I was recently a guest on Wellness Mama’s Healthy Moms Podcast talking all about why hormonal birth control messes with our hormones, and what to do instead.
After the episode aired, I got flooded with questions about the pill, the IUD and natural birth control options. I’ve talked pretty extensively about the pill’s side effects here, here, and here, but I have never written specifically about the Paragard aka the copper IUD.
Before I jump in, I wanna say that I fully believe all women should choose the birth control they want to use, but that the decision should be based on fully informed consent.
Meaning, a medical doctor should be explaining ALL of the potential benefits, risks, and ALTERNATIVES involved in a medical treatment.
Currently that is not the case for most women – they are not offered all the birth control options, nor are they told all the risks (in many cases) which means they are not 100% informed.
What is a copper IUD?
An IUD is a small T-shaped device that is inserted into the uterus. There are 2 options for IUDs. The copper IUD (ParaGard) releases copper which is toxic to live sperm and the Mirena, Kyleena, Liletta or Skyla which release varying amounts of progestin (depending on which one you choose) to prevent ovulation. The Paragard is effective for up to 10 years and the hormonal options are effective for anywhere between 3-7 years.
This is the definition of the Paragard IUD from their website…
Paragard is a small, hormone-free IUD made of soft, flexible plastic wrapped with a thin layer of copper. It’s placed in your uterus by a healthcare provider during an office visit in just a few minutes.
How it works – also from their website
The copper in Paragard works to prevent sperm from reaching the egg and fertilizing it and may also prevent implantation.
What is the effectiveness of a copper IUD?
The Paragard is 99.2% effective versus the Mirena, which is 99.8% effective.
Disclaimer on the Paragard website. If you have an IUD, were you aware of all this when you had it inserted?
IMPORTANT SAFETY INFORMATION Do not use PARAGARD if you have a pelvic infection, get infections easily or have certain cancers. Less than 1% of users get a serious infection called pelvic inflammatory disease. If you have persistent pelvic or stomach pain, or if PARAGARD comes out, tell your healthcare professional. If it comes out, use back-up birth control. Occasionally, PARAGARD may attach to or in rare cases may go through the uterine wall and may also cause other problems. In some cases, surgical removal may be necessary. Although uncommon, pregnancy while using PARAGARD can be life threatening and may result in loss of pregnancy or fertility. Bleeding or spotting may increase at first but should decrease in 2 to 3 months. PARAGARD does not protect against HIV/AIDS or sexually transmitted diseases (STDs).
They fail to mention this:
You can’t use the copper IUD if you have an allergy to copper or have Wilson’s disease, which causes your body store too much copper.
I am curious if women who get the copper IUD are tested for an allergy, or Wilson’s disease before having it inserted?
My thoughts on the Paragard
A copper IUD isn’t the worst birth control option by any means, and in fact has the highest satisfaction of all birth control methods, but I have three main concerns.
#1. It’s not really clear on their website how it actually works!
Keep in mind, as mentioned above, the copper IUD does not stop your body from ovulating.
But all they say on their website is this:
“The copper in Paragard works to prevent sperm from reaching the egg and fertilizing it and may also prevent implantation.”
It would be good for them to explain how that works, but maybe it’s just me who wants ALL the answers all the time. 🤷🏽♀️
Mayo Clinic says:
The T-shaped plastic frame has copper wire coiled around the stem and two copper sleeves along the arms that continuously release copper to bathe the lining of the uterus. ParaGard produces an inflammatory reaction in the uterus that is toxic to sperm, which helps prevent fertilization.
Not loving this whole ”inflammatory response in the uterus” thing.
This IUD prevents fertilization by damaging or killing sperm and making the mucus in the cervix thick and sticky, so sperm can’t get through to the uterus.
Bottom line is this…
The copper IUD creates an inflammatory response in the uterus and reduces the thickness of the endometrial lining, which impairs implantation.
This means that sometimes the copper IUD is effective post-fertilization, and this is why it can be placed after unprotected sex to prevent implantation of a fertilized egg. So basically, it can be used as emergency contraception.
Note: Localized inflammation in the uterus and cervix isn’t a problem for all women, but for others it is – causing severe period pain.
Additionally, the copper is toxic to sperm, which impairs its motility, and copper concentration in the cervical mucus is higher which also leads to an inhibition of sperm motility.
All of this totally makes sense, but I would love for it to be said on the Paragard website so women know what they’re getting.
#2. The side effects of the copper IUD freak me out.
Maybe because of the nature of my work I hear ALL the bad stories, but seriously, why do we have to put up with any birth control side effects ever? Are women’s bodies just collateral damage??
The possibility of the IUD becoming dislodged and either coming out or getting stuck and having to be surgically removed is very real. Additionally, MANY women experience increased cramps (I’ve heard they can be debilitating cramps), and extremely heavy bleeding. It tapers off for some women after about six months, but not everyone. This is the number one reason women have it removed .
Plus, spotting for up to ten days leading up to a period, menstrual blood clots and very long periods are very common too. Ultimately you have to decide what is best for you but I strongly recommend weighing the pros on cons carefully.
Bacterial disruption – all IUD’s are placed in the uterus and their strings hang down through the cervix into the vaginal canal. The composition of the microbiota in the uterus versus the vagina are different, and the string creates a “line of communication” between these two areas which would otherwise not happen.
This can change the microbes in vagina, and increase the likelihood of vaginal infections.
#3. I’m concerned about “excess copper” and “copper toxicity” from using an IUD.
I get A LOT of pushback when I mention it, because I’m basing this on anecdotal evidence. There is no actual scientific study proving that excess copper or copper toxicity is a “thing”….yet.
But does that mean it doesn’t exist? Hell no.
There were no studies in 1990 proving that fat didn’t cause high cholesterol, and look how that turned out. Why wait for science to catch up with something that is so clearly happening? And you can bet your bottom dollar that the manufacturer of the copper IUD is not interested in scientific proof that their product sucks anyways, so we might be waiting awhile for that.
While there may not be any proven direct correlation, there is a ton of evidence linking excess copper to all kinds of problems related to our menstrual cycle and fertility . Copper levels are significantly higher in women with infertility, and there is a correlation between both the hormonal and copper IUD, and infertility . On the flip side, low copper is often linked to miscarriages.
Copper has an affinity for estrogen – when one rises, so does the other. This is why women tend to have more copper in their bodies, and subsequently more problems with copper imbalance than men. Additionally, this is why the oral contraceptive pill contributes to higher copper levels [4,5] – the synthetic estrogens raise copper. Also good to know – Low copper is associated with low estrogen.
Copper is an antagonist for zinc, meaning they compete for absorption. Adequate zinc supports ovulation and raises progesterone, so when copper is too high compared to zinc, we tend to run into problems with ovulation, which will lower progesterone and lead to menstrual cycle and fertility abnormalities. Excess copper also impairs thyroid function, which further impacts our menstrual cycle and fertility.
Increased estrogen, lower progesterone and lowered thyroid function are the reasons I think copper IUD’s make periods heavier and more painful.
Finally, adrenal function dictates how much copper is circulating at any given time. This is because the adrenals tell the liver to produce ceruloplasmin, the principal copper binding agent in the body. When the adrenals are chronically overloaded, their message to the liver is interrupted and we produce less of the copper binding agent – and copper levels go up! So, as per usual, you gotta step up your stress management game 🙂
Keep in mind that we are all physiologically different, so a copper IUD might be fine in one woman and not in another. I say this all the time – conventional medicine’s biggest flaw is their blanket approach to our health. Each of us have different genes, diets, stress, gut health etc, and we can’t expect something to work the same for everyone across the board.
I read some interesting research by Dr. Lawrence Wilson about fast oxidizers vs slow oxidizers – fast oxidizers need more copper, and slow oxidizers need less copper. It’s way too involved for this post, but you can check it out here.
Copper excess/zinc deficiency results in a fair amount of physical and emotional symptoms
Severe anxiety and panic attacks , depression, ADHD, acne (caused by lowered zinc in relation to copper), eczema, psoriasis, hair loss, anemia, increased anger and rage, brain fog, spaciness, paranoia, fatigue (like tired all the time), low libido in women and men, estrogen dominance, PMS, and post-partum depression to name a few.
These symptoms tend to happen most often in the presence of zinc deficiency, because as I just said, these two trace elements compete with each other for absorption. In other words, copper and zinc balance each other out, so an excess of one or the other can cause issues.
Are you on the copper IUD and experiencing any of these symptoms? If so it might make sense to have your copper levels tested. Well, really you should have a complete mineral test done, and if your copper/zinc ratio is off, consider ditching your IUD.
What I’ve heard from women who have used an IUD
I want to reiterate that everyone should choose whatever birth control feels best for them. While I don’t have an issue with the copper IUD necessarily, and think it definitely works for plenty of women, I can’t ignore what people have said to me. And you can’t afford to either.
These are just a few of MANY positive and negative opinions in my Facebook group.
Ultimately, I don’t really recommend IUD’s because in my opinion it’s unnecessary to have a foreign object inserted into our uterus to protect us from the 2 days a month we are actually fertile.
At the same time, I also believe that women should make the decision about their birth control that feels right to them, so do your research, speak to your doctor and always go with your gut.
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