Copper IUDs Available in Canada
The copper IUDs currently available in Canada include the Flexi-T380+ and historically the Nova-T200, though availability has changed over time and differs from the U.S. market where only ParaGard (TCu380A) is available. 1, 2
Current Canadian Copper IUD Options
Flexi-T380+ (NTCu380 Mini)
- This is a 380 mm² copper IUD that has been available in Europe and Canada, designed with a smaller frame that may improve tolerability, particularly in nulliparous women 3
- The device demonstrated a 3-year cumulative Pearl Index of 1.86 pregnancies per 100 woman-years, with a cumulative pregnancy rate of 4.8% through year 3 3
- Importantly, the Flexi-T380+ resulted in significantly fewer discontinuations due to adverse events (20.8%) compared to the TCu380A (33.2%), particularly for bleeding or pelvic pain (14.5% vs. 27.3%) 3
- This device is approved for up to 10 years of use, similar to other 380 mm² copper IUDs 4, 5
Nova-T200
- The Nova-T200 was described as "the only other brand of copper IUD available in Canada" at the time of a 2012 study, suggesting it was a standard option historically 2
- This device has a smaller copper surface area (200 mm²) compared to the 380 mm² devices 2
Key Differences from U.S. Market
- Canada does NOT have ParaGard (TCu380A) readily available, which is the only copper IUD marketed in the United States 1
- The Canadian market has focused on alternative copper IUD designs, particularly the Flexi-T380+, which appears to offer improved tolerability profiles 3, 2
Clinical Considerations for Copper IUDs
Efficacy and Duration
- All 380 mm² copper IUDs (including those available in Canada) are approved for up to 10 years of continuous use with typical-use failure rates of less than 1% per year 1
- These devices can be inserted at any point in the menstrual cycle if pregnancy has been reasonably excluded 1
Common Side Effects
- The principal side effect of copper IUDs is increased menstrual bleeding and cramping, which may persist with long-term use 1
- However, the Flexi-T380+ demonstrated lower rates of bleeding and pain-related discontinuation compared to the standard TCu380A design 3
Emergency Contraception Use
- When placed within 5 days of unprotected intercourse, copper IUDs prevent more than 95% of unintended pregnancies, making them the most effective method of emergency contraception 1
Important Safety Information
- Copper IUDs contain no hormones and work primarily through copper's toxic effect on sperm, preventing fertilization 1
- These devices do NOT provide protection against sexually transmitted infections or HIV 1
- Expulsion occurs in 5-10% of insertions within 5 years, with higher rates in younger nulliparous users 1