Who Should Not Use Paragard?
Do not use Paragard if you:
- Might be pregnant
- Have a uterus that is abnormally shaped inside
- Have a pelvic infection called pelvic inflammatory disease (PID) or have current behavior that puts you at high risk of PID
- Have had an infection in your uterus after a pregnancy or
abortion in the past 3 months
- Have cancer of the uterus or cervix
- Have unexplained bleeding from your vagina
- Have an infection in your cervix
- Have Wilson’s disease
- Are allergic to anything in Paragard
- Already have an IUD in your uterus
What are the Most Common Side Effects that I can Expect with Paragard?
The most common side effects of Paragard are heavier and longer periods and spotting between periods. For most women, these side effects diminish after the first 2 to 3 months. If you are switching from a hormonal birth control method, your period may seem heavier.
Every woman is different and for some, the adjustment period may take longer. Over time, periods usually return to whatever is normal for you. If your period continues to be heavy or long, or if spotting continues, contact your healthcare provider.
What are the Possible Side Effects of Paragard?
Infrequently, serious side effects may occur, including:
• Pelvic inflammatory disease (PID)
In rare occasions 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 following 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.
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.
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.
Can I Use Paragard if I Have a Pre-existing Condition?
Before starting Paragard, you should share your full medical history with your healthcare provider to find out if Paragard is right for you.
According to CDC (Centers for Disease Control and Prevention) recommendations, Paragard may be used with no restriction in over 20 pre-existing characteristics and medical conditions including but not limited to:
- Breast cancer (family history, current, past and no evidence of current disease for 5 years)
- Cystic fibrosis
- Gallbladder disease
- Headaches including migraines with and without auras and menstrual migraines
- History of bariatric surgery
- History of stroke
- History of high blood pressure during pregnancy
- Inflammatory bowel disease including Ulcerative colitis and Crohn’s disease
- Ischemic heart disease
- Liver tumors
- Risk factors for cardiovascular disease including smoking
- Multiple sclerosis (MS)
- Ovarian cancer
- Ovarian cysts
- Past ectopic pregnancy
- Thyroid disease
- Viral hepatitis
- Valvular heart disease
- Women with a body mass index (BMI) greater than or equal to 30
When Should I Call My 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 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
What if I Become Pregnant While Using Paragard?
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 (occurring 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.
The copper in Paragard does not seem to cause birth defects.