Copper intrauterine device (IUD)

Copper coil, the coil.

A plastic T-shaped device that has a fine copper wire wrapped around it. It is placed in the uterus and slowly releases copper particles.

It has two thin, flexible plastic threads attached to the base of the device that pass through the cervix and sit high in the vagina. There are 2 types of copper IUD available in Australia. One lasts for 5 years, and the other lasts for 10 years.

• Preventing pregnancy.
• Emergency contraception (preventing pregnancy after unprotected sex).

The copper IUD works by:

• making it harder for the egg and sperm to survive
• creating a reaction so if an egg is fertilised, it is less likely to implant to start a pregnancy
• The copper IUD does not contain hormones. It can be a suitable option for people who cannot use hormonal contraception for medical reasons.

The copper IUD can be used as emergency contraception if inserted within 5 days (120 hours) of having unprotected sex.

After insertion, the copper IUD starts working straight away to prevent pregnancy.

99.2–99.4% effective.

• Have the IUD inserted and removed by a trained clinician.
• Be aware of signs that the IUD has moved or fallen out (e.g., cannot feel the strings of the IUD, or severe abdominal pain).
• Have the IUD replaced on time (every 5 or 10 years, depending on the type).

It is a good idea to write down when you got the copper IUD inserted, so you can remember when it is time to get it replaced.

The copper IUD is very effective and works all the time without you needing to do anything. Medicines and everyday activities do not affect how well it works.

The copper IUD is less effective if it:

• moves out of place or falls out
• is past its recommended use time and has not been replaced

If there are signs that the IUD may have moved or fallen out, use another form of contraception (or avoid having sex) and seek immediate advice from a healthcare professional.

No.

Internal and external condoms are the only types of contraception that protect against STIs.

The copper IUD needs to be replaced every 5 or 10 years, depending on the type.

It can be removed at any time if you don’t want to use it anymore.

An IUD sits inside the uterus and cannot be seen. You and your partner(s) will usually not feel it during sex. In some cases, a partner may feel the IUD strings. These are more likely to be felt with fingers than with a penis.

Some people may experience side effects. Some possible side effects include:

• cramping or pain when the copper IUD is inserted, and for a few days after
• periods becoming heavier, longer or more painful
• spotting (light bleeding that is not your period) or bleeding between periods
• increase in vaginal discharge

Some people experience no side effects while using the copper IUD. Side effects can settle after a few months. If the side effects of the copper IUD bother you, you may want to try a different type of contraception.

In very rare instances, insertion of an IUD may cause a small tear in the wall of the uterus. See a healthcare professional immediately if you experience:

• severe pelvic/abdominal pain
• heavy vaginal bleeding
• pain during sex
• not being able to feel the IUD strings (particularly if you have previously been able to feel them)

Some common health conditions and lifestyle factors that may stop you from using the copper IUD include:

• Wilson's disease or a copper allergy
• painful periods
• cervical or endometrial cancer
• unexplained vaginal bleeding
• pelvic inflammatory disease or pelvic infection
• fibroids or other conditions that change the shape of your uterus

It is important to talk with a healthcare professional about your full medical history when deciding which contraception option is the safest and most suitable for you.

You will need a prescription. You can get one from a doctor (either a GP or relevant specialist, e.g. a gynaecologist) or nurse practitioner. They should ask you questions about your medical history and might do some tests to ensure that the copper IUD is a safe option for you before prescribing.

It is possible to get a prescription at:

• a GP clinic
• a specialist appointment
• a telehealth appointment (online or over the phone)
• sexual health clinics
• family planning clinics

Once you have a prescription, the copper IUD can be bought at most pharmacies, including online pharmacies.

You will then need to bring the IUD to a follow-up appointment where it will be inserted in your uterus through a small procedure. The copper IUD needs to be inserted and removed by a trained healthcare professional. This is usually done while awake, but in some cases can be done under sedation. There are various pain management options that can be used during the procedure. You can discuss these with your healthcare professional.

The copper IUD lasts for 5 or 10 years, depending on the type. The cost per IUD is between $70–120.

If you choose to get the IUD inserted under sedation, this can have additional out-of-pocket costs which may start from $500 but can range widely. You may be able to get it done in the public health system which will generally not have out-of-pocket costs, but spots are limited and wait times will be longer.

There are no ongoing costs until the IUD needs to be replaced.

Although some healthcare professionals bulk bill (which means you won’t pay anything to see them), some may charge out-of-pocket costs for the appointments needed to get your prescription and to get the IUD inserted and removed.

No, the copper IUD has no impact on long-term fertility.

Once the copper IUD is removed it is possible to become pregnant straight away.

If you have had an uncomplicated birth (vaginal or caesarean), the copper IUD can be inserted within the first 2 days (48 hours) of giving birth. If it is not inserted within the first 2 days, then you will have to wait until 28 days after birth before it can be inserted.