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Paragard Side Effects

Common Paragard IUD side effects include longer and heavier periods, pain during sex, backache and anemia. Serious Paragard side effects include embedment, uterus perforation, ectopic pregnancy and miscarriage. See your doctor immediately if you experience these Paragard side effects.

Last Modified: September 7, 2023
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What Are the Common Side Effects of Paragard?

Heavy menstrual bleeding and pain are two common side effects of Paragard and other copper IUDs. When doctors first insert Paragard, some women experience cramping. This can occur during or after the procedure, but typically goes away in a couple of days. If you are experiencing longer periods of pain or discomfort after Paragard insertion, contact your medical provider.

Other common side effects include:
  • Anemia (low red blood cell count) and iron deficiency
  • Backache
  • Cramping
  • Expulsion of the device (complete or partial)
  • Pain during sex or periods
  • Prolonged periods
  • Spotting
  • Vaginal discharge and irritation

If the Paragard device moves or comes out (expulsion) the individual loses pregnancy protection. If this occurs, contact your provider to address your birth control and family planning needs.

Serious Side Effects of Paragard

Serious side effects of Paragard include ectopic pregnancy, endometriosis and perforation. You should not use Paragard if you are allergic to copper, polyethylene or barium sulfate. Although rare, some women have developed dermatitis and eczema-type symptoms, which resolved after removing the copper-containing IUDs.

Additionally, you should not use Paragard if you have Wilson Disease. This disease prevents the body from removing excess copper, causing it to build up in the organs and potentially leading to life-threatening damage.

During your pre-insertion examination, your provider will examine you and discuss how any medical conditions or sensitivities you have impact the type of birth control that is best for you.

About one in 300 people get an infection after insertion of the Paragard device. People who experienced severe, life-threatening side effects have filed Paragard lawsuits seeking damages, medical expenses and lost wages.

Lawsuit Information
Surgery to remove broken pieces, pain and infertility upon removal are among the injuries claimed in Paragard lawsuits.
View Lawsuits

Ectopic Pregnancy and Paragard

Researchers have found that the presence of an IUD increases the risk of extrauterine or ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, often in a fallopian tube. Ectopic pregnancy is a medical emergency that may cause internal bleeding, infertility or death. It usually requires surgery.
There’s a very low chance of pregnancy for women using Paragard. But if you conceive while using Paragard, the risk of ectopic pregnancy is high. Researchers have found that the contraceptive failure rate for copper IUDs is one of the highest among long-acting reversible contraception methods.

Embedment and IUDs

Paragard may become attached or embedded into the uterus wall. Embedment makes it harder to Paragard removal harder and may also lead to fracture of the device when pulling it out with the string.

Fractured IUD pieces embedded in the uterus can happen. That’s why careful removal by a doctor is important. Embedment may also pose a risk for unintended pregnancy, especially if the IUD lies in the lower segment of the uterine cavity.

Endometriosis or Pelvic Inflammatory Disease

Pelvic inflammatory disease, or PID, associated with the use of Paragard is rare. When it happens, it is usually within three weeks of insertion. However, PID may lead to sterility, which is a serious consideration. Research has found that copper IUD users have a higher risk of bacterial vaginosis, or BV. BV is associated with multiple adverse outcomes, including PID and transmission of sexually transmitted infections.

Unlike IUDs that release hormones, doctors do not recommend a copper IUD for endometriosis. Copper IUDs may irritate the endometrial lining, causing mild cases of endometriosis. Experts advise against Paragard if you have any pelvic infection, including PID.

Perforation and Paragard

There is a slight chance that IUDs may puncture the uterus wall, though the risk is higher in certain users. Perforation may also occur during IUD placement. The manufacturers of Paragard state that if perforation happens during placement, it usually heals without surgery or complications.

One study found that inserting the device between four to six weeks postpartum raised the risk of perforation by almost seven times. Perforation risk also increased by around one-third if inserted while breastfeeding.
Waiting more than a year after delivery to insert an IUD lowers the risk of perforation as does insertion at delivery, or in women who have never had a baby.

Managing Paragard Side Effects

Over-the-counter pain medication can help manage the cramping and pain from Paragard side effects. Post-insertion cramping usually only lasts for a few minutes after insertion. Other effects should subside after a few months once your body gets used to Paragard. If symptoms persist, talk to your doctor or health care provider.

Studies show that vitamin B1 may reduce the amount and duration of bleeding and the number of spotting days. Additionally, NSAIDs like mefenamic acid may reduce the volume (but not the duration) of bleeding.

Contact your health care provider immediately if you have unusually heavy bleeding, pelvic pain or unexplained fever while using Paragard. Also, if the strings of your Paragard are missing or seem longer, you feel the device in your vagina, or sex is painful for you or your partner, it may no longer be in place so you should request an exam.

FAQs About Paragard Side Effects

Does Paragard contain hormones that can cause side effects?
No, Paragard does not contain hormones. It’s made of copper, which prevents pregnancy by altering sperm mobility and function in the uterus.
Do most Paragard side effects go away?
Yes, most Paragard side effects, such as cramping and heavy bleeding, get better within a few months of insertion.
Can I experience side effects if I have my Paragard IUD removed?
Some people experience cramps and spotting after Paragard removal. You may also get pregnant almost immediately after IUD removal because it doesn’t impair fertility once removed.
Please seek the advice of a medical professional before making health care decisions.