Copper Intrauterine Device (IUD)

What is a Copper IUD

An IUD (intrauterine device) is a small plastic device that is inserted into the uterus (womb) to prevent pregnancy. The copper IUD has copper and sometimes silver, wrapped around its stem and arms. It does not contain any hormones. The copper IUD is a highly effective, long-acting reversible contraceptive.

How does it work?

The copper IUD works in the following ways:

• the copper is toxic to eggs and sperm which stops an egg being fertilised
• it slows the movement of egg and sperm so reduces the chance of them meeting
• it changes the lining of the uterus and prevents the implantation of a fertilised egg

How effective is it?

The copper IUD is 99.5% effective at preventing pregnancy.

How long does a Copper IUD last?

The copper IUD lasts either 5 or 10 years, depending on the typ

What are the advantages of a Copper IUD?

• It is a highly effective contraceptive (99.5%)
• It does not require any day-to-day action on your part
• It is long-acting (5 or 10 years, depending on the type)
• The contraceptive effect stops as soon as you have the IUD removed
• It is suitable regardless of whether you have given birth or not
• As with most contraception, it can be used when breastfeeding
• There is an upfront cost for the IUD and the insertion procedure. However, because it lasts for 5 to 10 years it is an inexpensive method over time.
• It has no hormones so no hormonal side effects and is a suitable method for people who cannot use or choose not to use hormonal contraception.

What are the disadvantages of a Copper IUD?

• It must be inserted and removed by a specially trained doctor or nurse
• As with any procedure, there is a small risk of complications
• The insertion procedure can be uncomfortable
• If you have painful or heavy periods the copper IUD can worsen these
• It does not protect from sexually transmissible infections(STIs)
• There is an upfront cost for the device and the insertion procedure
• Some people may have differences in their bodies that prevent them from having an IUD inserted

Who cannot use Copper IUD?

The copper IUD is not suitable if:

• you have an allergy to copper or have Wilson’s disease
• you think you might be pregnant
• you have had a recent infection of your pelvic area (pelvic inflammatory disease)
• you have unexplained bleeding from your vagina
• you have very heavy or painful periods

What are the possible problems that may occur with a Copper IUD?

• Periods may become heavier, longer, and more painful with the copper IUD. This is manageable for most people but can be a problem if your periods are already heavy and painful.
• There is a small risk of pregnancy occurring with a copper IUD (less than 1 in 100). If pregnancy does occur, there is a slightly increased risk of it occurring in the fallopian tube (this is called an ectopic pregnancy).
• Infection: There is a small risk of infection at the time of insertion (about 1 in 500).
• Expulsion: In about 5% of cases, the uterus will expel (push out) the copper IUD. It is essential to check that the IUD is still in place by feeling for the IUD string at the upper end of the vagina after each period. If the string is absent, this may mean that the IUD has moved or been expelled, and you should see your doctor.
• Perforation: This is a rare event (approximately 2 in 1,000) when the copper IUD passes through the uterus wall into the pelvic area. A perforation requires minor surgery under a general anaesthetic to remove the copper IUD.

Where can I have a Copper IUD insertion?

Copper IUDs are only inserted by doctors or nurses who have undergone specialised training in IUD insertion. Our clinic at SHFPACT provides IUD insertion services with doctors. Some GPs and most gynaecologists also offer this service

What happens when I have a copper IUD instered at SHFPACT?

First appointment

• You will need a first appointment with a doctor to see if a copper IUD is right for you.
• At this appointment, the doctor will discuss the copper IUD and explain the insertion procedure. You may also need a vaginal examination at this time.
• This is a good time to ask any questions or raise concerns.
• The doctor will discuss the best timing of your insertion with you, taking into consideration your menstrual cycle, and what contraceptive you might be using currently.
• Following your first appointment you will need to make an appointment for the insertion.

IUD Insertion appointment

• You will be at the clinic for 1 to 1.5 hours. If parking, please ensure you leave enough time.
• The doctor will talk with you about the procedure and explain what will happen.
• You will be asked to go behind a screen, remove your clothes from the waist down, and lay on the examination table. You will be offered a privacy sheet to cover yourself.
• The doctor will do a quick vaginal examination, then a speculum will be inserted into the vagina. The copper IUD will then be inserted. The IUD strings are trimmed, and the speculum is then removed.
• An uncomplicated insertion procedure takes about 15 minutes.
• A nurse will also be with you throughout the procedure.
• You will be asked to stay at the clinic for at least 20 minutes following the procedure. If you are not feeling well, you will need to stay until the staff caring for you think you are well enough to leave.

The copper IUD is provided to you on the day of the insertion appointment; the cost is included in the fee charged on the day.

Will the copper IUD insertion be uncomfortable?

• The IUD insertion procedure can be uncomfortable for some people. It can be quite painful for a few people (15%). The pain is similar to bad period pain.
• It is recommended that you take oral pain relief (two paracetamol and two ibuprofen) an hour before your appointment.
• While we offer local anaesthetic to numb the cervix at the time of insertion and can provide an anti-anxiety medication beforehand if needed, we are unable to provide sedation. If you would like to have your IUD insertion under sedation, some clinics do provide this service; please ask our staff about this.
• A few people may feel faint or nauseous following the procedure. If this happens, you may be asked to stay at the clinic for a little longer.
• If you are concerned about possible discomfort, please discuss this with the doctor at your first appointment.

After your IUD insertion

• At SHFPACT, we encourage you to arrange to be driven home and to rest up after the procedure. You may need to organise care for children, time off work, etc.
• You will probably be fine to return to normal activities the following day. There may be cramping and bleeding in the first few days after insertion.
• • It is important that nothing enter the vagina for 72 hours afterward to reduce infection risk– for example: no tampons, no penetrative sex, no water (showering is ok).
• • No further appointment is needed unless you are experiencing problems. Your doctor will discuss this with you at the time of your insertion.

You should contact a doctor if:

• You think you might be pregnant.
• You experience excessive pelvic pain or tenderness, fever or chills, deep pain with intercourse, or vaginal discharge that smells unpleasant or is very different in colour or quantity normal for you.
• You can’t feel the string or can feel the plastic of the device coming out of the cervix.

References

• Contraception: An Australian Clinical Practice Handbook 4th Edition
• The Copper IUD Fact sheet, Family Planning NSW
• Faculty of Sexual & Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists UK.
• Contraception: Your Questions Answered. 7th ed. Churchill Livingstone, Guillebaud, J & MacGregor, A 2017.