How does the patch work?

When you are not using birth control, estrogen and progesterone are released from your ovaries. When the patch is applied to your skin, the estrogen and progesterone move from the adhesive on the patch, through your skin and into your body. Your body then knows that estrogen and progesterone are coming from somewhere else (from the patch), so your ovaries don’t need to release hormones; they “take a little nap.” While the ovaries are “napping,” they don’t release hormones, and don’t release an egg, which is how the patch works for birth control.

Forgetting to replace the patch on time can cause the ovaries to “wake up.” When that happens, the ovaries release hormones and may release an egg, which can cause pregnancy.

How to use the patch

• Apply your first patch as directed.
• The day you apply the first patch is your “patch change day.” After applying the first patch, replace the patch once every week for 3 weeks on the patch change day.
• On the 4th week you will not wear a patch. This is the “patch free week.” You should start bleeding this week. Most people start bleeding on the 2nd or 3rd day of this week.
• After 7 days off the patch, apply another patch on your “patch change day”. You might or might not still be bleeding; it doesn’t matter either way. You will again be using the patch for 3 weeks and then 1 week off the patch.
• If you are using the patch as an extended cycle, your doctor or nurse practitioner will tell you when to expect bleeding.

What to do if you forget to change a patch

• If an edge or corner of the patch becomes loose, try to press it down again.
• If the patch comes off and you are sure it has been off for less than 24 hours, apply a new patch. Stay on the same schedule with your patches and keep the same patch change day.
• If the patch comes off and you have no idea when it came off, apply a new patch and start a new cycle. (This becomes patch #1 and this is your new patch change day.)
• If you forget to replace a patch, your ovaries may “wake up.” Be sure to use condoms during intercourse to prevent pregnancy; start a new patch cycle.
• If you have questions about what to do, call the triage nurse.

Are there side effects with the patch?

Most people don’t have any side effects with the patch. However, during the first three months you may experience:

• Bleeding or spotting when the patch is on. This is called breakthrough bleeding and is usually worst during month 1, less during month 2, and by month 3 most people have regular periods during the patch free week. If breakthrough bleeding continues after month 3, you may need a different method.
• Write down the dates of any bleeding that you have on a calendar. Bring the calendar to each visit with your doctor or nurse practitioner.
• Other problems are not common, but you may have nausea, breast tenderness, headaches, or mood changes. If this happens, it is usually mild and doesn't last long.
• If you are having problems that are making you feel miserable, call the triage nurse, do not stop using the patch.
• The patch does not cause weight gain.

Danger signs using the patch

Call the office immediately if you have:

• Dizziness
• Vision changes

Consider immediate evaluation if you experience the following:

• Severe headaches (the worst headache you’ve ever had)
• Chest pain
• Pain in the calf of one leg

Remember

• The patch does not protect against sexually transmitted diseases. Use condoms every time you have sex.
• Never run out of patches. You can always call the triage nurse and ask for a refill.
• Never use someone else’s patches or share yours with anyone else.
• If you are having a problem, don’t just stop using the patch. Call the triage nurse.
• The Ortho Evra Patch is the only birth control patch available at this time. If you feel miserable while using this method, discuss other methods of birth control with your doctor or nurse practitioner.

[See also: Using the pill; not for contraception]

How does the pill work?

Without birth control pills, estrogen and progesterone are released from your ovaries. When you are on birth control pills (“the pill”), your body knows that estrogen and progesterone are coming from somewhere else (from the pills). Because your ovaries don’t need to release hormones, they “take a little nap.” While the ovaries are “napping,” they don’t release hormones, and don’t release an egg, which is how they work for birth control.

Forgetting pills or taking them at different times of the day can cause the ovaries to “wake up.” When that happens, the ovaries release hormones, which can cause irregular periods and may release an egg, which can cause women to get pregnant.

How to use the pill

• Start your first pack of pills as directed - You may be told to start on the first day of your next period, or - on the Sunday after your next period begins, or - on the day you are in the clinic or office.
• After starting the pill, continue taking one pill every day at the same time. There should not be any days that you don’t take a pill.
• With birth control pills the first 21-24 days are hormone pills and the last 4-7 are usually sugar pills (placebo). Most people start their bleeding on the 2nd or 3rd day of the placebo pills.
• If you are taking the pills with an extended cycle, your doctor or nurse practitioner will tell you when to expect bleeding.

What to do if you forget to take a pill

• If you forget to take a hormone pill at your usual time, take your pill as soon as you remember. Then take the next pill at the usual time. You will be taking two pills that day.
• If you forget to take a hormone pill for 1 whole day, take 2 hormone pills the next day at the regular time.
• If you forget to take a hormone pill for 2 days, take 2 hormone pills for each of the next 2 days.
• If you forget to take the pill for 3 days, your ovaries may “wake back up.” Start a new pack of pills.
• Forgotten placebo pills do not need to be made up.
• If you have questions about what to do with missed or late pills, call the clinic.

Are there side effects with birth control pills?

Most people don’t have any side effects with birth control pills. However, during the first 3 months you may experience:

• Bleeding or spotting during the hormone pills. This is called breakthrough bleeding and usually happens more during month 1, less during month 2, and by month 3 most people have regular periods during the last week of pills. If breakthrough bleeding continues after month 3, you may need a different pill.
• While other side effects are not common, you may have nausea, breast tenderness, headaches, or mood changes. If this happens, it is usually mild and doesn't last long.
• If you are having side effects that are making you feel miserable, call the clinic. Do not stop taking your pills.
• Birth control pills do not cause weight gain.

Danger signs on the pill

Call the office immediately if you have:

• Dizziness
• Vision changes

Consider immediate evaluation if you experience the following:

• Severe headaches (the worst headache you’ve ever had)
• Chest pain
• Pain in the calf of one leg

Remember

• Birth control pills do not protect against sexually transmitted infections. Use condoms every time you have sex.
• Never run out of pills. You can always call your pharmacy and ask for a refill.
• Never take someone else’s birth control pills or share your pills with anyone else.
• If you are having a problem, don’t just stop taking the pill. Call the clinic.
• There are about 100 different birth control pills. If you feel miserable while taking the pill you were given, call the clinic and ask to change to another pill that may be better for you.

[See also: Using the pill]

How does the pill work?

Without birth control pills, estrogen and progesterone are released from your ovaries. When you are taking the pill, your body knows that estrogen and progesterone are coming from somewhere else (from the pills). Because your ovaries don’t need to release hormones, they “take a little nap.” While the ovaries are “napping,” they don’t release hormones, and don’t release an egg, which is how pills work for cramps, to decrease bleeding ad cysts, etc.

Forgetting pills or taking them at different times of the day can cause the ovaries to “wake up.” When that happens, the ovaries release hormones which can cause irregular bleeding.

How to use the pill

• Start your first pack of pills as directed - You may be told to start on the first day of your next period, or - on a specific day after your next period begins, or - on the day you are in the clinic or office.
• After starting the pill, continue taking one pill every day at the same time. There should not be any days that you don’t take a pill.
• With pills the first 21-24 days are hormone pills and the last 4-7 are usually sugar pills (placebo). Most people start their bleeding on the 2nd or 3rd day of the placebo pills.
• If you are taking the pills with an extended cycle, your doctor or nurse practitioner will tell you when to expect bleeding.

What to do if you forget to take a pill

• If you forget to take a hormone pill at your usual time, take your pill as soon as you remember. Then take the next pill at the usual time. You will be taking two pills that day.
• If you forget to take a hormone pill for 1 whole day, take 2 hormone pills the next day at the regular time.
• If you forget to take a hormone pill for 2 days, take 2 hormone pills for each of the next 2 days.
• If you forget to take the pill for 3 days, your ovaries may “wake back up.” Start a new pack of pills.
• Forgotten placebo pills do not need to be made up.
• If you have questions about what to do with missed or late pills, call the clinic.

Are there side effects with the pill?

Most people don’t have any side effects with birth control pills. However, during the first 3 months you may experience:

• Bleeding or spotting during the hormone pills. This is called breakthrough bleeding and usually happens during month 1, less during month 2, and by month 3 most people have regular periods during the last week of pills. If breakthrough bleeding continues after month 3, you may need a different pill.
• While other side effects are not common, you may have nausea, breast tenderness, headaches, or mood changes. If this happens, it is usually mild and doesn't last long.
• If you are having side effects that are making you feel miserable, call the clinic. Do not stop taking your pills.
• Birth control pills do not cause weight gain.

Danger signs on the pill

Call the office immediately if you have:

• Dizziness
• Vision changes

Consider immediate evaluation if you experience the following:

• Severe headaches (the worst headache you’ve ever had)
• Chest pain
• Pain in the calf of one leg

Remember

• Never run out of pills. You can always call your pharmacy and ask for a refill.
• Never take someone else’s birth control pills or share yours with anyone else.
• If you are having a problem, don’t just stop taking the pill. Call the clinic.
• There are about 100 different birth control pills. If you feel miserable while taking the one you were given, call the clinic and ask to change to another pill that might be better for you.

If you think that your child will need surgery or your primary care doctor has referred your child to pediatric and adolescent gynecology for surgery, you will first schedule a preoperative evaluation appointment with a pediatric and adoloescent gynecologist at Children’s.

Before a surgery is scheduled, a gynecologist must see and evaluate your child to determine whether surgery is appropriate and the best procedure for care.

Once the gynecologist has examined your daughter, she will explain the surgical procedure and the risks and benefits of surgery.

If you decide to proceed with the surgery, the gynecology surgery scheduler will arrange a future surgery time with you. Usually, surgery is not scheduled the same day as the first doctor's appointment.

Once you have been given a surgery date, you may call the surgery scheduler if you have any questions or if you need to change the date.

More about pediatric gynecology surgery

Learn more about pediatric gynecology surgery at Children’s, and about conditions that may require gynecology surgery.