What are the side effects of the copper coil?

What exactly is a copper IUD?

Visit copper IUD, also known as Copper IUD (Intrauterine Device) is a small, T-shaped device inserted into the uterus by a doctor or midwife. Its active ingredient? Quite simply, copper. The copper ions continuously released into the uterus have a natural spermicidal effect that prevents fertilization.

It is a method of hormone-free contraception, making it a very popular option for women who want to avoid the side effects of hormonal contraceptives such as the pill. Its effectiveness is impressive: it’s said to have a success rate of over 99 %, comparable to that of the pill.

Its lifespan ranges from 5 to 10 years, depending on the model you choose. Once it’s in place, you don’t have to think about it on a daily basis. Convenient, isn’t it? But like any method of birth control, it has its pros… and its cons.

💡 The copper IUD is one of the most effective methods of birth control in the world, with an effectiveness rate of over 99 %, and it contains no hormones. But the fact that it contains no hormones does not mean it has no side effects.

What are the most common side effects of the copper IUD?

That’s THE question everyone asks themselves before taking the plunge. And I’ll be honest with you: the copper IUD can cause side effects, especially in the first few months after insertion. Here’s what you can expect.

Heavier and more painful periods

This is the most common side effect, and it affects the vast majority of women who use a copper IUD. Periods may become significantly heavier—sometimes by as much as 50 to 75 % in additional volume—and may be accompanied by cramps that are more intense than before.

Why? Copper triggers a local inflammatory reaction in the uterus, which stimulates the production of prostaglandins—molecules responsible for uterine contractions and, consequently, pain. This is a direct physiological mechanism linked to the presence of the device.

Pelvic pain after the procedure

In the first few hours, or even the first few days after insertion, it’s completely normal to experience cramps and pelvic pain. This is the uterus adjusting to the presence of the IUD. These pains often feel like menstrual cramps and usually subside within 48 to 72 hours.

Some women also report pain during sexual intercourse in the first few weeks. If this pain persists for more than a month, it’s best to talk to your doctor.

Irregular bleeding between periods

Spotting (light bleeding between periods) may occur during the first 3 to 6 months after insertion. This is common and often temporary, but it can be unsettling. Your cycle usually regulates itself over time.

A possible iron deficiency

Heavier periods over the long term can lead to increased iron loss, and thus potentially to a iron-deficiency anemia. If you feel tired, short of breath, or have a dull complexion, consider having your ferritin levels checked. Regular blood tests are recommended.

Acne and Skin Imbalances

It’s not widely known, but some women report that their acne worsens after having a copper IUD inserted. The mechanism is complex: the inflammation caused by the copper can disrupt the local hormonal balance, indirectly affecting the skin. This doesn’t happen to everyone, but it’s worth mentioning.

An increased risk of infections and fungal infections

The IUD strings that protrude into the vagina can, in some cases, allow bacteria to travel up into the uterus. Vaginal infections, yeast infections, or urinary tract infections may occur more frequently. Good personal hygiene and regular gynecological checkups can help minimize this risk.

Why does the copper IUD cause these symptoms?

To understand the side effects, one must understand how the device works. Copper is naturally toxic to sperm—it impairs their motility and their ability to fertilize the egg. But to produce this effect, it generates a local inflammation in the uterus.

This low-grade chronic inflammation is the cause of most side effects: longer, more painful periods; bleeding between cycles; and pelvic tenderness. This is the «price to pay» for hormone-free birth control, and every woman reacts to it differently.

For some women, the body adapts quickly and the symptoms go away within a few months. For others, they persist for as long as the IUD is in place. It’s impossible to predict in advance how your body will react.

Rare but Serious Risks You Should Be Aware Of

In addition to common side effects, there are some less frequent but more serious complications. Don't panic—they're still rare—but it's best to be aware of them so you can act quickly if necessary!

Uterine Perforation

During insertion, there is a very low risk (about 1 to 2 cases per 1,000 insertions) that the IUD could perforate the uterine wall. This is usually painful right away. This risk is more closely related to the medical procedure than to the device itself, which is why it’s important to choose an experienced healthcare provider.

Voluntary Eviction

The IUD may be expelled from the uterus, especially in the first few months after insertion. This affects approximately 2 to 10 % of women. That is why it is recommended to check regularly to make sure the device’s strings are still present, especially after each menstrual cycle.

Ectopic Pregnancy

In the event of contraceptive failure—which is rare but possible—the risk of ectopic pregnancy (EP) is higher with an IUD than with other methods. If you have an IUD and think you might be pregnant, see a doctor right away. An untreated ectopic pregnancy can be dangerous.

Copper Intolerance

Wilson's disease (a copper metabolism disorder) and certain allergies are absolute contraindications for the copper IUD. More generally, sensitivity to copper can exacerbate inflammatory reactions and make wearing the IUD unbearable.

⚠️ Heavy and painful periods affect the majority of women who use a copper IUD and can lead to iron deficiency over the long term. Regular medical follow-up is therefore strongly recommended after insertion.

When should you see a doctor?

Certain signs should not be taken lightly. If you have a copper IUD and notice any of the following symptoms, seek medical attention immediately:

• A fever higher than 38°C in the days following the procedure
• Severe, persistent pelvic pain (lasting more than 2 to 3 weeks)
• Abnormal vaginal discharge (unusual odor, color, or texture)
• The absence of the IUD strings during self-examination
• A missed period or a positive pregnancy test
• Pain during sexual intercourse that persists over time

These symptoms may indicate a pelvic infection, an expulsion, or, in rare cases, a perforation. It’s better to get checked out quickly than to wait too long to prevent a complication!

How can you alleviate the side effects of the copper IUD?

Good news: there are practical strategies to help you feel more comfortable with your IUD and reduce everyday discomfort.

Anti-inflammatory diet

Since inflammation is at the heart of the problem, adopting an anti-inflammatory diet can really make a difference. Focus on omega-3 (fatty fish, flaxseeds, walnuts), turmeric, ginger, colorful vegetables, and red fruits. These foods help regulate the body’s inflammatory response.

Replenishing Iron Losses

If you have heavy periods, focus on iron-rich foods: red meat, lentils, spinach, tofu, and quinoa. Taking vitamin C at the same time improves the absorption of plant-based iron. If a blood test confirms a deficiency, you may consider taking supplements after consulting your doctor. The Probiotics can also support optimal nutrient absorption and improve overall digestive health.

Natural and Prescription Anti-Inflammatory Drugs

Ibuprofen, taken before or during your period, is often effective at reducing cramps and pain caused by inflammation. On the natural side, herbal remedies (yarrow, raspberry leaf, shepherd’s purse) can help with menstrual comfort. Talk to a naturopath or your doctor about this.

The Hot Water Bottle and Local Heat

It’s simple, easy to do, and really effective against cramps! The heat helps relax the uterine muscles and relieve pelvic pain. Just place a hot water bottle on your lower abdomen for 15 to 20 minutes, and you’ll feel much better right away.

Does the copper IUD affect mood or libido?

This is a question many people ask, and the answer is nuanced. Unlike the hormonal IUD or the birth control pill, the copper IUD does not directly alter hormone levels in the blood. Therefore, there is no proven direct effect on mood or libido related to hormones.

On the other hand, if you experience painful periods, fatigue caused by iron deficiency, or pain during intercourse, this can indirectly affect your psychological well-being and your sex life. That’s perfectly logical and human.

On the contrary, some women report an improvement in their libido after switching to non-hormonal birth control, as they regain a natural cycle and feel more in tune with their bodies. Every experience is unique!

What are the alternatives if the copper IUD isn't right for you?

If the side effects are too severe, keep in mind that there are other birth control options that are hormone-free or have fewer side effects.

Symptothermal Method

Visit symptothermal method is a natural method based on observing the signs of the menstrual cycle: basal body temperature, cervical mucus, and cervical position. When practiced rigorously, with proper training (such as that offered by the CLER association or Sensiplan), it can achieve an effectiveness rate of 98 to 99.6 %. It is a viable alternative for women who want to reconnect with their cycle.

The hormonal IUD

The hormonal IUD (such as Mirena or Kyleena) releases a low dose of levonorgestrel locally into the uterus. It often has the opposite effect of the copper IUD: it reduces menstrual flow or even stops it altogether. This is ideal if you suffer from endometriosis or very painful periods. The hormones remain localized and very little enters the general bloodstream.

Other Nonhormonal Methods

Male or female condoms, diaphragms, cervical caps, and spermicidal gel are other options to consider depending on your personal situation. A tailored nutritional approach, such as the one proposed in Specialized Nutrition for Health, can also support your overall well-being. Every woman is different, and there is no one-size-fits-all solution.

Comparison Chart: Copper IUD vs. Hormonal IUD

FAQ: Your Questions About the Side Effects of the Copper IUD

Does the copper IUD cause weight gain?

No! That’s a very common misconception. Unlike the birth control pill or the hormonal IUD, the copper IUD does not contain any hormones that could affect fat storage or water retention. If you gain weight while using a copper IUD, the device is not to blame.

How long do the side effects last after the procedure?

The most severe symptoms (cramps, spotting, heavy periods) tend to occur mainly during the first 3 to 6 months. For many women, the body gradually adjusts and the symptoms subside. If there’s no improvement after 6 months, see your gynecologist or midwife.

Does the copper IUD cause an abortion?

This is a debate that comes up often. Scientifically speaking, the copper IUD works primarily by preventing fertilization through the spermicidal effect of copper. The WHO and the HAS (Haute Autorité de Santé) classify the IUD as a contraceptive, not as an abortifacient.

Can you use a menstrual cup with a copper IUD?

That's a valid question! Some studies suggest that using a menstrual cup could increase the risk of the IUD being expelled, especially if the cup is removed using gentle suction. It’s not strictly prohibited, but it’s best to discuss this with your doctor and be very careful when removing it.

Is the copper IUD compatible with endometriosis?

This is a relative contraindication. Since endometriosis already involves significant inflammation and painful periods, adding a copper IUD—which exacerbates inflammation—can worsen symptoms. In this case, the hormonal IUD is generally preferred because it reduces bleeding.

Can you feel the IUD strings during sex?

Normally, no! The strings are flexible and sit along the cervix. If your partner feels them during intercourse, it may mean that the strings are too long or that the IUD has shifted. In that case, you should see your doctor for a checkup.

Is the copper IUD covered by insurance?

In France, the copper IUD is reimbursed at 65 % by the national health insurance program, and the insertion procedure is also covered. For women under 26, contraception has been completely free since 2022, including the device itself. This is great news for anyone who wants to start using it without breaking the bank!