Information for the patient

A copper-bearing intrauterine device (IUD) is a small flexible plastic device with a copper wire wound around its vertical shaft that is inserted into the uterus through the vagina and cervical canal during a gynecologic visit to prevent pregnancy.

Some models also have copper sleeves on the horizontal arms, and all of them have a knotted thread on the vertical shaft that hangs from the cervix towards the vagina to control its position and presence, as well as for its removal.

The copper IUD is an ideal contraceptive method for most the women of childbearing age, regardless of whether or not they have had children, and can be used until menopause is established.

Its contraceptive action is local and is mainly produced by copper, which causes a normal inflammatory reaction in the uterine mucosa that prevents nesting of the ovum. Copper is also a natural spermicide, so it limits the mobility of the spermatozoon, thus preventing it from fertilizing the egg.

The IUD with copper is a long-lasting contraceptive method whose effectiveness is very high. It is established that less than 1 pregnancy occurs for every 100 women during the first year of use. A small risk of pregnancy remains after the first year and continues as long as the copper IUD is in use.

The copper IUD can be used as emergency contraception if it is inserted within 5 days after unprotected intercourse.

In most cases, a copper IUD can be inserted at any time as long as there is no pregnancy. Usually, it is done with the menstruation because the cervical canal is naturally dilated, which facilitates insertion.

The gynecologist performs an examination to assess the size and position of the uterus, and thus determines the appropriate model and size.

Insertion of an IUD is usually painless, although it may cause some discomfort that can be prevented by taking pain killers 30 minutes before insertion.

In the first months after insertion, changes in menstrual patterns such as heavier and longer bleeding, irregular bleeding, intermenstrual spotting, and increased abdominal and sacral pain during menstruation may occur. It is normal and over time they tend to subside once the body gets used to its presence.

Removing it is usually very simple and fast, and can be done at any time with an immediate return to the fertility that existed before its use. However, it is convenient to remove it during menstruation because the cervical canal is naturally dilated.

If a new copper-bearing IUD is not inserted immediately after removal, contraceptive protection disappears.

Like insertion, removal is usually painless.

Both procedures are performed during a gynecologic visit.

• It is a contraceptive method of long duration and low rate of complications
• Returning to previous fertility immediately after removal
• Does not interfere with sexual intercourse, ovulation, or breastfeeding
• Does not contain hormones and does not require rest periods
• Does not cause side effects typical of medicalized devices (hormones)

The copper IUD has a very low rate of complications. Still, these can happen. Expulsion, pregnancy, uterine or cervical perforation, or certain infections are some of them. You may need additional medical treatment if any of these risks or complications occur.

You should always go to your doctor in case of any doubt or sign of an anomaly, especially if:

• You have a lack of menstruation or you could be pregnant
• Post-insertion symptoms worsen
• You have persistent abdominal pain, fever of unknown cause, or unusual or foul-smelling vaginal discharge
• You or your partner feel pain during intercourse
• You notice the thread is too long or you don't notice it, or you notice any other part of the IUD in your self-checks
• You feel itching or hives in genital area

Remember that:

• The copper IUD does not protect against STDs or HIV
• If you have any questions or concerns, you must contact your doctor
• You must go to your periodic check-ups
• You must perform the self-checks to control the thread of the IUD

There are two threads attached to the bottom of the IUD that sit high up in the vagina. These threads allow your doctor to remove the IUD when necessary, and also you to chek that the IUD remains correctly in place, since it is possible for your IUD to slip out or lose its correct position without you to notice it. Therefore, it is important for you to check your threads regularly, and very specially after each menstruation.

• Clean your hands with soap and water
• Wither sit or squat
• Insert your index or middle finger into your vagina until you touch the cervix (which should feel firm like the tip of your nose)
• If the threads feel longer or shorter than the last time, or you cannot feel them, it is possible that your IUD may have moved

If you cannot touch the threads, you should check your pads or tampons. Get in touch with your doctor and use a backup birth control method in the meanwhile. If the IUD had been expelled without you having noticed it, contraceptive protection may be impaired.

The copper IUD

Can be used at any time of childbearing age whether or not you have had children

• Does not increase the risk of contracting STDs or HIV
• Does not increase the risk of miscarriage when a pregnancy occurs after removal
• Does not produce sterility
• Does not cause birth defect
• Does not cause cancer
• Does not travel to other sites in the body such as the heart or brain
• Does not increase the risk of ectopic pregnancy