Copper IUD

What is the copper IUD?

• The copper IUD (intra-uterine device) is a small, T-shaped piece of plastic that is wrapped with copper wire that a clinician inserts into your uterus.
• This factsheet is about the copper IUD. For information on the hormonal IUD, see The Hormonal IUD factsheet.

How does the copper IUD prevent pregnancy?

• In order to get pregnant, sperm must enter your vagina*, swim up into your uterus and fertilize an egg that has been released from your ovaries during ovulation. Having the combination of the plastic IUD structure and the copper wrapped around it in your uterus changes the chemistry of the uterus and makes it hard for sperm and eggs to survive and meet.
• The copper IUD can be used as emergency contraception to prevent pregnancy up to 7 days after sperm has entered your vagina.

How effective is the copper IUD?

• The copper IUD is 99% effective. This means that if 100 people had the copper IUD in for one year, only one person would get pregnant.

How do you use the copper IUD?

• A clinician will insert the IUD into your uterus.
• The copper IUD looks like a plastic T with strings attached at the bottom. The plastic part stays in your uterus, and the strings hang outside your cervix (the opening of your uterus). These strings are short and will not hang outside your vagina. You can feel them if you put a finger into your vagina and touch your cervix, but the strings cannot not usually be felt with a penis.*
• It is normal for the strings to move around a bit or seem to change length. If you are curious, you can check your strings by feeling for them with your finger(s).
• You can have a copper IUD removed by a clinician whenever you are finished with it, or leave it in place for up to 3, 5 or 10 years depending on the model.

*We know that these aren’t the words everyone uses for their bodies (e.g. trans folks), and support you using the language that feels best for you.

How to start using the copper IUD

• If you decide, along with your clinician, that the copper IUD is right for you, your clinician will write you a prescription. You can purchase your IUD at a pharmacy (approximately $80 – $350) or at a sexual health clinic that sells IUDs (approx. $50 – $175).
  • PPT’s Health Services inserts IUDs and sells the copper IUD for $44.50 (3 or 5 year models) or $57.50 (10 year model).
• On the day of the insertion, your clinician will need to do a pelvic exam and test you for some sexually transmitted infections (STIs). They will also want to rule out pregnancy.  There can be increased risks if you are pregnant before the device is inserted.
• On the day of the insertion, your clinician may do a pelvic exam and test you for some sexually transmitted infections (STIs). They will also want to make sure you are not pregnant. There can be increased risks if you are pregnant when the IUD is inserted.
• It may be easier to get an IUD inserted while you are on your period, but this is not always necessary.
• Your clinician will measure your uterus with a thin rod called a sound and insert the IUD into your uterus using a thin (less than 5mm) applicator tube.
• During insertion, you will likely have strong cramping, more painful than normal period cramps. Your clinician may use a tool to hold your cervix steady that can feel like a sharp pinch. Talk with your clinician about pain management options. Some people take an over-the-counter painkiller before their insertion. Some clinicians offer local anesthetic (a numbing spray or injection to the cervix) for the insertion. A small number of clinics offer insertion with sedation.
• Your clinician may want to put in the IUD while you are on your period, but this is not always necessary.
• After insertion, you may feel some discomfort and cramping. This usually goes away within a few days. Your clinician will discuss ways to manage any discomfort you may have after the insertion at the time of your visit.
• You will be protected from pregnancy right away.
• It is recommended to avoid inserting anything into your vagina, including fingers, toys, penises, tampons, and menstrual cups for at least 48 hours after the insertion.

What are the side effects of the copper IUD?

• You may have heavier periods.
• Menstrual (period) cramps may be more intense or painful.

Advantages of the copper IUD

• It can be used for up to 3, 5, or 10 years, depending on the model.
• You don’t have to do anything just before or after you have sex.
• It is a relatively “hands off” method. You only need to have a clinician check for your strings when you get a routine pelvic exam to make sure the IUD is in place.
• There are no hormonal side effects. People who can’t or do not want to take hormonal birth control can use this method.
• It doesn’t affect your ability to get pregnant in the future.
• You don’t have to rely on your partner(s) to use it.
• If you want to keep your birth control use private, there is no packaging to be found.
• Over the course of 3, 5, or 10 years, the monthly cost of the IUD works out to be cheaper than other options like the pill, patch or ring.

Disadvantages of the copper IUD

• A clinician must insert and remove the IUD.
• Insertion may be uncomfortable or painful. Insertion may be harder in people who have never given birth, but it is still possible.
• There is small chance (2-10%) your body could expel (push out) your IUD, most commonly in the first 6 weeks after insertion. If your copper IUD expels and you want another one inserted, you would have to pay for a new IUD – the old expelled IUD cannot be reinserted.
• There is a very small chance that the IUD could break through the wall of your uterus while it is being put in. (Fewer than 1 in 1000 insertions). Your uterus should heal if this happens.
• If you have an STI or other infection when you have your IUD inserted, or if you get one within the first 3 weeks of having an IUD, you have a slightly higher risk of developing pelvic inflammatory disease (PID). PID can be painful and can lead to infertility. The risk of PID after 3 weeks is not significantly higher than for people without IUDs.
• IUDs make any pregnancy very unlikely but with IUDs in place a higher proportion of the pregnancies that do happen are ectopic (they happen outside of the uterus). Overall, the rate of ectopic pregnancy is lower with an IUD than in the general population.
• You may experience side effects.
• It doesn’t protect you from STIs.