And now new appeal for non-hormonal birth control: the rise of weight loss drugs like Ozempic. A spate of unplanned pregnancies among women taking GLP-1 agonists has doctors cautioning patients to be extra careful with contraception. “Medications that affect glucose metabolism, insulin sensitivity, and weight will affect hormonal regulation,” says Dr. Banafsheh Bayati, a Santa Monica-based ob-gyn and co-founder of Perelel women’s health supplements. “Contraception needs to be discussed when taking such medications.”
But like with any medication, there are downsides. Paragard—which accounts for 23% of IUDs used according to data from 2015 to 2017—has a known side effect of heavier and more uncomfortable periods, a change some women simply won’t consider or tolerate especially when hormonal IUDs can sometimes provide lighter menstruation. Read on to learn more about the copper IUD, the only non-hormonal IUD and LARC.
How does a copper prevent pregnancy?
While hormonal birth control—pills, implants, and hormonal IUDs—works by safely stopping ovulation, copper IUDs work by creating an inhospitable environment for pregnancy.
“The T-shaped copper-supported IUD releases copper ions, and copper and sperm don’t really mix very well,” says Bayati. “Essentially, it forms a little inflammatory cytotoxic environment in the cervical mucus as well as the endometrial lining. We consider it to be spermicidal.”
A copper allergy is a contraindication, but otherwise the inflammation, which is a “sterile inflammatory response” stays local and minimal. And as for the risks of having copper in your body for extended periods of time, a concern perpetuated on social media: “There’s not enough copper in it to be copper toxic,” says Dr. Elizabeth Bailey Rodgers, an ob-gyn at Spring Ob/Gyn in New York City. “It’s not a thing.”
How painful is insertion?
The notoriously painful insertion (and removal) can be a dealbreaker for some women, but the good news is more doctors are providing pain management—something that was not even part of doctor training a few decades ago.
Insertion requires grabbing and pulling the cervix with an archaic sharp hooked device called a tenaculum and inserting a tube through the cervix for up to a couple of minutes. “We put the IUD in folded and then pop the arms open inside the uterus cavity,” says Rodgers. Paragard is one of the largest of the IUDs. While it’s described as “temporary discomfort” on the website of the American College of Gynecology, most anecdotal descriptions on social media are pretty raw and use language such as “the worst pain I’ve ever experienced.” There is even a corner of TikTok where women record their faces to capture their pained expressions during appointments.
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