Xulane works by delivering two hormones through your skin that stop your ovaries from releasing eggs, thicken your cervical mucus to block sperm, and thin your uterine lining — a three-layer defense against pregnancy.

What Xulane Does in Your Body

Xulane is a transdermal patch, which means it delivers medication directly through your skin into your bloodstream. Each patch contains two synthetic hormones:

• Norelgestromin (150 mcg/day) — a progestin
• Ethinyl Estradiol (35 mcg/day) — an estrogen

These are the same types of hormones found in combination birth control pills, but instead of swallowing a pill daily, you absorb them continuously through your skin.

Think of it like a slow-release nicotine patch — but instead of delivering nicotine, Xulane delivers a steady stream of pregnancy-preventing hormones 24 hours a day, 7 days a week.

The Three-Layer Defense

Xulane prevents pregnancy through three complementary mechanisms:

1. Stopping ovulation (the main event)

The most important thing Xulane does is tell your brain to stop triggering ovulation. Here's how: normally, your pituitary gland releases hormones called FSH and LH that signal your ovaries to mature and release an egg each month. The steady dose of Norelgestromin and Ethinyl Estradiol from the patch suppresses these signals. No egg release means no egg for sperm to fertilize.

Think of it as putting your ovaries on pause — they still function, but they stop their monthly egg release as long as you're using the patch.

2. Thickening cervical mucus

Even if ovulation were to somehow occur, Xulane has a backup plan. The progestin (Norelgestromin) thickens the mucus at the opening of your cervix, creating a barrier that sperm have a very hard time getting through. Imagine trying to swim through honey instead of water — that's essentially what sperm face when cervical mucus is thickened by the patch.

3. Thinning the uterine lining

As a final layer of protection, the hormones thin the endometrium (the lining of your uterus). This makes it much less likely that a fertilized egg could implant and develop. This is also why many women on Xulane experience lighter periods during their patch-free week.

How Long Does Xulane Take to Work?

This depends on when you start it:

• If you apply your first patch on the first day of your period: You're protected against pregnancy right away.
• If you start on any other day ("Sunday start" or otherwise): Use a backup method of contraception (like condoms) for the first 7 days.

Each individual patch starts delivering hormones within hours of application. Hormone levels in your blood reach effective levels within about 48 hours and remain steady throughout the 7-day wear period.

How Long Does Xulane Last?

Each patch is designed to deliver hormones effectively for 7 days. After that, hormone levels begin to decline and you need to apply a new patch.

If you forget to change your patch, there's a small grace period — studies show hormone levels remain protective for about 1 to 2 days beyond the 7-day window. However, this is not something to rely on. Change your patch on time, every time.

After you stop using Xulane, fertility returns quickly. Most women begin ovulating within 1 to 3 months of discontinuing the patch.

What Makes Xulane Different From Similar Medications?

Xulane belongs to the family of combined hormonal contraceptives (CHCs), but its delivery method sets it apart:

Xulane vs. Birth Control Pills

• Frequency: Xulane is weekly; pills are daily. If you struggle to remember a daily pill, the patch may be more convenient.
• Hormone delivery: The patch delivers a constant, steady stream of hormones. Pills cause peaks and valleys as each dose is absorbed and metabolized. Some women find the steady delivery reduces side effects like nausea.
• Estrogen exposure: Studies show the patch delivers about 60% more total estrogen exposure than a typical 35 mcg pill. This higher exposure is why the patch has specific BMI and weight considerations.

Xulane vs. Twirla

Twirla is a newer contraceptive patch with a lower hormone dose — it delivers Levonorgestrel (120 mcg/day) and Ethinyl Estradiol (30 mcg/day). If your doctor is concerned about estrogen exposure, Twirla might be an alternative worth discussing.

Xulane vs. NuvaRing

NuvaRing is a vaginal ring that delivers Etonogestrel and Ethinyl Estradiol. Like the patch, it's a non-daily method — you insert it once and leave it for 3 weeks. The ring delivers lower systemic estrogen levels than the patch, which may make it preferable for some women.

Xulane vs. Zafemy

Zafemy is another generic version of the original Ortho Evra patch. It contains the same hormones as Xulane at the same doses. The main difference is the patch size — Zafemy's patch is slightly smaller. Both work the same way.

Final Thoughts

Xulane's mechanism is straightforward: it delivers a steady dose of two hormones through your skin that work together to prevent pregnancy in three ways — stopping ovulation, blocking sperm, and thinning the uterine lining. The weekly application schedule and transdermal delivery make it a practical choice for women who want effective contraception without a daily pill.

To learn more about what Xulane is and how to use it, or to check potential side effects, explore our other Xulane guides. Ready to fill your prescription? Find Xulane in stock near you on Medfinder.