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Copper Intrauterine Device (IUD) – Paragard®

Patient Education
Oct 14, 2026

What is an IUD?

  •  It is a type of birth control that does not have hormones.  
  • It is known as a long-acting reversible contraceptive (LARC) method of birth control. 
  • You can get pregnant right after an IUD is taken out. 
  • Paragard® is a copper IUD. It can stay in your uterus for up to 10 years. It is very effective at preventing pregnancy. 
  • A copper IUD can also be used for emergency contraception when put in within 5 days of unprotected sex. 
  • Your provider can help you choose the right IUD for you.    

A copper IUD might be a good choice if you:

  • Want birth control that is very effective at preventing pregnancy.
  • Want birth control that is longer acting and does not need daily, weekly, or monthly maintenance. It will last up to 10 years, but you can have it taken out at any time.
  • Do not want or cannot have hormones (such as having a history of breast cancer).
  • Do not want to be on a birth control that could stop or lessen your period. 
    o  A copper IUD will not stop your periods. It can make them heavier and cause more cramping. 
    o  You should not have bleeding or spotting when you do not expect it.

What are the benefits of a copper IUD?

  • It works right after it is put in.
  • Less than 1 in 100 people who use it get pregnant during the first year of using it.
  • It is very safe. 
  • You do not need to take birth control each day.
  • There are few side effects, aside from changes in periods.  
  • The IUD does not have hormones. Although hormones for contraception are very safe and effective, some people want to use a non-hormonal method.
  • You can take the IUD out when you want. Your ability to get pregnant comes back very soon. 
  • If you use an IUD for many years, it can cost less overall than many other types of birth control. There are no costs after it is put in.

What are the downsides of an IUD?

  • It does not protect against sexually transmitted infections (STIs). Only condoms protect from STIs. You should still use a condom to protect against STIs.
  • Many people get heavier or longer periods. They often have more cramps or worse cramps. This is the biggest reason some people have it taken out.
    o    Because a copper IUD can make periods heavier, check your Paragard® strings every month after your period to make sure the strings are there.
  • Very rarely it will come out by itself (expulsion). You need a new IUD if this happens. Call your provider if you are worried that it has come out. 
  • The first cost is higher than the cost of other methods. Many IUDs are covered by insurance. 
  • Only a provider can put it in. IUDs are often taken out by providers in the clinic.

What if I get pregnant while using an IUD?

  • It is very unlikely, but you can get pregnant. 
  • Take a urine (pee) pregnancy test if you miss any periods or feel like you may be pregnant. If you have a positive test, call the clinic right away. Your provider needs to see you as soon as possible.

What can I expect after a copper IUD is put in?

It may take some time for your body to adjust to hormone-free protection. Right after it is put in, you may feel:

  • Dizzy
  • Faint or lightheaded
  • Pinching and cramping
  • Sick to your stomach 

The first 1 to 3 months, you may have: 

  •  Irregular bleeding, such as random spotting to bleeding like a period
  • Cramping that comes and goes
    • If you have cramping, you may take:
      • Ibuprofen:  600 mg (milligrams) every 6 hours
      • Acetaminophen (Tylenol®) 650 mg every 4 to 6 hours

Talk to your provider about follow-up plans.

After the first 3 months:

  • Your body should be used to the copper IUD. Each person is different though. If you have questions or concerns, talk with your provider.
  • Remember: Your periods can be heavier, and you can have more cramping.

Checking your strings

  • A copper IUD is designed to fit comfortably and stay inside your uterus.
  • Check the strings each month after each period stops.
    1. Put your finger in your vagina. Feel for your cervix.  
    2. The strings should feel like 1 piece of thread on the cervix.
  • Make an appointment with your provider right away if:
    • You think the copper IUD has moved. 
    • You can no longer feel the strings. 
  • Use backup birth control if your strings are missing. Do this until you see your provider.

A copper IUD does not protect against STIs or human immunodeficiency virus (HIV). Use a condom with new partners or if you are concerned about being exposed.

Call your provider if you:

  •  Have heavy bleeding with your period.
  • Have severe belly pain.
  • Have a temperature of 100.4 F (38.0 C) or higher.
  • Think the copper IUD has moved.
  • Cannot feel the strings.