Infrequently, serious side effects may occur, including:
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 has 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.