What You Need To Know About The Copper IUD

Since I talk about the effects of hormonal birth control and how to transition off so frequently, I often get asked about the copper IUD. I had the copper IUD for seven years since I wanted a non-hormonal form of birth control and wasn’t ready to rely 100% on the Fertility Awareness Method (FAM) yet. In this post, I’ll be sharing the history of the copper IUD, how it impacts the body, possible side effects, and how to be healthy with a copper IUD.

History of the Copper IUD

The first IUD was made in 1909 by a German physician Richard Richter. His IUD was made of silkworm gut but wasn’t widely used (wonder why). IUDs started to get more popular in the US in the 1950s as they began to improve the design making them easier to insert and remove. The copper IUD was invented in the 1960s and made the T-shape design more popular since it fit better inside the uterus, and would reduce the rates of IUD expulsion (cringe). The physician that invented the copper IUD, Howard Tatum, discovered that copper could be an effective spermicide and that’s when the copper IUD was born. The hormonal IUD was invented in the 1960s and 1970s, but I’ll go into that in another post.

How It Works

The copper IUD is a plastic device wrapped in copper (see image above) inserted into your uterus to prevent pregnancy. Insertion takes place in your doctor’s office and only takes a few minutes. When I had my copper IUD put in, it hurt. I’ve since had friends and clients who have taken prescription medication before insertion to help with the pain. Either way, it’s a quick process. You will likely have cramping after, so if you plan on getting one, plan to rest of the day post-insertion. The IUD has two little strings that make it easy to take out. You have to go back into your doctor’s office for removal, but it’s another simple procedure. I didn’t experience much pain when they took it out and just had a little spotting after.

How exactly the copper IUD prevents pregnancy isn’t super clear. The copper coil continuously releases copper into the uterus. It creates an inflammatory reaction that is supposed to be toxic to sperm and prevent fertilization. 

Prevents Pregnancy Without Hormones

Unlike hormonal birth control, the copper IUD does not contain hormones and does not technically change your hormones (more on that below). It also does not suppress ovulation (yay!).

How exactly the copper IUD prevents pregnancy isn’t super clear. The copper coil continuously releases copper into the uterus. It creates an inflammatory reaction that is supposed to be toxic to sperm and prevent fertilization. 

The copper ions also impair sperm motility, change the consistency of cervical mucus, and thin the endometrial lining. This prevents implantation from happening and is why the copper IUD can be placed after pregnancy has occurred to be used for emergency contraception, so that the egg does not implant. 

The presence of something in your uterus prevents embryo implantation in general as well. 

The copper IUD is effective as soon as it’s placed in your uterus and is safe to keep in for up to 10 years. The failure rate is only .6% making it the most effective method of birth control. This all sounds super amazing, but I’m going to be honest. It’s not all sunshine and roses with the copper IUD. Below are some of the side effects, and then I go through the pros & cons to give you more perspective on if it’s right for you (only you know that).

Side Effects of the Copper IUD

Although the copper IUD is the most popular form of birth control in the world, there are some side effects that I feel women should feel aware of when deciding if it’s right for them.

Pain Upon Insertion

Typically, there is pain when the IUD is inserted and cramping and/or backaches for a few days after. This is all considered a normal reaction. 

Spotting Between Periods/Irregular Periods

 There is a risk of spotting between periods with any IUD and the copper IUD and bleeding for a few months after insertion. This is technically considered “normal.”

Heavier and/or Longer Periods

Research has shown that the copper IUD increases period blood loss by 20-50% for the first 12 months. I experienced the increase the entire time I had my copper IUD. Everyone is different.

Cramping During Your Periods

I’m sorry, but this is an understatement. One of the main reasons I got mine out (after 7 years) was the intense period cramps. I would be doubled over in pain. It was worth it for a long time because I didn’t have to use hormonal birth control, but eventually it wasn’t. In fact, a study shows that pain does not always clear up over time for everyone.

Expulsion–it might come out

This is always a risk with an IUD, especially within the first month, but decreases the longer you have it in. Some signs of expulsion include pain, spotting, and/or no longer feeling the string (or if it gets longer).

Pelvic Inflammatory Disease

Less than 1% of women experience this from the copper IUD, and it only occurs if you have a pre-existing infection of gonorrhea or chlamydia. Your doctor should screen for those before insertion. Mine did require testing before I got it in.

Bacterial Vaginosis

Bacterial overgrowth in the vagina, aka bacterial vaginosis, has been shown to be increased in IUD users; however, more research is needed. If you begin to get a fishy-smelling vaginal discharge, then this is a sign, there is an imbalance. Learn more about how IUDs impact the vaginal microbiome in this article.

Copper Excess

There are quite a few studies that show that copper levels are increased in copper IUD users vs. those that do not have the copper IUD. There’s also a study that shows copper accumulation in the fallopian tubes that could potentially be causing inflammation. The problem is that these studies aren’t showing toxic levels, so we aren’t sure how it impacts the body, but some women report anxiety and depression when using copper IUD. Toward the end of my copper IUD journey, I experienced increased depression and anxiety (not my norm) and could not handle it, so I got mine removed.

The Paragard website says that these symptoms (cramping/heavy periods) should clear up for most women after 2-3 months, but I did not experience this. And most doctors I’ve talked to warn you that it’s common to have heavy periods and more cramping the entire time (this is usually when they are trying to convince you to use a hormonal option–at least in my experience).

If you have issues with your copper IUD, such as the commonly seen increased bleeding and pain, your doctor will likely recommend Ibuprofen or other anti-inflammatory drugs. This study showed that even when following the recommended doses of Ibuprofen, it did not reduce removal rates. All this to say, listen to your body.

If you have Wilson’s disease, which impacts how you process copper, you should not get the copper IUD. 

Copper IUD & Estrogen Excess

Research on rats (I couldn’t find anything done on humans for estrogen levels) shows that the copper IUD increases the uptake of estrogen. There is a theory that estrogen and copper have an affinity for each other. 

There is also research that shows that estrogen and copper have an affinity for each other. Estrogen raises copper and copper raises estrogen. This is why women that take hormonal birth control that contain estrogen (the synthetic form) often have higher copper levels. And low copper is associated with low estrogen levels. 

Copper is a very important mineral that powers thousands of functions in the body. The issue with hormonal birth control and the copper IUD raising copper levels is that they are actually making copper unavailable for use in the body. This leads to low zinc and iron levels

If you want to get a copper IUD, consider having your doctor test your copper and zinc levels prior to insertion to monitor any changes. Zinc and copper compete for each other, so you don’t just want to supplement with high levels of isolated zinc without testing your levels. 

Pros & Cons

I recommend making your own list of pros and cons if you are considering getting the copper IUD. Below is a list from my perspective as a women’s health practitioner and personal user.


  • Non-hormonal birth control that allows you to ovulate.
  • You insert it and forget it and can leave in for up to 10 years.
  •  Your partner can’t feel it.
  •  Women of any age can get this (even if you haven’t had kids).
  •  Your fertility returns to normal as soon as you remove it.
  •  It’s the most effective form of birth control–failure rate is .6%.


  • Painful when inserted.
  • Can lead to painful, heavy periods.
  • Can potentially lead to copper excess and the unwanted symptoms that come with that.
  • Increases your risk for bacterial vaginosis.
  • Increases the uptake of estrogen.
  •  Risks of expulsion, perforation, though small, are present.
  • Cannot use it if you have current infections.
  • You might have to pay for it–some insurance companies cover, and some don’t. I had to pay $150 for mine, but I had it in for seven years and felt it was worth it.

That wraps it up! Again, I can’t say this enough, you have to do what works for you. If you have a history of painful, heavy periods, or maybe low iron–probably not the best option. If you don’t have a history of period problems, then this could be a good fit.



Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

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