The copper IUD (coil) is one of the few non-hormonal methods of birth control we have. From a natural health perspective, it’s not as appealing as fertility awareness method (FAM), Daysy, condoms, or cervical cap—but it’s certainly worth considering.
Should you consider it?
It permits normal, healthy ovulation, and that is its biggest advantage over hormonal methods. If you’re a regular reader of my blog or my book, then you know how much I care about ovulation. That’s because I care about women’s hormones—and ovulation is the only way to make them! The pseudo-hormone steroids of hormonal birth control are not real hormones. (See The Crucial Difference Between Progesterone and Progestins, and my new short animation: Why Birth Control Can Never Regulate Periods.)
It’s more effective than almost any other method, with a failure rate of just 0.6 percent.
After insertion, you don’t need to do anything or take anything, and it lasts up to 10 years.
Fertility returns to normal as soon as you remove it.
It’s the most popular method of birth control in the world.
It has the highest rate of user satisfaction of any method.
It is now officially deemed suitable for women of any age, including women who have not yet had children, and teenagers.
It’s effective as emergency contraception.
Your doctor might not be very supportive or helpful because many doctors still suffer from incorrect, outdated information about IUDs.
You might have to pay. The device itself costs about $150 (one time cost), but your insurance may cover it.
Your doctor has to insert it, and that will probably be somewhat painful. But just to clarify: It’s an in-office procedure that takes a few minutes—it’s not surgery. You’ll probably be instructed to take a painkiller like ibuprofen to ease the cramping, or your doctor may decide to use a local anesthetic (or more rarely, a general anesthetic ). One woman described IUD-insertion this way:
“It’s like a PAP smear test but a little weirder and more uncomfortable.”
The cramping may continue for a couple of weeks after insertion, and then you may experience more pain with your periods. One study found that 38 percent of IUD-users reported more period pain at first, but then it reduced over 12 months.
Your periods will probably be heavier, and you might experience spotting between periods. One study found that copper IUDs increased blood loss by 20–50 percent for the first 12 months after insertion. Periods then returned to normal in some women, but not all. Heavier blood loss can be managed with ibuprofen or the herbal medicine turmeric. Please see Natural Treatment for Very Heavy Periods.
It might come out. Risk of expulsion is highest in the first month after insertion (5.7 percent), and then decreases to 2 percent per year. If it comes out, and you don’t realize, then you could become pregnant. Signs of expulsion include pain, spotting, and the absence or lengthening of the string. A new “frameless” IUD called GyneFix (available in Europe) is easier to insert and has a lower risk of expulsion.
There’s a risk of pelvic inflammatory disease (PID) during the first three weeks after insertion, but only if you have a pre-existing infection with gonorrhea or chlamydia. That’s why your doctor should screen for those common conditions before inserting an IUD.
⚠️ Dark memory of the Dalkon Shield. A badly designed IUD in the 1970s caused 18 deaths and thousands of complications for its 2.8 million users. The problem was the string of that particular IUD, which was multifilament and grew bacteria. Modern IUDs have a safer design and carry no significant risk of infection.
There’s a small risk of uterine perforation, which could lead to surgery. Perforation occurs in 0.1 percent of users (1/1000), but is more likely if you are breastfeeding.
It might cause copper excess. The amount of copper released is actually quite tiny compared to the copper we obtain from food. For example, one serving of dark chocolate contains 2 mg copper. Some IUD users anxiety, possibly from copper toxicity and one study found that IUD users do have higher serum copper compared to non-users. Copper excess is more likely to be a problem if you are deficient in zinc, so your doctor may want to test your zinc and copper levels before inserting an IUD. I would love to see more research on this topic.
⚠️ Tip: Users of hormonal birth control also have higher serum copper but for a different reason. Synthetic estrogen causes the body to retain copper.
If and when you want it out, you will need to see your doctor. In theory, you cannot remove it yourself, but actually many women do successfully manage self-removal, and one study found “little health risk from a woman removing her own intrauterine device”. The authors go on to say that IUDs would be more popular if women had the control to remove it themselves.
Your partner might feel the string, but most men don’t.
It doesn’t protect against STIs (sexually transmitted infections).
Bottom line about the copper IUD
As a naturopathic doctor, what do I think? Put it this way: I’m not a cheerleader for the copper IUD. I prefer other non-hormonal methods such as condoms, fertility awareness methods, and Daysy (a technology-assisted method of fertility awareness).
I am aware of the internet horror stories. I’m also aware of the millions of women (including some of my own patients) who are happy with the copper IUD (and not posting about it online). Remember, it has the highest user satisfaction rate of any method of birth control.
From a natural health perspective, my main criteria for birth control is that it not shut down ovulation. That it not shut down hormones. In other words, that it not castrate women. Copper IUD meets that criteria.
Next month: The Pros and Cons of the Hormonal IUD (Mirena).
Now, I’d love to hear your thoughts. Please comment.
(For a first-hand description of a positive IUD experience, please read Joanna’s March 9 comment below.)