1000 women reported pregnancy through ‘perfect use’ in one year.
Through proper use, Xulane patches are 91-98 percent effective, however, they may prove to be less effective if worn improperly or if the user is concurrently taking other medications such as:
You must wait a period of 7 days after applying the Xulane patch before it can be completely protective against pregnancy. Meanwhile, it may be advisable to use another form of contraception as a back-up, such as the male condom.
The length of time it takes for Xulane to come out of your system will vary from woman to woman. You will most likely get your period within a few days of taking off the patch. For most women, fertility should return within a few weeks, however, this can in some cases happen almost immediately or, on the other hand, take several months.
The active ingredients in Xulane patches are the hormones norelgestromin and ethinyl estradiol.
The inactive ingredients in Xulane patches are: polyisobutene adhesive, crospovidone, mineral oil, non-woven polyester fabric, oleyl alcohol and dipropylene glycol.
Be sure to carefully follow the directions on the information label before using the Xulane patch. You can also refer to the following steps on how to correctly apply the patch:
Ideal parts of the body where the Xulane patch can be applied include the lower abdomen, back, upper arm or buttocks where it will not rub against tight clothing. Wherever you decide to apply the patch, ensure that the area is clean and dry and leave it there for a period of 7 days. Be sure to change the location of the patch each time you apply a new one.
Do not apply the patch on the breast or on damaged, broken or irritated skin. Do not use any lotions, creams, oils or powders at the patch site as this may reduce adhesiveness and cause the patch to become loose or fall off.
Depending on your doctor’s instructions, you will either apply the patch on the first day of your period or on the first Sunday after your period begins.
The patch method operates on a 4-week cycle. A new patch must be applied on the same day every week for a period of 3 consecutive weeks. On the fourth week you go patch-free before starting a new cycle. You should get your period during the patch-free week, also known as a withdrawal bleed, although this may not always occur. Do not allow more than 7 days to pass before repeating the cycle.
Do not wear more than one skin patch at a time. Do not cut, damage or alter the Xulane patch in any way as this may impair the efficacy of the contraceptive.
Some of the most common side effects brought about by hormonal contraceptives, including Xulane are:
If you do experience any of the above symptoms, do not stop using Xulane. Such issues will usually subside as your body adjusts to the contraception; however, if the problem persists or worsens seek medical advice.
Less common yet adverse reactions from Xulane include:
Remove the patch and seek immediate medical attention if you experience any of the above symptoms.
Do not smoke whilst using Xulane patches, especially if you are aged 35 or over.
Grapefruit and its derivatives may interact with Xulane to cause unwanted side effects. It is therefore important not to use or consume any products containing grapefruit.
Xulane patches will not protect you from sexually transmitted diseases. Using a condom is the only way to obtain protection from such diseases.
The patch may also be less effective for women who weigh more than 198 pounds. Always consult your doctor to determine whether Xulane patches are the right contraceptive method for you.
Before using the Xulane patch, you must inform your doctor of your full medical history. You may be unsuited to the patch if you have any of the following:
Xulane patches must not be used during pregnancy. If you think you may be pregnant, inform your doctor immediately. If you have just given birth or had a miscarriage, speak with your doctor who will advise you on what type of contraception is best for you.
It is also advised to take caution when using Xulane whilst breastfeeding as the estrogen may reduce breast milk production. Small amounts of the hormones may also be present in the milk which may produce undesirable effects on the nursing infant.
Some medications can make Xulane patches less effective. Inform your doctor of any other medications you are taking, both prescribed and over-the-counter, as well as any herbal or vitamin supplements, especially:
While the Xulane patch is a worthwhile contraceptive method for many women, it is not suited for all. There are a wide range of effective options available on the market for those wanting an alternative birth control method. If you are unsure of which option is best for you, always speak with your doctor or a healthcare professional for advice.
Implant (Implanon or Nexplanon)
This is a small rod inserted into the skin, typically in the upper arm and is over 99 percent effective in preventing pregnancy for up to 4 years. It is estrogen-free and therefore suitable for women who cannot use estrogen-based contraception. It is a fairly low-maintenance method that is safe for smokers as well as those with diabetes.
Some women have reported irregular menstrual cycles as well as dizziness, headaches, acne breakouts and hair loss as a result of the implant.
This is an injectable solution containing the hormone progestin that is 94 percent effective in protecting against pregnancy for 3 months. It is a great alternative for women who do not want to take a pill every day and because it is estrogen-free, it is also a viable option for those who are breastfeeding.
Most women may experience changes, particularly during the first year, including heavier menstrual bleeding and spotting in between periods as well as weight gain.
Intrauterine Device (Mirena, ParaGard, Skyla, Liletta and Kyleena)
This is a small T-shaped device that is placed in the uterus and is 99 percent effective in preventing pregnancy for 3 to 12 years, depending on the type. Women have reported reduced cramps and lighter periods and it is also suitable for smokers as well as those with diabetes or hypertension.
There is a risk of the device slipping out or pushing through the uterus wall, increasing the risk of infection.
Cervical Cap (FemCap)
This is a silicone cup that is inserted into the vagina and works by preventing sperm from reaching the uterus. It is recommended that spermicide be used in conjunction with the cap for it to be most effective. It is a prescription-free option that can also be used while breastfeeding.
The cup is 79-86 percent effective in typical use and can cause some vaginal irritation. Many women have a hard time inserting the cup and it can be pushed out of place during intercourse. It cannot be used by women who are allergic to spermicide or silicone.
The male condom is a latex sheath that is put over the man’s erect penis to prevent the sperm from meeting the egg. With typical use, it is around 85 percent effective and there is a risk of the condom splitting or slipping off during intercourse.
The female condom is a pouch that is inserted into the vagina and helps to prevent pregnancy by retaining sperm during intercourse. However, in typical use it has proven 79 percent effective and can cause irritation as well as reduce sensitivity in some users during intercourse.
Both contraceptives are prescription-free and effectively protect against STIs.
Xulane patches are a doctor-prescribed contraception and therefore cannot be purchased over the counter in the United States. Medzino is able to offer first and repeat prescriptions for those who are interested in using Xulane patches as an effective method of contraception. Through our online consultation service, our doctors will carry out an assessment and subsequently advise you on the most suitable contraception for you.
The hormones in the Xulane patch can make your periods considerably lighter and, occasionally make you skip a period altogether. If you want to skip a period or stop having them completely, it is perfectly safe to skip the patch-free week and start a new cycle instead. Speak with your doctor if you are looking to skip your period with the Xulane patch.
The birth control patch was first introduced in 2002 as a non-invasive, easy-to-use contraceptive method. Originally sold as ‘Ortho Evra’, the patch was rebranded in 2014 as Xulane after being approved by the FDA.
You must pay attention to your menstrual cycle in order to determine the effectiveness of the Xulane patch in preventing pregnancy. If you applied the patch during the first 24 hours of your period then it will be effective immediately. However, if you applied the patch on the first Sunday after your period started, then you will need to use a back-up contraception method for a further week until the patch can be fully effective.
If you forget to apply a patch on week 1 of your cycle following your patch-free week, apply it as soon as you remember. You must use another method of birth control for at least 1 week. The day that you apply the patch is now considered day 1 of your new cycle.
If you forget to change your patch on week 2 or 3, you can apply a new patch right away if you are 1-2 days late. The next patch should be changed on your regular patch change day. It is best to use backup contraception for 7 days thereafter.
While Xulane patches have its side effects, muscle weakness should not typically be one of them. If you do experience any muscle weakness from using the patches, it is best to discontinue use and contact a healthcare professional right away.
Vaginal discharge is a common side-effect of the Xulane patch and should not be a cause for concern. Unless the symptom becomes particularly bothersome continue using the patch as normal, otherwise consult your doctor about another form of contraception.
Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.
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