Conditions and Management

The birth control patch is an effective method of pregnancy prevention. Patch treatment also regulates the menstrual cycle, thus reducing discomfort before and during a woman’s monthly period. A birth control patch is a plastic-coated square sticker designed for discreet body application.

Here is a contraceptive care guide for mastering the birth control patch application-to-removal process.

The Patch. Why Use It?

Each birth control patch contains the two same synthetic hormones found in birth control pills: estrogen and progesterone. Hormonal release from the patch within the body prevents ovulation. The patch also thickens the surrounding cervical mucus, blocking penetration by sperm during sexual intercourse.

For immediate effectiveness, initial patch application should be performed between the first and fifth days of a woman’s period. A secondary form of birth control contraception, such as a condom, should be used for a week or more if the patch is applied during an alternate time than the prescribed period.

The Patch. Where to Place It

Physician-recommended instructions for birth control patch treatment indicate application to an area of the body where the skin is clean and dry:

• Buttocks
• Hips
• Shoulder
• Stomach
• Upper arm
• Upper back

Avoid applying a birth control contraceptive patch in the following areas:

• Head
• Breasts
• Chest
• Neck
• Irritated or sore skin
• Areas rubbed by apparel
• Areas where cosmetics are applied

The Patch. How to Use It

Birth control contraceptive patch application is performed manually and is relatively simple. It is recommended to wash and dry the hands and the skin area where the patch will be placed before birth control contraceptive patch application.

Open the foil pouch by holding it flat and partially peel the patch without touching the adhesive. Apply the patch to the skin and peel off the remainder of the plastic tab backing. Finally, press the applied patch against the skin for ten seconds.

The Patch. Length of Use

The birth control patch is intended for seven days of use. Therefore, each patch application should be removed and replaced weekly for three weeks, followed by a 1 week break the fourth week.

If a patch application has not been changed according to schedule, and the duration of use is less than ten days, its effectiveness is reliable. If applied for longer, it should be replaced on the next scheduled date.

Physicians recommend use of a secondary contraceptive method in the interim. The secondary form of contraception can be eliminated after the next patch is in place for seven days.
It is advisable to check an applied patch daily. Check patch application after exercise activities which tend to cause the skin to sweat. Patch adhesive lasts up to 30 minutes in water. After a half hour of bathing or swimming, a patch may dislodge and require replacement.

When using the patch during the final 7-day cycle period, there may be some withdrawal bleeding or similar menstrual period spotting. If such an occurrence is accompanied by excessive pain, contact your physician.

The Patch. How to Remove It

If a patch detaches within the first 24-hour period post-application and still exhibits adhesive stickiness, reapply. If the adhesive has disintegrated, the patch should be replaced. If a patch application detaches after more than 24 hours post application, replace it.

The scheduled removal day for standard patch replacement is within the first three days after the end of the 7th day. To remove a patch, peel it away from the skin, fold it in half so the adhesive is stuck to itself and dispose.

Failure to remove a patch at the scheduled time after the third week should be followed by replacement on the next scheduled start day. Therefore, the scheduled patchless week will be shorter. Physicians recommend using a secondary birth control method with the patch for seven days after a lapse, followed by replacement.

Pregnancy Prevention. You Have Options

The birth control patch method is considered one of the safest pregnancy prevention treatments available from a medical doctor. Birth control patch pregnancy prevention treatment is also suitable for use with other contraceptive methods.

Find out if the birth control patch or other contraceptive care option is right for you. Pregnancy prevention is a choice. Explore your contraceptive care options. Consult with a licensed gynecologist healthcare practice.

Contraceptive Care Raleigh

Raleigh Gynecology & Wellness is a licensed medical physician practice providing routine care and procedural care services in Raleigh, North Carolina. Our practice specializes in gynecological and pregnancy prevention services, including birth control patch prescriptions.

Discuss your healthcare options with a physician by scheduling an appointment with Raleigh Gynecology & Wellness.

Nexplanon is a form of contraception, or birth control. It is a small, plastic rod about the size of a matchstick that is inserted under the skin of your upper arm. Nexplanon is a contraceptive that protects against pregnancy for up to 3 years.

If you have decided to elect Nexplanon insertion, for post-procedure, physicians recommend to follow the “7-day Rule” for combined use with another form of birth control contraceptive to avoid pregnancy.

How does Nexplanon work?

After insertion of a Nexplanon implant, progestin is released. This is a hormone that stops the release of an egg from the ovaries during the ovulation phase of the menstrual cycle. Nexplanon works by thickening the mucus within the vaginal canal and cervix, thus preventing sperm from entry to the uterus.

Procedurally performed by a doctor, a Nexplanon implant can be replaced immediately once an earlier insertion is removed. Nexplanon contraception does not block pregnancy if removed and not replaced. Therefore, it is possible to become pregnant shortly after Nexplanon removal.

The 7 Day Rule

When scheduling an appointment, the timing of a Nexplanon implant insertion is important. If the procedure is performed within the first 5 days of a patient’s menstrual period, no back-up birth control method is required.

If the implant is performed after the 5th day of a patient’s menstrual period, a condom or other back-up method should be used for the first 7 days after insertion. If already employing a physician prescribed contraceptive method such as the piil, patch or ring, usage should be continued for 7 days after Nexplanon implant surgery.

Preparation for a Nexplanon Procedure

The Nexplanon implant is an in-office procedure that requires about 10 minutes. Preparation begins with cleaning of the arm with an antiseptic solution, followed by an anesthesia injection to reduce pain.

Nexplanon implants are inserted procedurally by a physician under the skin of the inside of the upper arm, followed by a topical bandage. A bandage should be worn 3 to 5 days after the procedure. Some discomfort or pressure during Nexplanon implant procedure is common.

Removal of an existing Nexplanon implant follows a similar procedure, beginning with the cleaning and numbing of the arm, then a scalpel is employed for making a slight incision adjacent to the implant location.

Surgical instruments are used to access and extirpate the contraceptive. A new Nexplanon implant can be inserted to replace the one removed for continued use of the same form of birth control. Nexplanon implant duration of use is 3-years, and should be removed on or before the expiration date.

FAQs

Will a patient experience post-procedure pain?

Patients who have recently had a Nexplanon implant procedure performed by their gynecologist should be aware of the risks. Bruising, discomfort, pain, and swelling in the location where the Nexplanon implant is placed may be a sign of infection.

It is recommended that a patient contact their physician if bleeding is excessive, or if any associated pain is not alleviated with over-the-counter pain reliever medication. Do not attempt to remove the implant yourself.

Contact your medical provider for a checkup and to avoid any long-term scarring of the skin. Contraceptive care patients experiencing severe pain, swelling or a fever above 102oF within the 3 days post-procedure period are advised to visit an emergency room.

Why pregnancy testing before a procedure?

Most physicians recommend a pregnancy test to ensure you are not pregnant prior to Nexplanon implantation. It is advised to avoid unprotected sex during the two weeks prior to the implant procedure, as it is often impossible to 100% confirm a negative pregnancy test until later in the gestation cycle. In a case where there are signs of pregnancy, Nexplanon implant contraception should be discontinued immediately.

What to expect during the menstrual cycle?

A benefit of Nexplanon implant is that some patients experience little to no menstrual bleeding after insertion. However, there may be a risk of irregular menstruation during the first few months after implant insertion.

Will an implant protect against STIs?

Nexplanon and other birth control contraceptives do not protect users against sexually transmitted infections (STIs). It is recommended that a condom be used with other birth control contraceptives to eliminate the risk of STIs during sex.

Contraceptive Care Specialists

We are a full-service, women’s healthcare medical provider, offering patients contraceptive care and other specialized gynecological services in Raleigh, NC. Our licensed physicians are specialists in in-patient, procedural contraceptive care, including Nexplanon implantation. If interested in finding out more about birth control contraception by prescription or Nexplanon implant procedure, schedule an appointment with a consultation today.

Birth control pills are currently one of the most popular types of female contraception in the United States. According to the Centers for Disease Control and Prevention, 65% of women who are at childbearing age are using some form of birth control to prevent unwanted pregnancy.

Birth control pills are preferred by many women because of their availability, effectiveness and ease of use. However, despite being referred to informally as “the pill” in a collective sense, there are many different types available, and it may take some trial and error to find the right choice for you.

What is a Combination Birth Control Pill?

Most birth control pills work by releasing hormones into a woman’s body that can prevent pregnancy from occurring. Combination pills use a blend of the hormone estrogen and one of the many different types of progestin. These are the most popular types of birth control pills, and many brands make them for the U.S. market.

These pills are taken at the same time every day, and their approach to preventing pregnancy is threefold:

• They suppress ovulation: When an egg is not released from the ovaries, there is no way for it to be fertilized and implanted which would result in pregnancy.
  They stop sperm from reaching an egg: These pills thicken a woman’s cervical mucus to a degree that prevents sperm from passing through it, which means the sperm cannot reach an egg to fertilize it.
• They thin the endometrial lining: Although the first two approaches are generally enough to stop pregnancy from occurring, these pills also thin the endometrial lining of the uterus. This means that if an egg is somehow fertilized, it will have trouble implanting due to the thin lining.

For preventing pregnancy, a combination pill is 99 percent effective when used correctly, which means it must be taken at the same time each day without fail. Typical use effectiveness, which accounts for incorrect use, is 93 percent. Women who forget to take a pill on time should use a condom as a backup method.

Combination Birth Control Pill Types

Combination birth control pills fall into one of three general categories: monophasic, biphasic or triphasic.

• Monophasic: These pills contain the same amount of estrogen and progestin in each active pill in the pack.
• Biphasic: With a biphasic birth control pill, the levels of estrogen and progestin change one time while a woman takes the active pills. This generally involves raising the level of progestin during the second half of the cycle.
• Triphasic: In triphasic birth control pills, the levels of hormones change three times during the woman’s cycle. The levels of both progestin and estrogen typically change throughout the cycle in these pills.

There are also variations in the number of pills that are included in a one-month supply. Most packs contain a set number of active birth control pills and reminder pills that do not contain hormones. These reminder pills serve to help women maintain their routine of taking a pill every day.

What Are The Most Popular Brands Of Birth Control Pills?

Here’s a look at some of the most popular brands of birth control pills in the U.S., listed by type.

Monophasic

• Alesse
• Apri
• Estrostep Fe
• Levora
• Loestrin
• Nordette
• Ortho-Novum
• Yaz
• Yasmin

Biphasic

• Mircette
• Azurette

Triphasic

• Ortho Tri-Cyclen
• Caziant
• Velivet

Choosing the Right Combination Birth Control Pill

Your doctor can provide valuable guidance on the right type and brand of birth control for you. While all types of birth control pills currently available are considered effective, the options available to you will depend on your lifestyle and personal health history.

For example, one possible side effect of combination birth control pills is elevated blood pressure. For women who have a history of high blood pressure, a low-dose combination pill might be the best choice. They contain less than 50 micrograms of estrogen in each active pill, but they may cause more breakthrough bleeding than their higher-dose counterparts.

Popular low-dose pill brand names in the U.S. include:

• Loestrin
• Apri
• Lo Ovral
• Yaz
• Yasmin
• Levora
• Aviane

It takes approximately three months for your body to adjust to a new type of birth control pill. If you find that you experience side effects after this adjustment period, your doctor may suggest a different option.

Some women, like those with a history of stroke or smokers over the age of 35, are not good candidates for combination birth control pills. There are estrogen free forms of birth control that may work well for them, including progestin only birth control pills, Depo Provera, contraceptive Implants and IUDs.

The Side Effects of Combination Birth Control Pills

Although many women can safely use these pills without experiencing any side effects, some will experience certain symptoms or effects due to the fluctuations in their hormone levels, particularly when they first start to take the pill.

These include bleeding between periods, breast tenderness, fluid retention, weight gain, vomiting, nausea and headaches.

Schedule an Appointment to Discuss Contraceptive Care

If you are sexually active and looking for an effective birth control pill, the contraceptive care team at Raleigh Gynecology and Wellness can provide valuable guidance. Contact us today to schedule an appointment.

The birth control patch is a convenient form of contraception that works in a similar manner to combination birth control pills by releasing hormones into the bloodstream that stop the ovaries from releasing an egg. Available by prescription, it is worn on the body and changed once per week. With perfect use, fewer than one out of every 100 women will get pregnant during their first year using the patch.

However, it is important to understand the instructions and follow them to the letter to enjoy this high degree of protection.

Here is a closer look at how to use a birth control patch.

Choose an Appropriate Day to Begin

Your health-care provider should walk you through the process of selecting an appropriate day to begin a patch cycle. For those who are using the patch for the first time, it is best to wait until the first day of your period. Once you begin using it, you will not need any backup contraception.

However, some people opt for a Sunday start for consistency. This means that you will apply the patch on the first Sunday after your period has begun. Women who use this approach should use backup contraception during the first week.

Find a Good Place to Apply Your Patch

Think carefully about where you will place your birth control patch on your body. Some common spots are the lower abdomen, upper outer arm, and buttock. It is not a good idea to apply your patch to an area where it could get rubbed, such as beneath your bra strap.

When applying the patch, be sure your skin is clean and dry; avoid using creams, makeup, and other products on the area where you wear your patch. Avoid placing it on irritated, red, or injured skin. If your patch causes your skin to become irritated, remove it and place a new one on a different area.

Position the Patch Carefully

It is important to handle your patch with care to avoid damaging it. Patches come in a foil pouch that should be opened carefully on one end. Using a fingernail, lift a corner of your patch to peel it away from the pouch.

You will notice that it has a protective clear lining on it, much like a bandage. Peel back half of this lining and apply the sticky surface that is revealed to your skin. Then, remove the rest of the liner and press the patch firmly onto your skin.

To ensure it sticks well, use the palm of your hand to put pressure on it for a few seconds. Then, smooth it out and check the edges to make sure they are adhering well to your skin. The patch must be left on for seven days and should not be removed for bathing, exercising, or swimming.

Ensure Your Patch Remains in Place

It is a good idea to check your patch regularly – at least once a day – to ensure it remains in place. If it has become partially detached and cannot be reapplied, place a new one on your skin immediately.

If your patch falls off and is no longer sticky or has other materials stuck to it or is stuck to itself, you cannot reuse it. You should also avoid using any type of wrapper adhesive to keep your patch in place.

If a patch has been partially or fully detached from your skin for longer than 24 hours, either in one stretch or cumulatively across a few days, apply a new one and be sure to use backup contraception for at least one week.

Change Your Patch on the Same Day Each Week

You will need to remove your patch and apply a new one once a week on the same day each week. It is best to apply your new patch to a different part of your skin to avoid irritation, even if you just move it slightly over from where the previous one was situated.

Once you have removed your patch, fold it in half so that the sticky sides adhere to one another and then throw it away. Patches should never be flushed in the toilet. If any adhesive is stuck to your skin after removal, lotion or baby oil can be used to remove it.

Skip Your Patch Every Fourth Week

You should replace your patch once a week for three weeks, then spend a week without wearing a patch. This is the week on which you can expect to have your period.

At the end of this week, place a new patch on your skin on the same day of the week that you previously applied your patch. If you do not apply your new patch at the correct time, you will need to use backup contraception.

Reach Out to Raleigh Gynecology & Wellness

To learn more about the birth control patch and other effective methods of contraception, reach out to Raleigh Gynecology & Wellness to schedule an appointment today.

The birth control shot is an effective type of contraceptive injection that prevents pregnancy by releasing the hormone progesterone into a woman’s bloodstream). Although it is considered one of the most convenient methods of birth control, it does come with some side effects.

Here is a closer look at what you need to know about the birth control shot and the effects it can have on your body.

What Is the Birth Control Shot?

The Depo-Provera™ birth control shot is a type of birth control that is administered in the form of an injection once every 12 weeks. It boasts an efficacy rate of up to 99.7 percent. It is a popular choice among women who are unable to use estrogen-based contraceptive methods because it only contains the hormone progestin.

What Are the Side Effects of the Depo-Provera™ Birth Control Shot?

Here is a look at some of the more common side effects of this birth control shot.

A Loss of Bone Density

One concern associated with long-term use of the Depo-Provera™ shot is the potential loss of bone density. The Food and Drug Administration notes that when the shot is used regularly for more than two years, women are more vulnerable to experiencing bone thinning and broken bones. For this reason, the use of this shot should be limited to no longer than two years.

Many doctors recommend that women who receive this shot take calcium and vitamin D supplements to help mitigate its effects on bone density. When bone loss does occur as a result of the shot, it is considered permanent. Depo-Provera™ carries a black box warning indicating this risk.

Weight Gain

Another potential side effect of the Depo-Provera™ birth control shot is weight gain. Research shows that two-thirds of women reported gaining five pounds during their first year using the shot.

By their second year, the figure had climbed to eight pounds, while those who continued taking the pill gained an average of 16.5 pounds by year six. This equates to approximately three pounds per year. Although not all women will experience this side effect, it is an important consideration for those who struggle to maintain a healthy weight.

Irregular Menstrual Bleeding

One of the most commonly reported side effects of the birth control shot is changes to a woman’s menstrual cycle. Irregular spotting and bleeding can occur for more than a year in some women, but there is no way of predicting who will experience this particular side effect and to what degree.

For women who find this side effect particularly frustrating, switching to a different method of contraception is the only viable solution. However, some women can enjoy short-term relief while their body gets used to the shot with supplements such as Lysteda and Ponstel.

Missing Periods

Like some other methods of birth control, such as intrauterine devices, birth control shots can cause menstruation to cease altogether in some women after they have received a few injections; others may experience much later periods.

For many women, this is considered a benefit of the shot rather than an unpleasant side effect. Indeed, some women start using this method of contraception in hopes of putting an end to their period.

According to clinical studies, more than a third of women who use Depo-Provera™ will stop getting their period after six months of treatment. After a year, this number climbs to 55 percent, while 68 percent of women will stop getting periods by the second year.

Mood Changes

Some women experience changes to their mood, including experiencing anxiety and depression. Almost 11 percent of women using the shot reported nervousness in clinical trials, while 1.5 percent reported experiencing depression.

However, the evidence showing that the shot caused these effects is considered inconsistent. Nevertheless, women with a history of depression should be monitored while using the shot and stop using it if they experience symptoms of depression.

Delayed Fertility

Depo-Provera™ is considered an effective and long-lasting birth control method, but it is important to note that unlike some other methods of birth control, it may take some time for women to begin ovulating normally again after they discontinue use.

Women who would like to get pregnant after using this shot should expect to wait at least nine months before successfully conceiving. Research shows that 68 percent of women got pregnant within their first year of stopping Depo-Provera™; this number reached 93 percent 18 months after stopping the shot.

Abdominal Pain

In clinical trials, 11.2 percent of women using Depo-Provera™ reported experiencing discomfort or pain in their abdominal area. It is important to keep in mind that severe abdominal pain can be a sign of an ectopic pregnancy, which may occur while using the shot.

Therefore, women who experience this side effect should immediately seek emergency care. Although it is rare, an ectopic pregnancy can be life-threatening.

Reach Out to the Raleigh Women’s Health-care Team

To discuss the advantages and drawbacks of various methods of birth control and find one that suits your needs, schedule an appointment with the women’s health-care team at Raleigh Gynecology & Wellness today.