If you think you are pregnant, contact your healthcare provider right away. If you are pregnant and Paragard® is in your uterus, you may get a severe infection or shock, have a miscarriage or premature labor and delivery, or even die. Because of these risks, your healthcare provider will recommend that you have Paragard® removed, even though removal may cause miscarriage.

If you continue a pregnancy with Paragard® in place, see your healthcare provider regularly. Contact your healthcare provider right away if you get fever, chills, cramping, pain, bleeding, flu-like symptoms, or an unusual, bad-smelling vaginal discharge. A pregnancy with Paragard® in place has a greater than usual chance of being ectopic (outside your uterus). Ectopic pregnancy is an emergency that may require surgery. An ectopic pregnancy can cause internal bleeding, infertility, and death. Unusual vaginal bleeding or abdominal pain may be signs of an ectopic pregnancy. If you have any of these symptoms, contact your healthcare provider right away.


The most common side effects of Paragard® are heavier, longer periods and spotting between periods; most of these side effects should diminish after 2–3 months. However, if your menstrual flow continues to be heavy or long, or spotting continues, contact your healthcare provider.

Infrequently, serious side effects may occur:

  • Pelvic inflammatory disease (PID): Uncommonly, Paragard® and other IUDs are associated with PID. PID is an infection of the uterus, tubes, and nearby organs. PID is most likely to occur in the first 20 days after placement. You have a higher chance of getting PID if you or your partner have sex with more than one person. PID is treated with antibiotics. However, PID can cause serious problems such as infertility, ectopic pregnancy, and chronic pelvic pain. Rarely, PID may even cause death. More serious cases of PID require surgery or a hysterectomy (removal of the uterus). Contact your healthcare provider right away if you have any of the signs of PID: abdominal or pelvic pain, painful sex, unusual or bad smelling vaginal discharge, chills, heavy bleeding, or fever.
  • Difficult removals: Occasionally, Paragard® may be hard to remove because it is stuck in the uterus. Surgery may sometimes be needed to remove Paragard®.
  • Perforation: Rarely, Paragard® goes through the wall of the uterus, especially during placement. This is called perforation. If Paragard® perforates the uterus, it should be removed. Surgery may be needed. Perforation can cause infection, scarring, or damage to other organs. If Paragard® perforates the uterus, you are not protected from pregnancy.
  • Expulsion: Paragard® may partially or completely fall out of the uterus. This is called expulsion. Women who have never been pregnant may be more likely to expel Paragard® than women who have been pregnant before. If you think that Paragard® has partly or completely fallen out, use an additional birth control method, such as a condom, and call your healthcare provider.
  • You may have other side effects with Paragard®. For example, you may have anemia (low blood count), backache, pain during sex, menstrual cramps, allergic reaction, vaginal infection, vaginal discharge, faintness, or pain. This is not a complete list of possible side effects. If you have questions about a side effect, check with your healthcare provider.


Call your healthcare provider if you have any concerns about Paragard®. Be sure to call if you:

  • Think you are pregnant
  • Have pelvic pain or pain during sex
  • Have unusual vaginal discharge or genital sores
  • Have unexplained fever
  • Might be exposed to sexually transmitted diseases (STDs)
  • Cannot feel Paragard®’s threads or can feel the threads are much longer
  • Can feel any other part of the Paragard® besides the threads
  • Become HIV positive or your partner becomes HIV positive
  • Have severe or prolonged vaginal bleeding
  • Miss a menstrual period