Paragard
Paragard (copper IUD) is a hormone-free intrauterine device (IUD) that's used to prevent pregnancy. It's a small, T-shaped device that's inserted into the uterus (womb) by a healthcare provider. Paragard (copper IUD) is convenient to use because you can leave it in place for up to 10 years. It's also one of the most effective forms of birth control available. Some common side effects of Paragard (copper IUD) include heavier or longer menstrual periods and bleeding and spotting in between each period.
What is Paragard (copper IUD)?
What is Paragard (copper IUD) used for?
To prevent pregnancy
How Paragard (copper IUD) works
Paragard (copper IUD) is a contraceptive, which means it helps prevent pregnancy. It works by continuously releasing a small amount of copper into the uterus. Some of the ways it's thought to do this is by disrupting sperm movement, fertilization of an egg, and possibly implantation (attachment of a fertilized egg to the uterus).
Drug Facts
More on Paragard (copper IUD) essentials
What are the side effects of Paragard (copper IUD)?
Common Side Effects
- Pain and cramping, including menstrual cramps (up to 12%)
- IUD falling out of place (up to 6%)
- Longer menstrual periods
- Spotting between menstrual periods
Other Side Effects
- Dizziness, tiredness, and other symptoms of anemia
- Backache
- Pain during sex
- Itching and pain in the vagina from inflammation
Serious Side Effects
- Sepsis: feeling confused, trouble speaking, fever, dizziness, chills, clammy skin, fast heart rate, not making much urine
- Serious infection: severe pain, fever, body aches, chills, feeling weak, flu-like symptoms
- Tear in the uterus: excessive pain, vaginal bleeding, can't feel IUD threads
Source: Prescribing Information
More on Paragard (copper IUD) side effects
Pros and cons of Paragard (copper IUD)
Pros
Over 99% effective at preventing pregnancy
Doesn't contain any hormones
Each Paragard (copper IUD) can be used for up to 10 years at a time.
Can be removed by a healthcare provider at any time
Cons
Must be placed into the uterus by a healthcare provider
Placement procedure can be uncomfortable
Might cause heavier or longer periods
Doesn't protect against sexually transmitted diseases (STDs)
Pharmacist tips for Paragard (copper IUD)
The placement of Paragard (copper IUD) is typically quick, but it can cause some cramping. Talk to your provider about ways to treat your cramps if this occurs.
It's possible to feel faint, nauseous, or dizzy right after getting the Paragard (copper IUD) inserted. If this happens, let your provider know. They might ask you to lie down until you feel better. If you feel dizzy, make sure you stand up slowly.
You and your partner shouldn't be able to feel Paragard (copper IUD). But you should be able to feel the strings at the top of your vagina. If you're able to feel any part of Paragard (copper IUD) other than the strings, this means it has fallen out of place and you should contact your healthcare provider to check for you. When Paragard (copper IUD) isn't in the right place, it can work less well to prevent pregnancy.
You can check to make sure the Paragard (copper IUD) is in place by doing a monthly self-check. Don't pull on the threads because this could cause the IUD to fall out of place. If you don't feel the strings, if the strings feel like they're a different length, or if you feel any other part of Paragard (copper IUD), use a back-up method of birth control and call your provider. They can check to make sure it's still in the right position.
You can use tampons while you have the Paragard (copper IUD) in place.
Paragard (copper IUD) lasts up to 10 years, but you can get it removed by a healthcare provider at any time. If you want to use Paragard (copper IUD) longer than 10 years, you must have the previous one removed on or before 10 years since you got it placed. Then, your provider can place a new Paragard (copper IUD).
You can become pregnant as soon as Paragard (copper IUD) is removed by your healthcare provider. If you don't want to become pregnant, you should use another method of birth control right away after getting Paragard (copper IUD) removed. Discuss the best birth control method with your provider.
Contact your provider if you miss your period, have severe vaginal bleeding, experience pain during sex, or have flu-like symptoms. They can check to make sure you're not pregnant or have an infection from Paragard (copper IUD).
It's safe to use Paragard (copper IUD) while you're breastfeeding. But keep in mind that having it placed while breastfeeding might raise your risk of it damaging your uterus. Let your provider know right away if you feel pain or experience bleeding after the Paragard (copper IUD) is in place.
Frequently asked questions about Paragard (copper IUD)
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What are the risks and warnings for Paragard (copper IUD)?
Paragard (copper IUD) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Changes in bleeding pattern
Paragard (copper IUD) can cause you to have heavier and longer menstrual periods. Having the IUD in place can also cause you to have more bleeding in between periods (spotting). The risk of these changes in bleeding pattern is higher during the first year of Paragard (copper IUD) placement, but the risk lowers over time. If you have heavy bleeds, let your provider know right away so that they can check to make sure you're okay. Sometimes, you might need to stop using Paragard (copper IUD).
Risks with becoming pregnant with Paragard (copper IUD) in place
Although rare, it's possible to become pregnant while Paragard (copper IUD) is in place. If you think you might be pregnant, contact your provider right away because you'll need to get your IUD removed. Having Paragard (copper IUD) in place while pregnant can raise your risk for complications, like infections, miscarriage, and early labor or delivery of your baby.
Additionally, a pregnancy that occurs while Paragard (copper IUD) is in place is more likely to be an ectopic pregnancy (pregnancy outside of the womb) than a pregnancy that happens in females without Paragard (copper IUD). However, keep in mind that this is very rare. Symptoms of an ectopic pregnancy include low back pain, abnormal vaginal bleeding, and cramping. If you experience any of these symptoms, contact your provider right away.
Sepsis (complication from an infection)
In some rare cases, a life-threatening infection can occur within a few days after getting Paragard (copper IUD) inserted. And sometimes, it can lead to sepsis, a serious, whole-body reaction to the infection. Get medical help right away if you experience severe pain within hours after the procedure, fever, chills, or other signs of an infection. Delaying treatment of such infections can be deadly.
Pelvic inflammatory disease and inflammation in the uterus
Risk factors: History of pelvic inflammatory disease | History of inflammation in the uterus | History of or currently have a sexually transmitted infection (STI) | Multiple sex partners | Conditions that weaken the immune system | Intravenous (IV) drug use
Though rare, inserting Paragard (copper IUD) can raise your risk of pelvic inflammatory disease (PID) or inflammation of the lining of your uterus. If you have these medical conditions already, you can't use Paragard (copper IUD). And if you develop these conditions while using Paragard (copper IUD), your provider will need to remove your IUD. Contact your provider right away if you experience lower stomach or pelvic pain, smelly vaginal discharge, unexplained bleeding, fever, or vaginal sores. If left untreated, PID can lead to infertility (not being able to have children), the need for surgery, infection, or death.
Difficult removal of Paragard (copper IUD)
It's possible for Paragard (copper IUD) to attach to tissue in the wall of the uterus, making it harder to remove it. In some cases, surgery might be needed to remove the IUD. If you have concerns, speak with your provider.
Tear in the uterus
Risk factors: Currently breastfeeding
In some rare cases, Paragard (copper IUD) can cause a tear or hole in the cervix or uterus while it's being inserted. If this happens, it could lead to a higher chance of pregnancy, scarring, inflammation in the tissue of your belly, infection, blockage in your intestines, or damage to nearby organs. One study showed that there might be a higher risk of this happening in females who were breastfeeding. Contact your provider right away if you experience excessive pain or vaginal bleeding during or after placement of Paragard (copper IUD) or if you can't feel the threads after placement.
Paragard (copper IUD) falling out
Risk factors: Recently have given birth
It's possible for Paragard (copper IUD) to fall out of place, which can cause it to work less well to prevent pregnancy. The risk of this happening might be higher if you've recently given birth. Contact your provider if you can't feel the threads or if you can feel any other part of Paragard (copper IUD).
Tissue damage from certain medical procedures or scans
Before having any medical procedures or scans done, always tell your provider you're using Paragard (copper IUD) and that it's in place. Some medical equipment that contain high levels of radiofrequency energy might cause tissue damage in females who have Paragard (copper IUD).
Paragard (copper IUD) dosage forms
Typical dosing for Paragard (copper IUD)
The Paragard (copper IUD) is inserted into the uterus by a healthcare provider. It can remain in place for up to 10 years.
Paragard (copper IUD) contraindications
Pregnancy
Abnormal uterus
Inflammation of the uterine lining (endometritis) in the past 3 months
Uterine or cervical cancer
Undiagnosed vaginal bleeding
Untreated inflammation of the cervix or vagina
Lower genital tract infection
Conditions that make you more likely to get a pelvic infection
A previously placed IUD that hasn't been removed
Allergy to copper
What are alternatives to Paragard (copper IUD)?
Prevent pregnancy for up to 8 years
Relieve heavy menstrual periods for up to 5 years
What is the latest news about Paragard (copper IUD)?
References
Best studies we foundBritton, L. E., et al. (2020). CE: An evidence-based update on contraception. The American Journal of Nursing.
Centers for Disease Control and Prevention. (2023). Contraception.
CooperSurgical, Inc. (n.d.). Can I use tampons with the Paragard IUD?
CooperSurgical, Inc. (n.d.). Maintaining your Paragard.
CooperSurgical, Inc. (n.d.). What if I change my mind and want to become pregnant?
CooperSurgical, Inc. (n.d.). Will my partner or I be able to feel the Paragard IUD during sex?
CooperSurgical, Inc. (2019). Paragard T 380A- copper intrauterine device [package insert]. DailyMed.
CooperSurgical, Inc. (2020). Paragard® (intrauterine copper contraceptive) [package insert].
Federal Communications Commission. (n.d.). RF safety FAQ.
Hubacher, D., et al. (2009). Side effects from the copper IUD: Do they decrease over time? Contraception.
Kaneshiro, B., et al. (2010). Long-term safety, efficacy, and patient acceptability of the intrauterine Copper T-380A contraceptive device. International Journal of Women's Health.
Nelson, A. L., et al. (2016). New developments in intrauterine device use: Focus on the US. Open Access Journal of Contraception.
Roy, S., et al. (1981). Role of prostaglandins in IUD-associated uterine bleeding--Effect of a prostaglandin synthetase inhibitor (ibuprofen). Obstetrics and Gynecology.
Taylor, M., et al. (2023). Endometritis. StatPearls.
You and Your Hormones. (2019). Prostaglandins.
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