Paragard can cause serious side effects, including:
- Ectopic Pregnancy and Intrauterine Pregnancy Risks: There are risks if you become pregnant while using Paragard (see “What if I become pregnant while using Paragard?”).
- Life-Threatening Infection: Life-threatening infection can occur within the first few days after Paragard is placed. Call your healthcare provider immediately if you develop severe pain or fever shortly after Paragard is placed.
- Pelvic Inflammatory Disease (PID) or Endometritis: Some IUS users get a serious pelvic infection called pelvic inflammatory disease (PID) or endometritis. PID and endometritis are usually sexually transmitted; you are at a higher risk if you or your partner has sex with others. PID and endometritis are usually treated with antibiotics. PID and endometritis can cause serious problems such as infertility, ectopic pregnancy, and chronic pelvic pain. More serious cases may require surgery and rarely, PID can even cause death. Tell your healthcare provider right away if you have any of these signs of PID or endometritis: low abdominal (stomach area) or pelvic pain, pelvic tenderness, painful sex, unusual or bad smelling vaginal discharge, chills, long-lasting or heavy bleeding, fever, genital lesions or sores.
- Embedment: Paragard may become attached to (embedded) the wall of the uterus. This may make it hard to remove Paragard. Surgery may be needed.
- Perforation: Paragard may go through the wall of the uterus. This is called perforation. You are not protected from pregnancy if perforation occurs. It may move outside the uterus and cause scarring, infection, damage to other organs, pain, or infertility. Surgery may be needed. Excessive pain or vaginal bleeding during placement of Paragard, pain or bleeding that gets worse after placement, or not being able to feel the threads may happen with perforation. The risk of perforation is increased in breastfeeding women.
- Expulsion: Paragard may partially or completely fall out of the uterus. This is called expulsion. Expulsion occurs in about 2 out of 100 women. Excessive pain, vaginal bleeding during placement of Paragard, pain that gets worse, bleeding after placement, or not being able to feel the threads may happen with expulsion. You are not protected from pregnancy if Paragard is expelled.
- Changes in Bleeding: You may have heavier and longer periods with spotting in between. Sometimes the bleeding is heavier than usual at first. Call your healthcare provider if the bleeding remains heavier or longer and spotting continues.
- Reactions After Placement or Removal: Some women have had reactions such as dizziness (syncope), slowed heart rate (bradycardia), or seizures, immediately after Paragard was placed or removed. This happened especially in women who have had these conditions before.