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Welcome! If you’re here, you’re considering getting a copper IUD — or your boo, BFF, or kiddo is — and you’ve got Qs.

Luckily for you, Info Seeker, we’ve got answers.

The copper IUD is a long lasting, nonhormonal birth control that gets placed into the uterus by a doctor, explains Kecia Gaither, MD, MPH, FACOG, double board certified in OB-GYN and maternal fetal medicine and the director of perinatal services at NYC Health + Hospitals/Lincoln.

Known by the name of the only brand that currently manufactures copper IUDs, ParaGard is a plastic T-shaped device that’s about the size of a quarter.

ParaGard, unlike other IUD options which are laced with hormones, is wrapped with a little coil of copper which prevents pregnancy.

Confused how a little twirl of copper can do such a big job?

The copper stops sperm from meeting an egg in a few different ways, says Felice Gersh, MD, author of “PCOS SOS: A Gynecologist’s Lifeline to Naturally Restore Your Rhythms, Hormones, and Happiness.”

“What it comes down to is that copper creates a toxic environment for the sperm,” says Gersh.

The copper releases copper ions locally, which changes the lining of the uterus and the makeup of the cervical mucus, she says. Both of which make the environment less hospitable to the little swimmers.

Sperm is repelled by copper, so the copper ions also change the swimming pattern of the sperm.

“As the sperm nears the uterus, the copper causes it to change direction and swim away from the uterus,” says Gersh.

“Copper also changes the natural microbiome of the vagina, which again, makes the environment less optimal for sperm survival,” adds Gersh. Pretty neat, right?

“The copper IUD has an excellent safety profile for most uterus owners,” says Alyssa Dweck, MD, OB-GYN, author of “The Complete A to Z for Your V” andINTIMINA sexual health expert.

The fact that it’s made out of copper is really only an issue for people with a copper allergy. Or, for those with a copper metabolism disorder called Wilson’s disease.

Really freaking effective.

Copper IUDs are somewhere between 99 and 100 percent effective at preventing unwanted pregnancy. This means that less than 1 in every 100 people using a copper IUD will become pregnant.

Generally speaking, Dweck says people with active pelvic infections or abnormalities of the uterus such as fibroids should avoid IUDs — or use them with extreme caution.

Anyone with a copper allergy, intolerance, or metabolism issue should also avoid getting a copper IUD.

Gersh says it also isn’t a good fit for anyone who has recently given birth or is breastfeeding a newborn.

“The uterus is more prone to perforation — which is when the IUD gets pushed all the way through the uterine wall into the pelvic cavity — during insertion at these stages,” explains Gersh.

“It’s generally best to wait to get the IUD inserted until after you’re done breastfeeding.”

Prepare yourself for some truly wild info: The copper IUD can be used as an emergency contraceptive — yes, like the morning after pill (!) — if inserted within 5 days of intercourse.

This is often the emergency contraceptive method doctors recommend for people who weigh over 175 pounds, says Gersh. That’s because both Plan B and Ella are considered less effective in people of this size.

Some research suggests that about 6 percent of people who weigh around 175 pounds will still become pregnant after taking an emergency contraceptive pill.

The copper IUD’s main claim to fame is that it majorly reduces the risk of unwanted pregnancy.

And it does so effectively without hormones.

“There are a number of reasons someone might want to avoid using a birth control method with hormones,” says Gersh.

For one, with a nonhormonal contraceptive, you can still have a regular menstrual cycle. Considering the menstrual cycle was named the fifth vital sign for uterus owners by The American College of Obstetricians and Gynecologists, this is no small potatoes.

Nonhormonal options also allow you to avoid — you guessed it — hormones, which have been linked to several symptoms.

This includes:

  • reduced interest in sex
  • spotting between periods
  • nausea
  • mood swings
  • increased risk of vaginal yeast infection
  • sore breasts

“Due to the hormones, hormonal contraceptives may also lead to reduced bone and ligament health,” says Gersh.

She adds that because copper IUDs are nonhormonal, they pose no risk to your bone and ligament health.

The most common side effect of the copper IUD is heavier and longer periods — especially the first 3 to 6 months after insertion, says Gaither.

After 6 months, many people find that their periods return to their pre-IUD state. But if your periods are already heavy, you may prefer a hormonal IUD.

“Because copper causes an inflammatory response in the body, and period cramps are a symptom of inflammation, the copper IUD can also worsen cramps,” says Gersh.

Both the nonhormonal copper IUD and hormonal IUD are V-E-R-Y effective at preventing pregnancy.

Neither protects against the transmission of sexually transmitted infections (STIs).

Ultimately, which option is right for you comes down to whether you have other menstrual symptoms you’re trying to solve for. (If you do, you may prefer a hormonal IUD.)

It’s also about how you feel adding synthetic hormones into your bod. (If you’re not into it, you’ll probably want the nonhormonal copper IUD.)

A copper IUD can cost anywhere from zero bucks to about $1,300, depending on whether you have insurance and what insurance you have.

If you can’t afford the cost, are 18+, and have a gross annual income at or below 200 percent of the poverty guideline, check out the ParaGard Patient Assistance Program, which will provide you with the copper IUD for free.

You can also reach out to your local health department, clinic, or Planned Parenthood to discuss your options. Many locations offer services at a sliding scale.

First, you may be offered numbing cream for your cervix. Next, you’ll lie down, pants off, and your provider will insert a speculum into your vagina with the help of lubricant.

Your provider will then check the position and size of your cervix, and look for any potential problems with your uterus.

If everything is good to go, they’ll fold the “T” arms of the IUD down, insert the IUD into a teensy tube, and slide the tube into the speculum.

Next, they’ll use that tube to push the IUD past your cervix and into your uterus.

When they remove the tube, the arms will release. Viola!

All IUDs have a string that hangs down from the uterus into the vagina — your provider will snip the string so it’s no more than an inch (ortwo) long.

In case you were wondering: That whole shebang usually takes less than 10 minutes.

Many people experience cramping for a few hours to a few days after insertion.

“Inserting an IUD requires opening the cervix and some cramping is a common reaction to that,” says Gersh.

Painful cramping is more common in folks who experience cramping leading up to or during their menstrual cycle.

To read some individual experiences with IUD insertion, check out this Reddit thread.

“Complications with the copper IUD are rare but possible,” says Dweck. These include:

Perforation

This is when the IUD punctures the uterine wall.

Data shows that it occurs in about 1 in 1,000 insertions.

Symptoms include:

  • pelvic or lower abdominal pain
  • fever
  • severe bleeding
  • nausea
  • vomiting

Expulsion

Expulsion occurs when the IUD falls out of the uterus, either partially or fully.

When this happens, it needs to be removed entirely so a new one can be inserted.

Symptoms include:

  • severe cramping
  • heavy bleeding
  • fever

Infection

This is super-duper rare, but if infection happens with an IUD, it could reach the uterus or pelvis and cause scar tissue formation that can lead to fertility issues down the line, says Dweck.

Symptoms include:

  • abdominal pain
  • discharge
  • pain during penetration
  • pain during urination
  • fever

“[This] is why IUD-havers are advised to use condoms and barriers to prevent STI transmission,” she says.

Up to 10 years!

Of course, if you decide you want your eggo preggo before the decade is up, you can schedule removal.

In one word: Easy.

Performed at a healthcare center, IUD removal is as easy as your provider grabbing the IUD’s string with either their hand or a medical hook and pulling it down.

As they pull, the arms of the device will be drawn upward, making exertion smooth.

“It literally takes just a few seconds,” says Gersh.

Occasionally, the string will be too short to grab, or it will be up in the uterus. Here, your provider will use a smaller medical tool to reach up there and grab it.

“If the patient can’t tolerate the discomfort of getting the string with a hook, then you would have to do a hysteroscopy, which is an invasive procedure that involves anesthetics… but this is very, very rare,” says Gersh.

If you want something you can mostly set and forget, talk to a healthcare provider about your options for IUDs or other long-term contraception.

They can answer any questions you may have and advise you on next steps.

If you try this method and later decide that it isn’t for you, you can meet with your provider to have it removed. They can work with you to find a method that best suits your needs.


Gabrielle Kassel is a New York-based sex and wellness writer and CrossFit Level 1 Trainer. She’s become a morning person, tested over 200 vibrators, and eaten, drunk, and brushed with charcoal — all in the name of journalism. In her free time, she can be found reading self-help books and romance novels, bench-pressing, or pole dancing. Follow her on Instagram.