Paragard

The U.S. Food and Drug Administration first approved Paragard for sale in 1984. Cooper Surgical manufactures and markets the IUD in the United States and is the only nonhormonal IUD available in the United States.

Paragard is a small flexible T-shaped piece of plastic wrapped in copper. Medical providers implant the device in a doctor’s office or clinic. This IUD can prevent pregnancy for up to ten years and can be removed any time if a woman wants to have a baby.

IUDs like Paragard are generally safe and very effective at preventing pregnancy. Once the IUD is inserted, it works without any further action from the patient.

Paragard works to prevent pregnancy by stopping sperm from reaching the egg. Unlike hormonal IUDs like Mirena or Skyla, Paragard doesn’t contain hormones. Its only active ingredient is copper.

Copper is toxic to sperm and makes it nearly impossible for the sperm to get to the egg.

Insertion

Paragard insertion is an outpatient procedure and doesn’t require surgery, according to Paragard’s prescribing information. It only takes a few minutes.

Medical providers load the IUD into a tube that folds the plastic arms down. The tube containing the IUD is then inserted into the uterus through the vagina.

Once properly positioned, the IUD is released into the uterus. The provider may or may not use a local anesthetic.

The provider may use an ultrasound to make sure the IUD is properly positioned. Threads from the IUD will protrude about 3 to 4 cm into the vagina.

Removal

A patient may have their provider remove Paragard any time prior to 10 years after insertion. Like insertion, Paragard removal is a simple outpatient procedure.

Providers will use a speculum to visualize the cervix. Then, they use forceps to gently tug on the exposed threads. The arms of the IUD will fold upwards as the IUD is taken out of the uterus.

During removal, the patient may feel some pain or have some bleeding, according to the prescribing information. They may also suffer from dizziness, seizures or slower than normal heartbeat.

If Paragard breaks or becomes embedded in the uterus, removal may be more complex. A 2022 research study identified 4,144 breakage reports for copper versus 2,140 for hormonal IUDs. Among the 170,215 adverse events reported, breaks were disproportionately higher for copper (9.6%) versus hormonal (1.7%) IUDs.

Paragard is generally safe and well tolerated, but it isn’t without side effects.

Most common side effects are minor and serious side effects are rare. According to Cooper Surgical, Paragard is the only IUD that has been clinically proven safe for over 30 years.

Serious Side Effects

Serious side effects with Paragard are more rare but can occur. These include ectopic pregnancy (pregnancy outside of the uterus), septic abortion, severe infection called sepsis, pelvic inflammatory disease, and perforation or embedment in the uterus.

Does Paragard Cause Weight Gain?

Because Paragard is 100 percent hormone free, it doesn’t cause hormone-related side effects such as weight gain like hormonal birth control. It’s only active ingredient is copper.

Paragard is more than 99 percent effective. One of the reasons it’s so effective is that women don’t have to remember to take a pill or do any other action to prevent pregnancy. Once the IUD is inserted, it can prevent pregnancy for up to 10 years.

Paragard can even be used for emergency contraception, according to Planned Parenthood. If it is inserted within 120 hours or five days after unprotected sex, it works as emergency contraception and is more than 99.9 percent effective.

Pregnancy with Paragard is rare, but it can cause infertility or loss of the pregnancy. It may even be life threatening.

According to Planned Parenthood, an IUD can cost anywhere from $0 to $1,300. But because of the Affordable Care Act, most people with insurance can get Paragard for little to no cost.

Patients can check with their insurance company to see if Paragard is covered. If it’s not covered as a medical benefit, it may be covered as a pharmacy benefit, according to Cooper Surgical.

Paragard may also be offered for free or at a low cost for people with Medicaid or through other government programs. Contact your local Planned Parenthood health center or local health department for details.

Some people have filed Paragard IUD lawsuits claiming the device can break upon removal, causing serious injuries. Injuries claimed in lawsuits include surgery to remove broken pieces of the device, pain and infertility.

On Dec. 16, 2020, judges on the United States Panel on Multidistrict Litigation issued a transfer order to centralize cases from courts across the country in the Northern District of Georgia. There are about 80 cases pending and attorneys expect hundreds more.

Defendants include Teva Pharmaceuticals USA, Inc., Teva Women’s Health, Inc., Teva Women’s Health, LLC, Teva Branded Pharmaceutical Products R&D, Inc., The Cooper Companies,Inc. and CooperSurgical, Inc.