Weight gain is a common concern when choosing a birth control method. Many women worry about the potential side effects of different options, and the copper intrauterine device (IUD) is no exception. This article will explore the relationship between copper IUDs and weight loss, providing you with the information you need to make an informed decision about your birth control.
What is a Copper IUD?
An IUD (intrauterine device) is a small, T-shaped piece of plastic that a healthcare provider inserts through your vagina and into your uterus to prevent pregnancy. There are two main types of IUDs: hormonal IUDs and copper IUDs.
A copper IUD, like ParaGard, does not contain hormones. Instead, a copper wire is coiled around the stem of the device, and copper sleeves cover each arm. ParaGard continually releases copper into the uterine lining. The copper is lethal to sperm and helps prevent fertilization. It works almost immediately and can prevent pregnancy for up to 10 years. You can have it removed anytime if you want to become pregnant or try another birth control method.
How Copper IUDs Work
A copper IUD is made up of a plastic “T” wrapped in a copper coil. Because sperm don’t like copper, they avoid the IUD. This prevents sperm from reaching an egg. If sperm can’t get to an egg, you won’t get pregnant. Copper also helps change the lining of your uterus and cervical mucus, which makes it a less ideal environment for sperm.
In some situations, a healthcare provider may recommend a copper IUD as emergency contraception. This means that if a provider inserts it within five days (120 hours) of unprotected intercourse, it reduces the chance of an accidental pregnancy.
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Effectiveness of Copper IUDs
ParaGard® is more than 99% effective. The only other birth control options with that level of effectiveness are the hormonal IUD and the birth control implant. One reason IUDs work so well: There’s less room for error. After you have an IUD in, it’ll continue working without any further action from you.
Side Effects of Copper IUDs
Since a copper IUD has no hormones, the side effects are generally less severe than those of hormonal IUDs or other forms of hormonal birth control. However, some people experience side effects after getting an IUD. Your side effects will probably ease up after about 3-6 months, once your body gets used to your IUD. So if you can stick it out for a few months, there’s a good chance any side effects you’re having will eventually go away or be less noticeable.
The side effects can include:
- A heavier or longer period.
- A more painful period (more cramping).
- Spotting between periods or irregular periods.
- Anemia
- A backache
- Breakthrough bleeding, or bleeding between periods
- Cramping
- Vaginal inflammation
- Pain during sex
- Severe menstrual pain
- Vaginal discharge
In rare cases, an IUD is expelled from the body. This is more likely to happen if any of these apply:
- You’ve never been pregnant
- You have heavy periods and severe menstrual pain
- You’ve expelled an IUD before
- You’re under age 20
- You had the IUD inserted immediately after childbirth or after an abortion in the second trimester
There’s a slight possibility of perforating the wall of the uterus, particularly during placement. If perforation occurs, the IUD should be removed and surgery may be needed. Perforation may cause infection, scarring, or damage to other organs. The process of getting your IUD placed can be painful for some people. It usually feels like strong period cramps. But the good news is, it’s really quick - the worst part is usually over in less than a minute, and then you’ve got really effective birth control that you don’t have to think about for several years. Even if the insertion is not exactly a fun time, lots of IUD users think it’s totally worth it in the end.
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While IUDs are one of the best ways to prevent pregnancy, they don't protect you from sexually transmitted infections. Luckily, using condoms every time you have sex reduces the chance of getting or spreading STDs.
Copper IUDs and Weight Changes: What Does the Research Say?
Weight gain isn’t listed as a side effect of ParaGard. Anecdotal evidence from women using the device indicates IUDs cause weight gain, but scientific evidence is inconclusive.
One study published in Contraception assessed weight changes in Brazilian women using copper IUDs and found that weight increased, especially in older women. It was also determined that the women tended to gain weight during their reproductive years independent of IUD insertion. Because of this, weight gain may have been related to age. Baseline variables recorded included age, parity, decade when the IUD was inserted and the presence of hypertension. A total of 1697 IUD users were followed for 7 years of use. The mean age (+/- SD) of the women at the beginning of follow-up was 27.6 +/- 5.8 years and the mean height (+/- SD) was 150 +/- 10 cm. The mean weight (+/- SD) at the time of IUD insertion was 58.5 +/- 0.30 kg. After 5 and 7 years of follow-up, the mean weight (+/- SD) was 61.2 +/- 0.33 kg and 62.4 +/- 0.51 kg, respectively. At insertion, the body mass index mean (+/- SD) was 24.5 +/- 0.12 and after 3 years it was 25 +/- 0.14, remaining above 25 up to the 7th year of observation. During the 7 years of follow-up, older women gained more weight than younger women. Parity, decade of IUD insertion and hypertension were not noted to be significant determinants of weight variation. In conclusion, this cohort of lower and middle class Brazilian copper IUD users tended to gain weight during their reproductive life, independent of other factors.
A more recent study published in the European Journal of Contraception & Reproductive Health Care compared weight gain in women who used hormonal contraception or IUDs. The study found users of both types of birth control gained significant weight over a 10-year period. Although these studies indicate IUD users experienced weight gain, it’s unclear if the gain was due to the IUD or normal aging and lifestyle factors such as diet and exercise. Removing the IUD didn’t necessarily result in weight loss. More research is needed to put an end to the debate about weight gain and IUDs.
Interestingly, researchers compared the medical records of 223 women aged 15 to 44 who were using two different types of IUDs, following them for up to two years later. "We really expected to see weight gain, and we didn't even expect that there would be weight loss," said study author Dr. However, Kwock pointed out that the weight loss among the women in her study is probably not a reliable result.
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Benefits of Copper IUDs
Copper IUDs have several benefits:
- Hormone-free: Copper IUDs are a great option for people who can’t take hormones due to certain medical conditions or for people who simply don’t want to take hormones.
- Reversible: Once you remove a copper IUD, your pregnancy protection ends. This means it’s OK if your plans change and you either want to become pregnant or want to try a different type of birth control.
- Effective: IUDs are more than 99% effective, even when used as emergency contraception.
- Long-lasting: Once it’s inserted, the ParaGard copper IUD helps prevent pregnancy for up to 10 years.
- Convenient: Unlike birth control pills or other devices that are easy to forget, an IUD is a “set it and forget it” type of birth control. That means it’s super convenient and you don’t have to think about it every day or every month. Once your provider places it in your uterus, you’re getting the pregnancy protection you need for years.
- Hormonal IUDs usually make your periods much lighter and less crampy. And for people who can’t use or don’t want to use hormonal methods (but still want super-effective, non-permanent birth control), copper IUDs are a really great option.
Risks of Copper IUDs
Overall, copper IUDs are a safe, effective form of birth control. Some potential risks of using Paragard include:
- Perforation: Your healthcare provider accidentally perforates, or tears, your uterine wall when placing or removing the IUD. This can happen with any type of IUD, not just a copper IUD. This happens in less than 1 in 1,000 cases.
- Expulsion: The IUD can fall out. If this happens, your provider needs to insert a new one.
- Infection: There’s a small risk of infection when your provider inserts or removes an IUD.
- Pregnancy: Getting pregnant with an IUD is rare, but it can happen. You should call your healthcare provider if you believe you may be pregnant at any time while you have an IUD.
IUDs don’t prevent you from sexually transmitted infections (STIs) or HIV/AIDS. Use a condom every time you have sex to lower your risk of getting or spreading STIs.
Who Should Avoid Copper IUDs?
Copper IUDs are safe for most people. Talk to your healthcare provider about your medical history before getting a copper IUD so they can help you decide if it’s the right birth control method for you.
Healthcare providers may advise against a copper IUD if you have:
- An active pelvic, vaginal or uterine infection (including STIs).
- Uterine fibroids or tumors.
- Cervical or uterine cancer.
- An allergy or intolerance to copper.
- Wilson’s disease, which causes the accumulation of copper in the brain and other organs
- A high risk of having an STD
- A history of problems with an IUD
Your provider won’t place an IUD if there’s any chance you’re pregnant.