For many women, Paragard — a copper intrauterine device (IUD) — is the only alternative to hormonal birth control. Paragard prevents pregnancy by creating an inflammatory environment that prevents sperm from reaching the egg and fertilizing it. It may also prevent implantation of a fertilized egg. From a scientific standpoint, the copper ions cause an endometrial change that causes sperm migration, quality, and viability (such as motility) to be hindered. (1) If the Paragard causes an “inflammatory environment,” the following questions arise: is the copper IUD a safe alternative to traditional birth control methods? Does the IUD cause pelvic inflammatory disease (PID) or result in copper toxicity? What about low levels of inflammation throughout the body?
Many websites report that all of these issues are possible — if not almost certain — but the medical research tells a different story.
In a study of 17 women with the copper IUD inserted 24 months, measurements of copper serum (the total count of copper in your blood) showed no alternation in levels throughout the 24-month period. Researchers found the level of copper in the blood was no different between women with the copper IUD and the control population (those without). They also found there was no difference in the level of copper in urine 24-hours after insertion. These findings helped support the researchers hypothesis that copper emitted by Paragard could not be readily absorbed by the body. (2)
Another study has shown that it’s not the type of IUD that increases infection, but rather the length in time of insertion. While not conclusive, the study revealed that 85% of women with a specific form of infection had worn their IUD for over 3 years. Researchers hypothesized that with long-term use, the IUD develops a surface coating of mucoid and cellular elements that are inflammatory and, in turn, the body perceives the IUD as a foreign object potentially contributing to the development of PID. These findings led researchers to conclude that Inflammation and infection, once thought to be solely caused by STIs, may now also be caused by the degradation of the IUD’s nylon tail. Researchers recommended that for safe and effective use of any IUD, women should consider removing and replacing their IUD every three years. (3)
Considering that women can keep their IUD inserted for up to 10 years, it raises important questions about whether this FDA-approved recommendation is as safe as once perceived. If you elect to remove an IUD in advance of the maximum, 10-year recommendation, regardless of whether it’s for the reinstatement of your fertility or to simply insert a new IUD, are there insurance cost consequences?
You may also face an uphill battle with your physician if you disclose that you are having your IUD removed only to have a new one re-inserted. A study by the World Health Organization (WHO) showed the efficacy of IUDs across the span of 10 years is similar to the rate of failure seen in women that have undergone sterilization. It also showed efficacy remained beyond the recommended 10 years up until year 12. In other words, it’s extremely reliable. As a result, the study recommends women elect to have the fewest number of insertions throughout their lifetime to help save commodity costs, including staff time, which adds up to US $60 million annually. (4)
Regardless of your decision (electing to have a Paragard inserted or electing to have an early replacement as a precautionary method), it’s important to remember that it is your body and the only person that should make decisions as to what you do with it — is you.