What is a recommended non-hormonal Intrauterine Device (IUD)?

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From the Guidelines

The ParaGard (Copper T 380A) is the recommended non-hormonal intrauterine device (IUD) available in the United States. This T-shaped device is made of plastic wrapped with copper wire and is highly effective at preventing pregnancy for up to 10 years after insertion, as supported by recent studies 1. ParaGard works primarily by creating a spermicidal environment in the uterus, as copper ions are toxic to sperm. It also causes an inflammatory reaction in the endometrium that prevents implantation if fertilization occurs. The device can be inserted during an office visit by a trained healthcare provider and becomes effective immediately upon placement. Common side effects include heavier, longer periods and increased cramping, especially in the first few months after insertion. These symptoms typically improve over time. ParaGard is ideal for women who want long-term contraception without hormones, cannot use hormonal methods due to medical conditions, or prefer not to use hormones. It can also be used as emergency contraception if inserted within 5 days of unprotected intercourse.

Some key points to consider when recommending the ParaGard IUD include:

  • It is a highly effective form of contraception with a failure rate of less than 1% 1.
  • It is safe for use in nulliparous adolescents and does not increase the risk of pelvic inflammatory disease (PID) beyond the first 21 days after insertion 1.
  • It can be used in women with certain medical conditions, such as liver disease, and is considered a safe option for women who are at risk for HIV or have HIV 1.
  • It is a convenient and low-maintenance form of contraception that does not require daily or weekly action, making it a good option for women who want a hassle-free birth control method.

Overall, the ParaGard IUD is a highly effective and safe form of contraception that is suitable for a wide range of women, including those who want a non-hormonal option or have certain medical conditions.

From the Research

Non-Hormonal IUD Options

  • A non-hormonal Intrauterine Device (IUD) is a type of contraceptive that is placed in the uterine cavity to prevent fertilization, mainly by preventing sperm from reaching the egg 2.
  • The most well-known non-hormonal IUD is the copper IUD, which has a copper surface area that prevents fertilization 2, 3.
  • Copper IUDs are a highly effective method of contraception, with a failure rate of about 6 pregnancies per 1000 woman-years 2.
  • They are also a good option for women who want a non-hormonal form of contraception, as they do not contain any hormones 3.

Comparison to Hormonal IUDs

  • Hormonal IUDs, such as the levonorgestrel-releasing IUD, are also available, but they contain hormones that can have additional effects on the body 2, 4.
  • The levonorgestrel IUD has been shown to be effective for emergency contraception, but the evidence is limited and more studies are needed to confirm its effectiveness 4.
  • Copper IUDs have been compared to hormonal IUDs in terms of their effectiveness and safety, and have been found to be a good alternative for women who want a non-hormonal option 2, 5.

Benefits and Risks

  • Non-hormonal IUDs, such as copper IUDs, have several benefits, including high effectiveness, ease of use, and reversibility 2, 3.
  • However, they can also have some risks and side effects, such as heavier menstrual bleeding, menstrual pain, and expulsion of the device 2.
  • It is essential to discuss the benefits and risks of non-hormonal IUDs with a healthcare provider to determine if they are a good option for individual women 2, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

[Non hormonal contraception].

La Revue du praticien, 2008

Research

Copper containing intra-uterine devices versus depot progestogens for contraception.

The Cochrane database of systematic reviews, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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