
Paragard is a copper-releasing system that is placed in your uterus by your healthcare provider to prevent pregnancy for up to 10 years.
Paragard can be removed by your healthcare provider at any time.
Paragard does not contain any hormones.
Paragard can be used whether or not you have given birth to a child.
Paragard is a small, flexible plastic “T” shaped intrauterine system with copper wrapped around the stem and placed on arms of the “T”. Two thin white threads are attached to the stem (lower end) of Paragard. The threads are the only part of Paragard you can feel when Paragard is in your uterus; however, unlike a tampon string, the threads do not extend outside of your body.
Paragard does not protect against HIV infection (AIDS) or other sexually transmitted infections (STIs).
What if I need birth control for more than 10 years?
Paragard must be removed on or before 10 years from the date of insertion. Your healthcare provider can place a new Paragard during the same office visit if you choose to continue using Paragard.
What if I want to stop using Paragard?
Paragard is intended for use up to 10 years, but you can stop using Paragard at any time by asking your healthcare provider to remove it. You could become pregnant as soon as Paragard is removed; however, if you do not want to become pregnant you should use another method of birth control. Talk to your healthcare provider about the best birth control methods for you.
What if I change my mind about birth control and want to become pregnant in less than 10 years?
Your healthcare provider can remove Paragard at any time before the 10 years after placement. You may become pregnant as soon as Paragard is removed.
How does Paragard work?
Paragard works by preventing sperm from reaching the egg, preventing sperm from fertilizing the egg, or possibly preventing attachment (implantation) in the uterus. Paragard does not stop your ovaries from making an egg (ovulating) each month. 
Who might use Paragard?
You might choose Paragard if you:
want long-term birth control that provides a low chance of getting pregnant (less than 1 in 100)
want birth control that works continuously for up to 10 years
want birth control that is reversible
want a birth control method that you do not need to take daily
are willing to use a birth control method that is inserted in the uterus
want birth control that does not contain hormones
Who should not use Paragard?
Do not use Paragard if you:
are or might be pregnant
have a condition of the uterus that changes the shape of the uterine cavity, such as large fibroid tumors
have an untreated pelvic infection called pelvic inflammatory disease (PID) now
have had an infection in your uterus after a pregnancy or abortion in the past 3 months
can get infections easily. For example, if you:
have problems with your immune system
have multiple sexual partners or your partner has multiple sexual partners
use or abuse intravenous drugs
have or suspect you might have cancer of the uterus or cervix
have unexplained bleeding from your vagina
have an untreated lower genital infection now in your cervix
have Wilson’s disease (a disorder in how the body handles copper)
are allergic to copper, polyethylene, or barium sulfate
have an intrauterine system in your uterus already
Before having Paragard placed
Before having Paragard placed, tell your healthcare provider if you have:
any of the conditions listed above
slow heart beat (bradycardia)
dizziness (syncope)
seizures
recently had a baby or if you are breastfeeding
have AIDS, HIV, or any other sexually transmitted infection
Using Paragard
How is Paragard placed?
Paragard is placed in your uterus during an in-office visit.
First, your healthcare provider will examine your pelvis to find the exact position of your uterus. Your healthcare provider will then cleanse your vagina and cervix with an antiseptic solution and then, measure your uterus. Your healthcare provider will then slide a plastic tube containing Paragard into your uterus. The tube is removed, leaving Paragard inside your uterus. Two white threads will extend into your vagina. The threads are trimmed so they are just long enough for you to feel with your fingers when doing a self-check.
As Paragard goes in, you may feel cramping or pinching. You may have some bleeding. Some women feel faint, nauseated, or dizzy for a few minutes afterwards. Your healthcare provider may ask you to lie down until you are feeling better, and to get up slowly.
Should I check that Paragard is in place?
Yes, you should check that Paragard is in proper position by feeling the threads. It is a good habit to do this 1 time a month. Your healthcare provider should teach you how to check that Paragard is in place.
First, wash your hands with soap and water. You can check by reaching up to the top of your vagina with clean fingers to feel the 2 threads. Do not pull on the threads.
If you feel changes in the length of the 2 threads, you cannot feel the threads, or you can feel any other part of Paragard other than the threads, Paragard may not be in the right position and may not prevent pregnancy. Use back-up birth control (such as condoms or spermicide) and ask your healthcare provider to check that Paragard is still in the right place.
If Paragard is accidentally removed, you may be at risk of pregnancy, and should talk to a healthcare provider.
How soon after placement of Paragard should I return to my healthcare provider?
Call your healthcare provider if you have any questions or concerns (see “When should I call my healthcare provider?”). Otherwise you should return to your healthcare provider for a follow-up visit after your first menses after Paragard is placed to make sure that Paragard is in the right position.
What if I become pregnant while using Paragard?
Call your healthcare provider right away if you think you may be pregnant. If you get pregnant while using Paragard, you may have an ectopic pregnancy. This means the pregnancy is not in your uterus. Unusual vaginal bleeding or abdominal pain especially with missed periods may be a sign of ectopic pregnancy.
Ectopic pregnancy is a medical emergency that often requires surgery. Ectopic pregnancy can cause internal bleeding, infertility and even death.
There are also risks if you get pregnant while using Paragard and the pregnancy is in the uterus. Severe infection, miscarriage, premature delivery, and even death can occur with pregnancies that continue with an intrauterine device (IUD). Because of this, your healthcare provider may try to remove Paragard, even though removing it may cause a miscarriage. If Paragard cannot be removed, talk with your healthcare provider about the benefits and risks of continuing the pregnancy.
If you continue your pregnancy see your healthcare provider regularly. Call your healthcare provider right away if you get flu-like symptoms, fever, chills, cramping, pain, bleeding, vaginal discharge, or fluid leaking from your vagina. These may be signs of infection.
It is not known if Paragard can cause long-term effects on the fetus if it stays in place during a pregnancy.
How will Paragard change my periods?
Your period may become heavier and longer. You may also have frequent spotting between periods.
Is it safe to breastfeed while using Paragard?
You may use Paragard when you are breastfeeding. The risk of Paragard becoming attached to (embedded) or going through the wall of the uterus is increased if Paragard is placed while you are breastfeeding.
Will Paragard interfere with sexual intercourse?
You and your partner should not feel Paragard during intercourse. Paragard is placed in the uterus, not in the vagina. Sometimes your partner may feel the threads. If this occurs, or if you or your partner experience pain during sex, talk with your healthcare provider.
Can I have an MRI with Paragard in place?
Paragard can be safely scanned with MRI only under specific conditions. Before you have an MRI, tell your healthcare provider that you have Paragard, an intrauterine device (IUD), in place.
Before you have a medical procedure using heat therapy tell your healthcare provider that you have Paragard in place.
