EP 37: Is the Copper IUD Safe?

The Copper IUD, also called Paragard, is a small 100% hormone-free IUD (intrauterine device). It claims to be over 99% effective at preventing pregnancy.

It works differently than hormonal birth control by using one active ingredient—copper—instead of hormones. Sperm don’t like copper so they avoid the IUD, which prevents sperm from reaching an egg, which prevents pregnancy.

Once in place, the copper IUD provides continuous pregnancy prevention for up to 10 years.

It is made of soft flexible plastic wrapped with a thin layer of copper around the arms and stem.

How Effective?:

  • Copper IUD - 99%

  • Shot (Depo-Provera or Depo shot): 94%

  • Pill, patch, and vaginal ring: 91%

  • Condoms: 85%

Side effects: VERY COMMON

approximately 50% of all patients who have a Copper T-380A will discontinue it within 5 years

RARE side effect - Copper Toxicity:

  • Copper toxicity - Copper poisoning can happen, but in a majority of women using the IUD they don’t experience any problems associated with copper toxicity,

  • Copper toxicity can causes symptoms such as headaches, fever, fainting, nausea, vomiting, blood in your vomit, diarrhea, black stools, abdominal cramps, brown rings in the eyes, and jaundice. Some women report severe depression, suicidal thoughts, anger, brain fog, ect.

  • Patient stories: https://medtruth.com/articles/patient-stories/patients-poisoned-by-copper-toxicity-describe-neurological-impacts-of-iud/

  • Evidence does not suggest the IUD can cause copper toxicity. Few studies actually look into this link. The study most often referenced is a 1980 study by Dr. Krishnamurthy Prema that found no evidence of increased levels of copper in the bodies of women who wore copper IUDs for 24 months.


Important Safety Information from Paragard.com

  • IUDs, including Paragard, have been associated with an increased risk of pelvic inflammatory disease (PID). infection of the uterus or other reproductive organs that requires medical attention. Don’t use Paragard if you have a pelvic infection, certain cancers, a copper allergy, Wilson’s disease, or PID.

  • Perferation of uterus / dislodging (any IUD)

  • If you miss a period, have persistent abdominal pain, or if Paragard comes out, tell your healthcare provider (HCP). If it comes out, use back-up birth control.

  • Paragard may attach to or go through the uterus and cause other problems.

  • Pregnancy with Paragard is rare but can be life threatening and may cause infertility or loss of pregnancy.

  • Periods may become heavier and longer with spotting in between. Bleeding may be heavier than usual at first.

  • Paragard does not protect against HIV or STDs.

IUD removal:

  • You can have the copper IUD taken out whenever you want. You must get it taken out after 10 to 12 years which is when the copper IUD expires.

  • A provider must do the IUD removal, do not try to remove it yourself at home.

  • Copper IUD removal is a quick procedure. The provider gently pulls on the strings, and the IUD slips out easily with minimal or no discomfort.

  • Shouldnt effect long term hormones like regular birth control does (can take months to regulate)


1. Included 1,947 first-time copper IUD users. Over a one year period of use.

"Roughly 40% of women reported increased menstrual pain at 9 weeks. 67% reported heavier periods at 9 weeks. After 39 weeks of having the IUD 33 % reported still having increased menstrual pain, while there was a reduction of 49% reported still having heavier periods at 39 weeks" (Hubacher,Chen, Park. 2009).

Hubacher, D., Chen, P. L., & Park, S. (2009). Side effects from the copper IUD: do they decrease over time?. Contraception, 79(5), 356–362. https://doi.org/10.1016/j.contraception.2008.11.012

2. "Cu-IUD fragments were inserted into the uterine horns of female Wistar rats for 26 weeks (equivalent 15.42–17.33 years in humans). We tested copper at 20, 40, and 60 times the clinical dosages to study copper toxicity under severe conditions. Classic chronic systemic toxicity evaluations, including body weight, hematology, organ coefficient, and tissue reactions, were performed.

The body weight of the rats increased during the 26 weeks, which showed that the Cu-IUD implant had no effect on animal growth. Histological examinations and organ coefficients of the uterus and other major organs indicated no obvious systemic or local impairment. Blood tests confirmed that the hepatic and renal functions remained normal" (Zhao, Liu, Sun, Hu, Wang. 2017).

Zhao, X., Liu, Q., Sun, H., Hu, Y., & Wang, Z. (2017). Chronic Systemic Toxicity Study of Copper Intrauterine Devices in Female Wistar Rats. Medical science monitor : international medical journal of experimental and clinical research, 23, 3961–3970. https://doi.org/10.12659/msm.902137