IUD With Copper - Side Effects

Side Effects

Expulsion: Sometimes the copper IUD can be spontaneously expelled from the uterus. Expulsion rates can range from 2.2% to 11.4% of users from the first year to the 10th year. The TCu380A may have lower rates of expulsion than other models. Unusual vaginal discharge, cramping or pain, spotting between periods, postcoital (after sex) spotting, dyspareunia, or the absence or lengthening of the strings can be signs of a possible expulsion. If expulsion occurs, the woman is not protected against pregnancy.

Perforation: Very rarely, the IUD can move through the wall of the uterus. Risk of perforation is mostly determined by the skill of the practitioner performing the insertion. For experienced medical practitioners, the risk of perforation is 1 per 1,000 insertions or less. If perforation does occur it can damage the internal organs, and in some cases surgery is needed to remove the IUD.

Infection: The insertion of a copper IUD poses a transient risk of pelvic inflammatory disease (PID) in the first 21 days after insertion. However, it is a small risk and is attributable to preexisting gonorrhea or chlamydia infection at the time of insertion, and not to the IUD itself. Proper infection prevention procedures have little or no effect on the course of gonorrhea or chlamydia infections, but is important in helping protect both clients and providers from infection in general. Such infection prevention practices include washing hands and then putting on gloves, cleaning the cervix and vagina, making minimal contact with non-sterile surfaces (using a "no touch insertion technique") and, after the procedure, washing hands again and then processing instruments. The device itself carries no increased risk of PID beyond the time of insertion.

Cramping:Many women feel cramping or pain during the IUD insertion process and immediately after as a result of cervix dilation during insertion. Taking NSAIDS before the procedure can reduce discomfort, as can the use of a local anaesthetic. Misoprostol 6 to 12 hrs before insertion can help with cervical dilatation. Some women may have cramps for 1 to 2 weeks following insertion. The copper IUD can also increase cramps during a woman’s period. This symptom will clear up for some women in 3 to 6 months, but may not for others.

Heavier Periods: The copper IUD increases the amount of blood flow during a woman’s menstrual periods. On average, menstrual blood loss increases by 20–50% after insertion of a copper-T IUD; increased menstrual discomfort is the most common medical reason for IUD removal. This symptom may clear up for some women after 3 to 6 months, but may not for others. Despite this, anemia is not listed as a contraindication by the World Health Organization.

Irregular Bleeding and Spotting: For the first 3 to 6 months after insertion, the copper IUD can cause irregular periods and spotting between periods.

String problems: A small portion of men report that they can feel the strings during intercourse. In this case, strings can be trimmed. However, very short strings can prevent the woman from checking the strings for expulsion.

Pregnancy: Although rare, if pregnancy does occur with the copper IUD in place there can be serious side effects. The risk of ectopic pregnancy to a woman using an IUD is lower than the risk of ectopic pregnancy to a woman using no form of birth control. However, of pregnancies that do occur during IUD use, a higher than expected percentage (3–4%) are ectopic. If a pregnancy occurs with the IUD in place there is a higher risk of miscarriage or early delivery. If this occurs and the IUD strings are visible, the IUD should be removed immediately by a clinician. Although the Dalkon Shield IUD was associated with septic abortions (infections associated with miscarriage), other brands of IUD are not. IUDs are also not associated with birth defects.

Some barrier contraceptives protect against STIs. Hormonal contraceptives reduce the risk of developing pelvic inflammatory disease (PID), a serious complication of certain STIs. IUDs, by contrast, do not protect against STIs or PID.