Paragard (Copper IUD)

1 What is a ParaGard (Copper IUD)?

ParaGard is an intrauterine device (IUD) that s inserted into the uterus to prevent long-term pregnancy.

It has a T-shaped plastic frame with a copper wire around the stem and two copper sleeves along the arms that continue to release copper to bathe the lining of the uterus.

ParaGard produces an inflammatory reaction inside the uterus that is toxic to sperm, thus preventing fertilization.

ParaGard is the sole copper IUD available in the United States. It is capable of preventing pregnancy for up to a decade after insertion.

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2 Reasons for Procedure

Here are the most common reasons to use a ParaGard (copper IUD).

This method of contraception is effective for a very long period of time. It can be used in premenopausal women of all ages, including teenagers.

The following are the benefits of ParaGard:

  • It eliminates the need to interrupt sex for contraception or seek partner compliance.
  • Can remain in place for ten years.
  • Can be removed at any time necessary, followed by a quick return to fertility.
  • It reduces the risk of endometrial cancer and possibly cervical cancer as well.
  • It can be used while breastfeeding, though the risk of perforation or expulsion when inserted soon after delivery, may be increased.
  • Does not carry the risk of side effects which can be associated with hormonal birth control methods.
  • Can be used for emergency contraception if inserted within five days after unprotected sex.

Your doctor may discourage the use of ParaGard for the following reasons:

  • If you had a previous problem with an IUD.
  • If you have uterine abnormalities that interfere with the placement or retention of ParaGard.
  • If you have uterine or cervical cancer.
  • If you have a pelvic infection, such as pelvic inflammatory disease.
  • If you are experiencing unexplained vaginal bleeding.
  • If you are allergic to any component of ParaGard.
  • If you have a disorder that causes the accumulation of too much copper in your liver, brain and other vital organs (Wilson's disease).
  • If you are at a high risk of a sexually transmitted infection, and will not use condoms.

3 Potential Risks

Along with using a ParaGard (copper IUD) comes potential risks. Less than 1 percent of women who use ParaGard will get pregnant within the first year of typical use.

If you get pregnant while using ParaGard, you are most likely to have an ectopic pregnancy, this is a situation that occurs when the fertilized egg implants outside the uterus, usually in the fallopian tube.

However, because ParaGard prevents most pregnancies, the general risk of having and ectopic pregnancy is lower than it is for other for other sexually active women who do not use contraception.

ParaGard does not offer any protection against sexually transmitted infections (STIs).

The following side effects can be attributed to ParaGard:

  • A backache.
  • Cramps.
  • Anemia.
  • Bleeding between periods.
  • Pain during sex.
  • Vaginal discharge.
  • Inflammation of the vagina (vaginitis).
  • Severe menstrual pain and heavy bleeding.

It is also possible to expel ParaGard from your uterus. You might not even feel it when it occurs.

You may be more likely to expel ParaGard in the following cases:

  • If you have never been pregnant.
  • If you have heavy or prolonged periods.
  • If you have severe menstrual pain.
  • If you have previously expelled an IUD.
  • If you are younger than 20.
  • If you had the IUD inserted immediately after childbirth or second-trimester abortion.

4 Preparing for your Procedure

Your doctor will make an evaluation of your overall health and also do a pelvic exam in order to prepare for the ParaGard (copper IUD). He or she may also recommend screening for STIs.

You can have ParaGard inserted at any time during a menstrual cycle if you have been constantly using another birth control method or you have not had sex since your last period.

If you are breastfeeding, have regular periods or have not been consistent when using birth control, you may need to take a pregnancy test before ParaGard is inserted or have it inserted during a period.

Taking a nonsteroidal anti-inflammatory drug, such as ibuprofen (Advil, Motrin IB, others), one or two hours prior to the procedure can help in reducing cramping.

5 What to Expect

Read on to learn more about what to expect before, during, and after your ParaGard (copper IUD).

Paragard is typically inserted in a doctor's office. During the procedure. A speculum will first be inserted into your vagina, then your vagina and cervix will be cleansed with an antiseptic solution.

After this, you doctor will use a special instrument to properly align your cervical canal and uterine cavity, and another tool to measure the depth of your uterine cavity.

Your doctor will then proceed to fold down ParaGard’s horizontal arms and place the device inside an applicator tube. He or she will then insert the tube into your cervical canal and carefully place ParaGard in your uterus.

When the applicator tube is removed, ParaGard will remain in place. Your doctor will then trim the ParaGard's strings so that they do not protrude far into the vagina and may also record the length of the strings.

During the insertion of ParaGard, as with other procedures, you might experience dizziness, fainting, nausea, low blood pressure or a slower than normal heart rate (bradycardia).

Your doctor will likely suggest that you remain laying down for a few minutes after the procedure in order to allow these side effects to pass. Rarely, it is also possible for the IUD to perforate the uterine wall or cervix.

After the procedure. You must check to feel that the ParaGard's strings are not protruding from your cervix after every period. It is fine to use tampons with ParaGard.

About a month after ParaGard is inserted, your doctor may re-examine you to make sure the device has not moved and check for any signs of infection.

While using ParaGard, contact your doctor immediately you have the following:

  • Signs and symptoms of pregnancy.
  • Unusual heavy vaginal bleeding.
  • Foul vaginal discharge.
  • Worsening pelvic pain.
  • Severe abdominal pain or tenderness.
  • Unexplained fever.
  • Possible exposure to a sexually transmitted infection.

It is also very important to contact your doctor immediately you think ParaGard is not in place anymore.

Call your doctor in the following cases:

  • You have breakthrough bleeding or bleeding after sex.
  • Sex is painful for you or your partner.
  • The strings are missing or suddenly seem longer.
  • You feel part of the device in your vagina or cervix.

Your doctor will check the position of the ParaGard and remove it if need be.

Removal. Paragard is usually removed in the doctor's office. Your doctor will likely use forceps to grasp the device's strings and proceed to pull gently.

The arms of the device will fold upward as it is removed from the uterus. During removal, it’s common to experience light bleeding and cramping. Removal can be more complicated in some cases.

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