Paragard is a prescription device used to help prevent pregnancy. Paragard can cause side effects that range from mild to serious, including back pain and painful periods.

Paragard is a birth control device used to help prevent pregnancy in people able to become pregnant. It contains copper as its active ingredient. (The active ingredient is what makes it work.) Paragard comes as an intrauterine device (IUD) that’s placed into your uterus by a healthcare professional. It can be used for up to 10 years.

Keep reading to learn about the common, mild, and serious side effects Paragard can cause. For a general overview of the device, including details about its uses, see this article.

Some people may experience mild to serious side effects with Paragard. Examples of Paragard’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

Mild side effects have been reported with Paragard. These include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist.

Paragard may cause mild side effects other than those listed above. See the device’s prescribing information for details.

Serious side effects have been reported with the Paragard intrauterine device (IUD). These include:

  • sepsis (an extreme response to infection, which may lead to severe problems, including death)
  • actinomycosis (a long-term infection that causes sores in the body’s soft tissues)
  • ectopic pregnancy (when a fertilized egg attaches somewhere other than the uterus)
  • full or partial expulsion of the IUD (when Paragard partially or completely falls out of your uterus)
  • embedment (when Paragard attaches to the wall of the uterus)
  • perforation (a tear in the uterus or cervix caused by the IUD)
  • pelvic inflammatory disease*
  • allergic reaction*†

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible with Paragard, but it’s not clear whether this side effect occurred in studies.

If you develop serious side effects while using Paragard, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Paragard may cause serious side effects other than those listed above. See the device’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug or device, it tracks and reviews side effects. If you’d like to notify the FDA about a side effect you’ve had with Paragard, visit MedWatch.

Get answers to some frequently asked questions about Paragard’s side effects.

Are there reviews of side effects from Paragard?

It’s possible. If you’re wondering about reviews of Paragard’s side effects, talk with your doctor. They may be able to provide information on side effect experiences of people who have used the device.

The Paragard drugmaker has reviews on its website. You can also find Paragard safety information here.

Does Paragard cause weight gain?

No. Weight gain wasn’t a side effect reported in studies of Paragard. The device contains copper, not a hormone. It doesn’t cause hormone-related weight gain like some hormonal-based intrauterine devices (IUDs), such as Mirena or Kyleena.

If you’re concerned about weight gain with Paragard, talk with your doctor. They can discuss possible causes for weight gain and suggest ways to manage a weight that’s healthy for you.

Will I experience certain side effects after removal of Paragard?

Yes, it’s possible. Paragard removal may cause:

These side effects were reported in studies of Paragard. You’re more likely to have these side effects if you’ve had these reactions in the past.

Tell your doctor about your medical history, including the reactions listed above, before having Paragard inserted or removed.

Can Paragard cause long-term side effects?

No. Long-term side effects weren’t reported in studies of Paragard. Most people experience mild side effects when Paragard is first inserted and for a few months after insertion. Side effects may include:

  • spotting
  • heavier or longer periods
  • late or missed periods
  • back pain*

* To learn more about this side effect, see the “Side effects explained” section below.

If you have side effects with Paragard that are bothersome or don’t go away after a few weeks to months, call your doctor. They can check whether your Paragard IUD needs to be adjusted or removed.

Call your doctor if you think you’re having a serious side effect. (See “What are the serious side effects of Paragard?” above for more information.) If your symptoms seem life threatening, call 911 or your local medical emergency number and get help right away.

Learn more about some of the side effects Paragard may cause.

Anemia

Paragard can cause anemia. This is a condition in which you have a low level of red blood cells in your body. This side effect was a common but mild side effect reported in studies of Paragard.

What might help

Tell your doctor if you have anemia. They’ll likely check your blood count levels. Depending on your condition, they may monitor you or suggest a different form of pregnancy prevention besides Paragard.

Back pain

Back pain was reported as a common but mild side effect in studies of Paragard. This may be more likely when Paragard is inserted or removed and for a few days after these procedures.

What might help

Your doctor may suggest a few ways to ease mild back pain with Paragard. These include:

If your back pain is severe or continues, call your doctor. They can discuss possible causes and whether Paragard needs to be removed.

Vaginitis

Vaginitis was a mild side effect reported in studies of Paragard. This device can cause changes in your vagina, including inflammation, irritation, or infection. Symptoms of vaginitis can include:

What might help

If you experience symptoms of vaginitis, call your doctor. They can diagnose your condition and treat it. Your treatment will depend on your symptoms and the severity of your condition.

Pelvic inflammatory disease

There were reports of pelvic inflammatory disease (PID) with Paragard use in studies of the device. PID was a rare but serious side effect of Paragard.

PID is an infection caused by several kinds of bacteria. If you’ve had PID in the past, you’re at higher risk of it with Paragard use. This condition can be life threatening if it spreads to your blood. Symptoms include:

What might help

If you’re having symptoms of PID, call your doctor right away. They will diagnose the cause of your symptoms. If you have PID, they’ll treat the condition.

The bacteria that causes PID can be sexually transmitted. If you’re sexually active, your partners will also need to receive treatment.

Allergic reaction

Like most drugs, Paragard can cause an allergic reaction in some people. But it’s not clear whether this side effect occurred in studies.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

If your doctor confirms you’ve had a mild allergic reaction to Paragard, they’ll decide whether you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Paragard, they may have you switch to a different form of birth control.

Keeping track of side effects

During your Paragard use, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start using the device.

Your side effect notes can include things such as:

  • how soon you had the side effect after insertion of Paragard
  • what your symptoms were
  • how your symptoms affected your daily activities
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Paragard affects you. They can then use this information to adjust your treatment plan if needed.

Paragard may not be right for you if you have certain medical conditions. Other factors may also affect whether Paragard is a good birth control option for you. Talk with your doctor about your health history before having Paragard inserted. Factors to consider include those described below.

Recent childbirth or an abortion. Using Paragard within 3 months of giving birth or after you’ve had an abortion can increase your risk of intrauterine device (IUD) expulsion. This is when the device partially or fully falls out of your uterus. Ask your doctor about the best time to have Paragard inserted after an abortion or after you’ve given birth.

Cervical cancer or uterine cancer. Your doctor will likely not recommend Paragard if you have or have had cervical or uterine cancer. Tell your doctor about your health history, including any kind of cancer you have or have had.

Conditions that affect the shape of your uterus. If you have a condition that affects the shape of your uterus, such as uterine fibroids, your doctor will likely recommend not using Paragard. This is because conditions such as fibroids can make it difficult to position Paragard properly to help prevent pregnancy. If you have a condition that affects the shape of your uterus, tell your doctor. They’ll discuss whether Paragard is suitable for you and recommend a different birth control option if it’s not.

Copper allergy. The active ingredient in Paragard is copper. (The active ingredient is what makes the device work.) If you’re allergic to copper, this device is not suitable for you. Tell your doctor if you’re allergic to copper and they’ll suggest safer birth control options for you.

Dizziness, slow heart rate, or seizures. During insertion or removal of Paragard, you may experience dizziness, fainting, seizures (changes in the electrical activity of the brain), or slow heart rate. These reactions usually resolve shortly after insertion or removal of Paragard. Tell your doctor if you’ve had any of these reactions in the past. Your risk of these side effects is higher if you have.

Wilson’s disease. Do not use Paragard if you’ve received a diagnosis of Wilson’s disease. This is a rare genetic condition in which your body can’t get rid of copper. Since copper is the active ingredient in Paragard, it could cause copper poisoning if you have this condition. Before using Paragard, tell your doctor if you have Wilson’s disease.

Unexplained vaginal bleeding. Your doctor will likely not recommend Paragard if you have a history of pelvic inflammatory disease (PID) or unexplained vaginal bleeding. This includes bleeding between periods or heavy or prolonged bleeding, as these could be signs of an infection such as PID.

Let your doctor know right away if you have changes in bleeding during the first few months following Paragard insertion. This includes heavy or unexplained bleeding or symptoms of an infection. (See “What are the serious side effects of Paragard?” above for more information.) Your doctor will determine the cause of your symptoms and suggest other birth control options for you if needed.

Infection in your cervix, pelvis, or vagina (including PID) that hasn’t been treated. Your doctor likely won’t recommend Paragard if you have or have had an infection in your pelvis, cervix, or vagina. Tell them if you have a history of PID, since Paragard can increase your risk of another infection.

Allergic reaction. If you’ve had an allergic reaction to Paragard or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other birth control options that might be better for you.

Alcohol and Paragard

There are no known interactions between alcohol and Paragard. Talk with your doctor if you drink alcohol and have any concerns about potential risks with Paragard.

Pregnancy and breastfeeding with Paragard

Paragard can cause serious side effects if you become pregnant. But it shouldn’t affect a child who is breastfed. Keep reading for more information on pregnancy and breastfeeding with this IUD.

Pregnancy

Paragard is an IUD that’s used to help prevent pregnancy in in people who are able to become pregnant. But there have been reports of pregnancy with Paragard use in studies. This is rare but can happen if you have certain IUD side effects such as:

  • perforation (a tear in the uterus or cervix caused by the IUD)
  • expulsion (when Paragard partially or completely falls out of your uterus)
  • embedment (when Paragard attaches to the wall of the uterus)

If you become pregnant while using Paragard, serious risks include:

Call your doctor if you have symptoms of pregnancy. They can check to see whether you’re pregnant and whether Paragard is inserted correctly or needs to be removed.

Breastfeeding

In studies of Paragard, there were no differences in the amount of copper in breast milk before and after Paragard insertion.

A 2022 study found a slightly higher risk of perforation* in people who had the IUD inserted 4 days to fewer than 6 weeks after delivery. It was also higher in those who were breastfeeding a child.

If you’ve just had a baby or plan to breastfeed, ask your doctor about the best time to have Paragard inserted.

* Perforation refers to a tear in the uterus or cervix caused by the IUD.

Paragard is a nonhormonal intrauterine device (IUD) used to help prevent pregnancy. It has some mild side effects. In rare cases, it’s possible to have serious side effects with Paragard. If you have questions about side effects this IUD can cause, talk with your doctor.

Examples of questions to help get you started include:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.