IUDs are an excellent choice for contraception. The long-term effectiveness of IUDs is well established, and their safety record is excellent. A common question among women considering the copper IUD (ParaGard) is whether it will change their menstrual periods and make them heavier..
Longer Use with Copper IUDs
The copper-containing ParaGard IUD is approved in the U.S. for 10 years of use, though research indicates that it remains effective for at least 12 years, and small studies suggest that even after 20 years of use, the risk of pregnancy remains extremely low.
One disadvantage of the non-hormonal copper IUD is that for some women menstrual bleeding can increase by up to 50%. Normal blood loss is up to 80 cc per month. If your usual period involves about 40 cc of blood loss, a 50% increase would mean approximately 60 cc—still within a normal range. However, if your baseline is 80 cc, you might experience closer to 120 cc per cycle. Most women with balanced diets and adequate iron intake tolerate this well and do not become anemic. Studies show that most women maintain stable blood counts in the first months or years of copper IUD use, although mild decreases in iron stores can occur over longer use due to cumulative menstrual loss. Increased bleeding remains the most common reason for IUD removal.
Rarely IUD bleeding patterns will increase
Women who experience stable bleeding patterns during their first year of IUD use typically continue to tolerate it well long term. However, over time, calcium deposits can form on the IUD’s surface, irritating the endometrial lining and contributing to heavier bleeding. Women who notice new or worsening bleeding after years of successful use should have their IUD evaluated or replaced.
In addition to its effectiveness as contraception, new evidence shows that copper IUDs such as ParaGard are associated with a reduced risk of endometrial cancer. This protective effect is believed to result from the local inflammatory response in the uterine lining triggered by the copper IUD. The immune activation appears to alter the endometrial environment in ways that reduce the likelihood of malignant cellular changes over time.
All women of reproductive age need effective and individualized contraception. Schedule a visit at Women’s Health Practice to determine which method best suits your health profile and ensures comprehensive gynecologic care.
