Editing Copper IUD (section)

== Medical uses ==
Copper IUDs are a form of [[long-acting reversible contraception]] and are one of the most effective forms of birth control available.<ref name="Winner2012">{{cite journal | vauthors = Winner B, Peipert JF, Zhao Q, Buckel C, Madden T, Allsworth JE, Secura GM | title = Effectiveness of long-acting reversible contraception | journal = The New England Journal of Medicine | volume = 366 | issue = 21 | pages = 1998–2007 | date = May 2012 | pmid = 22621627 | doi = 10.1056/NEJMoa1110855 | url = https://digitalcommons.wustl.edu/open_access_pubs/2773 | access-date = August 18, 2019 | url-status = live | s2cid = 16812353 | doi-access = free | archive-url = https://web.archive.org/web/20200817142915/https://digitalcommons.wustl.edu/open_access_pubs/2773/ | archive-date = August 17, 2020 }}</ref><ref>{{cite journal | vauthors = Hofmeyr GJ, Singata M, Lawrie TA | title = Copper containing intra-uterine devices versus depot progestogens for contraception | journal = The Cochrane Database of Systematic Reviews | volume = 2010 | issue = 6 | pages = CD007043 | date = June 2010 | pmid = 20556773 | pmc = 8981912 | doi = 10.1002/14651858.CD007043.pub2 | collaboration = Cochrane Fertility Regulation Group }}</ref> The type of frame and amount of copper in the device can affect the effectiveness of different copper IUD models.<ref name =Kulier2008 />

The copper IUD is effective as contraception as soon as it is inserted, and loses efficacy when removed or if it becomes malpositioned.<ref name=":2">{{Cite web |date=2024 |title=Long-Acting Reversible Contraception Implants and Intrauterine Devices: Practice Bulletin #186 |url=https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/11/long-acting-reversible-contraception-implants-and-intrauterine-devices |access-date=January 28, 2025 |website=American College of Obstetricians and Gynecologists |language=en}}</ref> The effectiveness of the copper IUD (failure rate of 0.8%) is comparable to [[Tubal ligation|tubal sterilization]] (failure rate of 0.5%) for the first year.<ref name="Guttmacher2012">{{Cite web | work = The Guttmacher Institute |year=2012 |title=Contraceptive Use in the United States |url=http://www.guttmacher.org/pubs/fb_contr_use.html |url-status=live |archive-url=https://web.archive.org/web/20131004232616/http://www.guttmacher.org/pubs/fb_contr_use.html |archive-date=October 4, 2013 |access-date=October 4, 2013}}</ref><ref>{{cite journal | vauthors = Bartz D, Greenberg JA | title = Sterilization in the United States | journal = Reviews in Obstetrics & Gynecology | volume = 1 | issue = 1 | pages = 23–32 | date = 2008 | pmid = 18701927 | pmc = 2492586 }}</ref><ref name=":2" /> The [[Comparison of birth control methods#Effectiveness comparison|failure rates]] for different models vary between 0.1 and 2.2% after one year of use. The T-shaped models with a surface area of 380&nbsp;mm<sup>2</sup> of copper have the lowest failure rates. The TCu{{Nbsp}}380A (Paragard) has a one-year failure rate of 0.8% and a cumulative 12-year failure rate of 2.2%.<ref name="Kulier2008" /> Over 12 years of use, the models with less surface area of copper have higher failure rates. The TCu{{Nbsp}}220A has a 12-year failure rate of 5.8%. The frameless GyneFix has a failure rate of less than 1% per year.<ref name=":9">{{cite journal | vauthors = O'Brien PA, Marfleet C | title = Frameless versus classical intrauterine device for contraception | journal = The Cochrane Database of Systematic Reviews | issue = 1 | pages = CD003282 | date = January 2005 | pmid = 15674904 | doi = 10.1002/14651858.CD003282.pub2 }}</ref> A 2008 review of the available T-shaped copper IUDs recommended that the TCu{{Nbsp}}380A and the TCu{{Nbsp}}280S be used as the first choice for copper IUDs because those two models have the lowest failure rates and the longest lifespans.<ref name="Kulier2008" /> Worldwide, older IUD models with lower effectiveness rates are no longer produced.<ref name="Treiman 1995">{{cite journal | vauthors =  | title = IUDs--an update | journal = Population Reports. Series B, Intrauterine Devices | issue = 6 | pages = 1–35 | date = December 1995 | pmid = 8724322 | url = http://www.k4health.org/sites/default/files/IUDS%20an%20Update%20b6.pdf | url-status = live | publisher = Johns Hopkins School of Public Health, Population Information Program | access-date = July 9, 2006 | archive-url = https://web.archive.org/web/20131029184823/http://www.k4health.org/sites/default/files/IUDS%20an%20Update%20b6.pdf | archive-date = October 29, 2013 }}</ref>

Though only approved by regulatory agencies for a maximum of 12 years, some devices may be effective with continuous use for up to 20 years.<ref name=":3" />

Because it does not contain hormones, the copper IUD does not disrupt the timing of an individual's menstrual cycle, nor does it prevent ovulation.<ref name="Winner2012" />

=== Emergency contraception ===
It was first discovered in 1976 that the copper IUD could be used as a form of [[emergency contraception]] (EC).<ref>{{cite journal | vauthors = Lippes J, Malik T, Tatum HJ | title = The postcoital copper-T | journal = Advances in Planned Parenthood | volume = 11 | issue = 1 | pages = 24–29 | year = 1976 | pmid = 976578 }}</ref> The copper IUD is the most effective form of emergency contraception, more effective than oral hormonal emergency contraception, including [[mifepristone]], [[ulipristal acetate]], and [[levonorgestrel]].<ref>{{cite journal |vauthors=Cheng L, Che Y, Gülmezoglu AM |date=Aug 15, 2012 |title=Interventions for emergency contraception |journal=The Cochrane Database of Systematic Reviews |doi=10.1002/14651858.CD001324.pub4 |pmid=22895920}}</ref><ref>{{cite journal | vauthors = Ramanadhan S, Goldstuck N, Henderson JT, Che Y, Cleland K, Dodge LE, Edelman A | title = Progestin intrauterine devices versus copper intrauterine devices for emergency contraception | journal = The Cochrane Database of Systematic Reviews | volume = 2023 | issue = 2 | pages = CD013744 | date = February 2023 | pmid = 36847591 | pmc = 9969955 | doi = 10.1002/14651858.CD013744.pub2 | collaboration = Cochrane Fertility Regulation Group }}</ref> Efficacy is not affected by user weight.<ref name=":2" /> The pregnancy rate among those using the copper IUD for emergency contraception is 0.09%. It can be used for emergency contraception up to five days after unprotected sex, and does not decrease in effectiveness during the five days.<ref name="Cleland2012">{{cite journal | vauthors = Cleland K, Zhu H, Goldstuck N, Cheng L, Trussell J | title = The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience | journal = Human Reproduction | volume = 27 | issue = 7 | pages = 1994–2000 | date = July 2012 | pmid = 22570193 | pmc = 3619968 | doi = 10.1093/humrep/des140 }}</ref> An additional advantage of using the copper IUD for emergency contraception is that it can then be used as a form of birth control for 10–12 years after insertion.<ref name=Cleland2012 />

=== Removal and return to fertility ===
Removal of the copper IUD should be performed by a qualified medical practitioner. Fertility has been shown to return to previous levels quickly after removal of the device.<ref name="Dean 2011">{{Cite book | vauthors = Dean G, Schwarz EB |title=Contraceptive technology |publisher=Ardent Media |year=2011 |isbn=978-1-59708-004-0 | veditors = Hatcher RA, Trussell J, Nelson AL, Cates W Jr, Kowal D, Policar MS |edition=20th revised |location=New York |pages=147–191 (150) |chapter=Intrauterine contraceptives (IUCs) |issn=0091-9721 |oclc=781956734 
 }}</ref>