Paragard (intrauterine copper contraceptive) is a brand-name prescription birth control device. The Food and Drug Administration (FDA) has approved it to help prevent pregnancy in females.*

Paragard may be used for short- or long-term birth control. You can ask your doctor to remove Paragard at any time. However, it’s effective for up to 10 years before it needs to be removed or replaced.

Here are some fast facts about Paragard:

As with other IUDs, Paragard can cause side effects. Read on to learn about potential common, mild, and serious side effects. For a general overview of Paragard, including details about its uses, see this article.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Paragard can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who used Paragard in clinical trials:

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Paragard use. This list doesn’t include all possible mild side effects of the device. For more information, you can refer to Paragard’s prescribing information.

Mild side effects that have been reported with Paragard include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while using Paragard and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.

Paragard may cause serious side effects. The list below may not include all possible serious side effects of the intrauterine device (IUD). For more information, you can refer to Paragard’s prescribing information.

If you develop serious side effects while using Paragard, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

* For more information about this side effect, see “Side effect specifics” below.
† An allergic reaction is possible after using Paragard. However, this side effect wasn’t reported in clinical trials. To learn more, see the “Side effect specifics” section below.

Paragard may cause several side effects. Here are some frequently asked questions about the device’s side effects and their answers.

Can Paragard cause weight gain?

No, clinical trials did not report weight gain as a side effect of Paragard.

Paragard is a hormone-free intrauterine device (IUD) that uses copper as its active ingredient. Typically, IUDs that contain hormones as their active ingredient, such as Mirena (levonorgestrel intrauterine system), can cause weight gain. In clinical trials of Mirena, weight gain was a reported side effect.

If you have any questions about how birth control can affect weight gain, contact your doctor or pharmacist.

Will I experience certain side effects after Paragard removal?

You may experience side effects after Paragard removal. In clinical trials, side effects that occurred after Paragard removal included:

You may be more likely to experience these side effects if you have had these conditions before.

It’s also possible for pieces of Paragard to break off during removal. This would be a serious side effect, as broken pieces can attach to or poke through your uterine wall. A broken Paragard IUD may require surgery to remove it. Symptoms include:

Talk with your doctor if you’re experiencing any symptoms of an incomplete Paragard removal.

Paragard’s manufacturer provides specific instructions for how to remove Paragard safely and minimize the risk of side effects. Your doctor will remove Paragard for you if you decide you no longer want to use it. Never attempt to remove Paragard yourself, as doing so could lead to serious side effects.

Is there somewhere I can find side effect reviews of Paragard?

Yes, side effect reviews for Paragard are available on the manufacturer’s website. These are reviews from other people who have used Paragard.

It’s important to note that your experience with Paragard may differ from these reviews. This is because every person’s body is different, and medical devices may not work the same or have the same side effects for everyone. Your past medical history can also affect the type of side effects you may be more likely to experience.

Talk with your doctor if you have any questions about side effects of Paragard. Your doctor knows your medical history and will be able to answer questions that are specific to you.

Does Paragard cause any long-term side effects?

Yes, Paragard can cause long-term side effects. Long-term side effects from Paragard typically range from mild to moderate, and can include:

Long-term side effects related to Paragard typically go away after your doctor removes the device.

Talk with your doctor if you feel as though you’re experiencing long-term side effects from Paragard that are bothersome or affecting your daily life.

Are hair loss and headache side effects of Paragard?

No, hair loss and headache were not reported side effects in clinical trials of Paragard. Hair loss is a common side effect of hormone-based IUDs, such as Mirena. Paragard is a copper-based IUD and does not have any hormones in it.

Headache was also not a reported side effect in Paragard’s clinical trials. However, headache is another common side effect of hormone-based IUDs, such as Mirena.

Talk with your doctor if you feel as though you are experiencing hair loss or headaches while using Paragard. Your doctor will evaluate your symptoms and help determine any possible causes.

Learn more about some of the side effects that Paragard may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Paragard.

Increased bleeding, spotting, or changes in periods after Paragard insertion

Increased bleeding, spotting, or changes in periods are possible after Paragard insertion. These were common insertion side effects reported in Paragard’s clinical trials, and were mild to moderate in severity.

These side effects include longer or heavier periods than is typical for you, vaginal bleeding between periods, and more frequent spotting. It’s possible to experience these side effects for months to years after Paragard insertion.

Worsening spotting, bleeding, or changes in periods may indicate serious side effects, such as pelvic inflammatory disease (PID) or sepsis. (PID is inflammation of the uterus, fallopian tubes, or ovaries. Sepsis is a severe response to an infection that may lead to serious complications.)

What you can do

When you start using Paragard, you should track any changes in your period and report them to your doctor. Both you and your doctor should keep track of any changes to monitor for worsening side effects.

Let your doctor know if you start having heavier periods after having lighter periods for several months. This may be a sign of an infection.

While you’re using Paragard, also let your doctor know if you don’t have your period for longer than 6 weeks. They’ll likely have you take a pregnancy test to make sure Paragard is still working.

If you have any of the side effects mentioned above, talk with your doctor. They can assess your symptoms to try and figure out the cause. Removing Paragard may be an option if your side effects are severe.

Cramps after Paragard insertion

Cramping and pinching are possible side effects during Paragard insertion. In clinical trials, these common side effects ranged from mild to moderate in severity. They typically lasted for a few minutes after insertion.

However, Paragard itself may cause occasional pain and cramping for months after insertion. In clinical trials, cramping symptoms were more common within the first 6 months of using Paragard. They typically eased over time.

What you can do

If you experience symptoms right after Paragard insertion, your doctor may recommend lying down until your symptoms ease. Let your doctor know if your symptoms persist, as this could mean that Paragard wasn’t inserted correctly. Your doctor may have you get up slowly to monitor for any remaining Paragard insertion symptoms.

However, Paragard itself may cause cramping for several months after placement. Talk with your doctor if your cramps become too bothersome or worsen in the months after Paragard insertion. They may be able to recommend ways to manage these symptoms, such as warm compresses, abdominal massages, and gentle exercise.

For severe or persistent pain and cramps, your doctor will evaluate your symptoms to diagnose a possible cause. In some cases, they may recommend Paragard removal.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is inflammation in the uterus, fallopian tubes, or ovaries. It typically results from an infection. In Paragard’s clinical trials, this serious side effect was rare.

Common symptoms of PID include:

Without prompt treatment, PID can cause infertility and sepsis. In severe cases, a hysterectomy (surgical removal of the uterus) may be necessary to treat the condition. Early diagnosis and treatment of PID can reduce the risk of long-term complications.

If you experience any of the above symptoms of PID, contact your doctor or call your local emergency services.

What you can do

Talk with your doctor if you’re experiencing symptoms of PID. Your doctor may perform a pelvic exam to screen for any infections. If they confirm that you have PID, your doctor will likely prescribe antibiotics, such as Rocephin (ceftriaxone) and Vibramycin (doxycycline).

Your doctor may recommend removing Paragard if your symptoms don’t ease after starting antibiotics.

Perforation of the uterus and cervix

During insertion, it’s possible for Paragard to perforate the uterus or cervix. When this happens, pieces of the device poke through the walls of these organs.

Without immediate treatment, a perforation can lead to more serious complications. Some of these complications can include infection, damage to nearby organs, peritonitis (inflammation around your abdominal organs), and abscesses.

Perforation can also make Paragard less effective at helping to prevent pregnancy.

In clinical trials, Paragard perforations were a rare but serious side effect. You may have an increased risk of this side effect if you’re lactating or have a condition affecting the shape of your uterus. Your risk of perforation is also higher if Paragard is inserted immediately after childbirth.

Symptoms of perforation include:

What you can do

Talk with your doctor if you’re experiencing symptoms of perforation due to Paragard. Your doctor will assess your symptoms and discuss treatment options for your condition.

If your doctor does diagnose a perforation, they will need to remove Paragard immediately. Depending on how severe the perforation is, surgery may be necessary to remove Paragard.

Back pain

Back pain is possible while using Paragard. In clinical trials, this was a common side effect and is typically mild to moderate in severity.

With this side effect, you may notice:

  • new back pain since starting Paragard
  • more pain than is typical for you when lifting things
  • new back pain when sitting or lying down

What you can do

Talk with your doctor if you’re experiencing bothersome back pain while using Paragard. Your doctor may recommend pain relieving medications, such as Advil (ibuprofen) or Aleve (naproxen), to help with your symptoms.

Allergic reaction

As with most intrauterine devices, Paragard can cause an allergic reaction in some people. However, this side effect wasn’t reported in clinical trials.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep using Paragard. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Be sure to talk with your doctor about your health history before you use Paragard. This device may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:

Allergic reaction. If you’ve had an allergic reaction to Paragard or any of its ingredients, your doctor will likely not prescribe Paragard. Ask your doctor what other types of birth control may be better options for you.

Copper allergy. If you have or have had a copper allergy, you’re more likely to experience an allergic reaction to Paragard. Paragard is a copper intrauterine device (IUD), and the copper material can trigger an allergic reaction in your body. Due to this risk, doctors will typically not prescribe Paragard if you have a copper allergy. However, they can recommend other birth control options for you.

Wilson’s disease. Wilson’s disease is a condition in which your body cannot remove copper, causing a high level to build up in your organs. Paragard is a copper IUD. If you use Paragard and have Wilson’s disease, you may have an increased risk of severe side effects from the disease. Due to this risk, doctors will not likely prescribe Paragard if you have Wilson’s disease.

Before using Paragard, talk with your doctor if you have a history of Wilson’s disease. They can recommend the right birth control options for you.

Untreated cervicitis, vaginitis, or urinary tract infection (UTI). An untreated inflammation or infection in your cervix, vagina, or urinary tract may increase your risk of serious side effects of Paragard. Before starting Paragard, tell your doctor if you have any symptoms of infection. These symptoms may include fever, chills, or unusual vaginal discharge. Your doctor will likely want to treat the infection before Paragard insertion.

Condition that changes the shape of your uterus. Before using Paragard, tell your doctor if you have or have had a condition that changes the shape of your uterus. An example of such a condition is fibroid tumors.

These conditions can make it more difficult to place Paragard, which can increase your risk of serious side effects. Due to this risk, doctors typically will not prescribe Paragard if your uterus is not a typical shape. However, they can recommend other birth control options for you.

Unexplained bleeding from your vagina. If you have unexplained bleeding from your vagina, your doctor will likely not prescribe Paragard. Unexplained bleeding can be a symptom of more serious conditions, such as pelvic inflammatory disease.

Talk with your doctor before starting Paragard if you have unexplained bleeding from your vagina. They’ll likely want to diagnose and treat any underlying conditions before prescribing Paragard.

Uterine cancer or cervical cancer. Your doctor will likely not prescribe Paragard if you have a history of uterine cancer or cervical cancer. These can increase your risk of serious side effects from Paragard, such as perforation or embedment. Talk with your doctor before Paragard insertion. They will help determine the best treatment strategies for you.

Dizziness, slow heart rate, or seizure. Some people may experience dizziness, slow heart rate, or seizure after Paragard insertion or removal. The risk of these side effects is higher if you’ve had these conditions in the past. Before Paragard insertion, tell your doctor if you’ve ever experienced any of these conditions.

Recent childbirth or abortion. Let your doctor know if you’ve recently given birth or had an abortion. The risk of Paragard expulsion is higher if it’s inserted soon after you give birth or have an abortion. (Expulsion is when Paragard partially or completely falls out of your uterus.) Your doctor can help you decide the best time to have Paragard inserted.

Alcohol with Paragard

In clinical trials, there were no reported interactions between Paragard and alcohol.

However, keep in mind that drinking alcohol may cause dizziness. This side effect is also possible with Paragard, especially during insertion or removal of the IUD. Consuming alcohol before Paragard insertion or removal may increase your risk of dizziness.

Ask your doctor how much alcohol, if any, is safe to consume while using Paragard.

Pregnancy and breastfeeding while using Paragard

It’s not safe to use Paragard during pregnancy. Paragard is approved by the Food and Drug Administration (FDA) to help prevent pregnancy, so it’s not necessary to use Paragard if you’re already pregnant. Using Paragard during pregnancy can increase your risk of complications, such as pregnancy loss, sepsis, and premature labor.

Paragard may be used while breastfeeding. In clinical trials, there was no information on how copper affects children who are breastfed. Additionally, there was no reported difference in the amount of copper in breast milk before and after Paragard insertion. (Paragard is a copper IUD.)

However, breastfeeding may increase the risk of certain side effects, such as perforation. In clinical trials, perforation of the uterus or cervix was more common in people who were lactating.

Talk with your doctor if you’d like to use Paragard to help prevent future pregnancies while breastfeeding. You and your doctor can discuss risks and benefits to decide whether or not you should use Paragard while breastfeeding.

Paragard is approved by the Food and Drug Administration (FDA) to help prevent pregnancy. Paragard has the potential to cause mild, moderate, and more serious side effects. Most side effects from Paragard are mild to moderate in severity. Talk with your doctor right away if you feel as though you may be experiencing serious side effects.

If you’d like to learn more about Paragard, talk with your doctor or pharmacist. They can help answer any questions you have about side effects while using the device.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Paragard. For details about other aspects of Paragard, refer to this article.
  • Drug comparison. To learn how Paragard compares with Mirena and Skyla, read this article.
  • A look at birth control. For details about birth control, see our women’s hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.