The Contraceptive Patch in South Africa: A Complete Guide to Evra Birth Control
- Samantha Pieterse
- Dec 18, 2025
- 10 min read
If you’ve ever wished birth control could be as simple as “stick it on and get on with your life”, the contraceptive patch might be your new favourite thing. It’s a small, beige, square sticker that quietly does its job all week while you run between work, kids, gym bags, and whatever else life throws at you.
And because it’s not a pill you need to remember every day, it suits women who want reliable contraception without adding another thing they need to remember.
This guide walks you through how the contraceptive patch works, how effective it is, side effects, cost in South Africa, where to put it, what to do if it falls off, and how it compares to the pill and the injection, all so you can decide if the fit will be right for you.
What Is the Contraceptive Patch (Evra) and How Does It Work?
The contraceptive patch, known in South Africa as Evra, is a small, square adhesive patch worn on the skin. It releases two hormones, oestrogen and progestogen, through the skin and into the bloodstream.
Evra prevents pregnancy by:
Stopping ovulation,
Thickening cervical mucus to block sperm,
Thinning the lining of the uterus so that a pregnancy cannot implant.
You wear one patch per week for three weeks, followed by one patch-free week, during which a period usually occurs. After that, the cycle repeats. Because hormones are absorbed through the skin, Evra delivers a steady dose without the daily ups and downs that some women experience with pills.
How Effective Is the Contraceptive Patch?
Effectiveness is often the deciding factor when choosing a contraceptive method, and the patch is no exception.
With perfect use, the contraceptive patch is more than 99% effective.
With typical use, meaning real life, where patches may lift, routines get busy, or a change is delayed, effectiveness sits around 93% over the course of a year of use, which is standard for short-acting hormonal contraception.
For women who struggle to remember a daily pill, the once-weekly routine often makes the patch feel more reliable in practice.
Where to Place the Birth Control Patch: Best Placement Areas and Tips
Getting the placement right from the start makes the patch easier to live with and reduces the chance of it lifting or irritating the skin during the week.
Where to Apply the Contraceptive Patch
Choosing the right area helps the patch stay in place and work consistently throughout the week. The Evra patch needs good contact with the skin to deliver hormones evenly throughout the week, so choosing the right area matters. You can place the Evra patch on:
The upper arm,
The lower abdomen,
The upper body or upper back,
The buttocks,
The thighs
Where You Shouldn’t Apply the Contraceptive Patch
The patch should not be placed on the breasts, on broken or inflamed skin, or on areas where there is constant rubbing from tight clothing or waistbands. These spots can interfere with how well the patch sticks and may increase skin irritation. Choosing a smooth area of skin that isn’t under pressure helps the patch stay secure and deliver hormones evenly throughout the week.
How to Apply the Contraceptive Patch Correctly
Before applying the patch, make sure your skin is clean, dry, and free from oils, lotions, or creams. These can stop the patch from sticking properly. Once the patch is on, avoid applying moisturiser, body oil, or sunscreen directly over it, as this can cause the edges to lift.
Wash and dry your hands.
Open the sachet and remove the patch.
Press firmly onto the skin for 10–15 seconds, especially around the edges.
Check that it is fully sealed.
You can shower, swim, exercise, and go about your daily life as usual. The patch is designed to stay in place.
What If the Contraceptive Patch Falls Off or Lifts?
Occasionally, a patch may lift at the edges, wrinkle, or come off completely, especially with heat, sweating, or friction from clothing. What you need to do depends on how long the patch has been off the skin.
If It Has Been Off For Less Than 24 Hours
Apply a new patch as soon as you notice it. Contraceptive protection is maintained, and no additional contraception is needed. Keep the new patch on only for the remaining days of your current patch week, then change it on your usual patch change day as planned.
If It Has Been Off For More Than 24 Hours
Apply a new patch as soon as possible and use condoms for the next 7 days. This is because hormone levels may have dropped enough to reduce pregnancy protection. You may also need to adjust your patch change day depending on when the new patch is applied.
If you’re unsure how long the patch has been off, or which week of your patch cycle you are in, treat it as more than 24 hours, use condoms for 7 days, and check with a clinician for personalised advice.
Never tape a patch back on. Once a patch has lifted or fallen off, it cannot reliably release hormones and should always be replaced with a new one.
The Contraceptive Patch Side Effects
Most women tolerate Evra well. Mild side effects are most common in the first few months as the body adjusts to the hormones. These effects usually improve on their own after two to three cycles as hormone levels stabilise. If side effects persist or worsen over time, it’s worth checking in to see whether the patch is still the right option for you.
Common Side Effects Include:
Headaches,
Breast tenderness,
Mild nausea,
Spotting between periods,
Mild skin irritation where the patch sits.
These usually settle after two to three cycles.
Seek Medical Advice Urgently If You Experience:
Severe abdominal pain,
Chest pain or shortness of breath,
Severe headaches with visual changes,
A painful, red, swollen calf.
These symptoms are uncommon, but they are important to take seriously with any combined hormonal contraception. While serious complications are rare, seeking medical advice promptly if these symptoms occur helps ensure your safety and allows any concerns to be assessed early.
Contraceptive Patch Price in South Africa
The Evra patch typically costs between R200 and R260 per month in South Africa, depending on the pharmacy and supplier.
This places it in a similar price range to many oral contraceptive pills and makes it more affordable than long-acting options like Implanon for some women. Some medical aids also cover it under contraception benefits.
At Mums & Bums Clinic in Centurion, we’re here to help you with the Evra contraceptive patch. We’re here to help you get started or switch safely if the patch feels like a better fit for you.
Birth Control Patch Brands in South Africa: Is There More Than One?
This is an area where online information often causes confusion, especially when international sources are mixed in with South African search results.
In South Africa, Evra is the only contraceptive patch currently available. You may come across the name Xulane online, which is a generic version of the patch used in some international markets. However, Xulane is not routinely available or registered for use in South Africa.
Both patches contain the same hormones and work in the same way, but for South African patients, Evra is the patch you will be prescribed and dispensed.
Contraceptive Patch vs Pill
Now that you understand how the patch works, it’s natural to wonder how it compares to more familiar options like the contraceptive pill. Neither method is better for everyone. Both are effective, well-studied forms of contraception, but they suit different needs and lifestyles. The right choice depends on how your body responds to hormones and how easy it is for you to stay consistent with the routine.
Contraceptive Patch (Evra) | Oral Contraceptive Pill | |
|---|---|---|
Effectiveness | Highly effective when used correctly. In everyday use, it may perform better for women who forget daily pills. | Highly effective when taken consistently every day. Missed pills can reduce protection. |
Side Effects | Similar hormonal side effects to the pill. Avoids possible stomach upset, but may cause mild skin irritation. | Similar hormonal side effects. Some women prefer pills if they have sensitive skin. |
Weight Changes | No strong evidence of long-term weight gain. Temporary bloating or fluid retention may occur early on. | No strong evidence of long-term weight gain. Temporary bloating or fluid retention may occur early on. |
Convenience | Changed once a week, which many women find easier to remember. | Needs to be taken every day at around the same time. |
The patch gives a slightly higher overall oestrogen exposure than many standard pills because hormones are absorbed continuously through the skin rather than in daily doses. For this reason, it isn’t suitable when oestrogen-containing contraception is not recommended. For most healthy women without risk factors, it remains a safe and effective option when prescribed appropriately.
Contraceptive Patch vs Injection
Because the contraceptive injection is such a commonly used option in South Africa, many women also want to understand how the patch compares. Neither method is better for everyone. Both are effective and well-established forms of contraception, but they differ in how they’re used, how flexible they are to stop or change, and how quickly fertility returns after stopping.
Contraceptive Patch (Evra) | Contraceptive Injection | |
|---|---|---|
Effectiveness | Highly effective when used correctly. Effectiveness depends on changing the patch on time each week. | Very effective once given, as it does not rely on daily or weekly user action. |
Side Effects | Similar hormonal side effects to other combined methods. Some women may notice mild skin irritation where the patch is applied. | Side effects vary. Periods may become irregular or stop, especially with longer use. |
Weight Changes | No strong evidence of long-term weight gain. Temporary bloating may occur early on. | Some women experience weight gain, although this differs from person to person. |
Convenience | Changed weekly at home and easy to stop or switch if side effects occur. | Given every 2 or 3 months at a clinic, with very little day-to-day maintenance. |
Women who want more control and predictability often prefer the patch, as it allows them to manage their cycle week by week and stop or switch easily if needed. Those looking for a low-maintenance option, with fewer day-to-day decisions, often prefer injections, as once it’s given, contraception is taken care of for several months.
Birth Control Patch vs Oestrogen Patch: Understanding the Difference
As women move through their late 30s and 40s, conversations about hormones often start to overlap. It’s common to see information about contraception mixed in with discussions around perimenopause and menopause treatment, which can make things confusing. This distinction is important because not all hormone patches are designed to prevent pregnancy.
The birth control patch (Evra) is a contraceptive. It contains oestrogen and progestogen and works by suppressing ovulation and preventing pregnancy.
Oestrogen patches used for perimenopause or menopause are different. They are prescribed to manage symptoms such as hot flushes and night sweats, but they do not reliably stop ovulation and are not designed to prevent pregnancy. If you are perimenopausal and still need contraception, an oestrogen patch on its own is not sufficient and should not be relied on for pregnancy protection.
It’s also important to know that Evra and an oestrogen patch should not be used together, as this would increase overall oestrogen exposure without providing additional contraceptive benefit. Using both at the same time can raise the risk of side effects and is not recommended.
If you are perimenopausal and need both symptom relief and contraception, this is something that should be discussed with your doctor so that the safest and most appropriate option can be chosen.
Who Should Avoid the Contraceptive Patch?
While the contraceptive patch is safe and suitable for many women, it isn’t the right choice for everyone. Certain medical conditions and risk factors mean that other contraceptive options may be safer.
Evra is not suitable for women who:
Have a history of blood clots,
Have migraines with aura,
Smoke and are over 35,
Cannot safely use oestrogen-containing contraception.
Breastfeeding parents in the early months may be better suited to progestogen-only methods.
Can You Get Pregnant on the Patch?
This is a very common and understandable concern when choosing any form of contraception. While the patch is highly effective when used correctly, it’s important to understand how and why pregnancy can still occur in certain situations.
Pregnancy can occur if:
Your patch falls off and is not replaced correctly.
Patch changes are delayed or missed,
You’re taking medications that interfere with hormone levels,
Body weight is very high, which may slightly reduce effectiveness.
Used correctly, the patch is one of the most reliable short-acting contraceptive options available.
Where Can You Get the Contraceptive Patch in South Africa?
Once you’ve decided that the contraceptive patch might be a good fit, the next practical question is where and how to access it. The Evra patch is available in South Africa through healthcare providers who offer contraceptive services, following a brief medical assessment to ensure it’s safe and appropriate for you.
For personalised contraception advice and prescriptions, you’re welcome to book a family planning consultation at Mums & Bums Clinic in Centurion. We take the time to review your health history, answer your questions properly, and help you choose a method that fits you.
Is the Contraceptive Patch Right for You?
The contraceptive patch can be a good option for women who want reliable pregnancy protection with a weekly routine instead of a daily one. It offers steady hormone delivery, predictable cycles for many users, and the flexibility to stop or switch if it doesn’t suit your body. Like all contraceptives, it works best when it’s chosen with your health history, lifestyle, and future plans in mind.
If you’re weighing up your options or have had mixed experiences with pills or injections in the past, we’re here to help. At Mums & Bums Clinic, we offer personalised contraception consults where you can talk things through properly and leave feeling clear and confident about your choice.
Frequently Asked Questions About the Contraceptive Patch
What is the contraceptive patch called in South Africa?
Evra is the only contraceptive patch currently available in South Africa.
How effective is the birth control patch?
Over 99% effective with perfect use, and about 93% effective with typical use over a year. Effectiveness depends on changing the patch on time each week.
How much does the contraceptive patch cost in South Africa?
Usually between R200 and R260 per month.
Where do you place the birth control patch?
On the upper arm, lower abdomen, upper body, upper back, or buttocks. Not on the breasts.
What should I do if my patch falls off?
Replace it immediately. If it has been off for more than 24 hours or you’re unsure, use condoms for 7 days and check with a clinician. Never tape a patch back on.
Is the patch safer than the pill?
Both have similar safety profiles. The patch is not suitable for women who cannot use oestrogen.
Does the contraceptive patch cause weight gain?
There is no strong evidence that it causes more weight gain than the pill. Temporary bloating may occur early on.
Is the birth control patch the same as an oestrogen patch for menopause?
No. Menopause hormone patches do not prevent pregnancy.
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