FDA Approved
Intrauterine Device

Copper IUD

A small copper device placed in the uterus that works for up to 10 years and is over 99% effective.

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Copper IUD (Intrauterine Device)Compare

Method at a Glance

Effectiveness

99 out of 100 people successfully prevent pregnancy in a year.

Typical use effectiveness rate.

DurationUp to 10 years
Cost$0–$1,424
ReversibilityReversible
STI ProtectionNo
How you get itIn-Person Procedure · Prescription required
Available Products

2 products in this category

Specific branded items that use this method. Compare manufacturer details, active ingredients, and regulatory status.

FDA Approved
MI
Intrauterine Device

Miudella

A copper intrauterine device FDA-approved for up to 3 years of contraception.

Copper IUD
FDA Approved
PC
Intrauterine Device

Paragard Copper IUD

A long-acting reversible copper IUD that provides up to 10 years of non-hormonal contraception.

Copper IUD
Providers

5,223 providers in this category

Clinics and telehealth services in our directory that offer this method.

See all copper iud providers
The details

What the evidence says

How well it works, what to watch for, who should avoid it, and the studies behind it.

How well it works

99.2%(perfect use: 99.4%)

Most effective: over 99 out of 100 people successfully prevent pregnancy per year.

How was this measured?▾

Typical use failure rate 0.8%, perfect use failure rate 0.6% per Guttmacher/Contraceptive Technology.

Research sourceGuttmacher Institute contraceptive effectiveness table / Contraceptive Technology 21st ed.

Cost & insurance

$0–$1,424

Often $0 with insurance; cash/AWP price around $1,424 as of Jan 2026 (WAC/list price $1,187 for the device, not including the insertion visit); sliding scale at public clinics

Insurance CoverageUsually

Duration & reversibility

Lasts forUp to 10 years
Reversibility
Reversible
STI ProtectionNo

The science

How it works in the body

Releases copper ions into the uterus that make the environment toxic to sperm and may prevent implantation if fertilization occurs.

Regulatory status & access

StatusFDA Approved
Used forBirth control
How you get itIn-Person Procedure · Prescription required
PrescriptionRequired

Side effects

  • Heavier or longer periods (especially first few months)
  • Increased cramping
  • Spotting between periods
  • Small risk of uterine perforation at insertion

Who shouldn't use this

  • •Active pelvic infection or PID (FDA label)(Ongoing pelvic or vaginal infections)
  • •Uterine anomaly preventing insertion (FDA label)(An atypically shaped uterus that prevents correct placement)
  • •Wilson's disease (copper metabolism disorder) (FDA label)(A genetic condition causing copper buildup, making copper devices unsafe)
  • •Known copper allergy (FDA label)(An allergy or sensitivity to copper)
  • •Current pregnancy (FDA label)(The treatment is not intended for use during pregnancy and may harm a fetus)

Clinical guidelines

CDC

U.S. MEC Category 1 for most users; Category 2 for nulliparous women and women <20 years

View Guideline
CDC

U.S. SPR - IUD insertion and management guidance

View Guideline
The full picture

What to know about Copper IUD

How it works

The copper IUD is a small, T-shaped device a clinician places inside the uterus. It releases copper ions, which make the uterine environment hostile to sperm and may prevent fertilization or implantation. It is a highly effective reversible contraceptive, with a typical-use failure rate under 1%.

The copper IUD is also called the copper coil in the UK and Ireland, the loop in South Africa, and the Spirale in Germany. These all refer to the same device.

How to use it

A trained clinician inserts the IUD during an in-clinic procedure that takes a few minutes. Two copper IUDs are FDA-approved in the US: ParaGard, approved for up to 10 years, and Miudella, a lower-dose copper IUD approved in 2025 for up to 3 years. The IUD can be removed at any time if you want to become pregnant. It also works as emergency contraception if inserted within five days of unprotected sex, with a pregnancy rate of about 0.1% according to a systematic review of over 8,500 insertions.

Copper IUD vs hormonal IUD

The copper IUD contains no hormones. Hormonal IUDs release levonorgestrel, a progestin. Both types are over 99% effective at preventing pregnancy.

The main difference is how they affect periods. The copper IUD tends to make periods heavier and longer, especially in the first 3 to 6 months. Hormonal IUDs tend to make periods lighter, and in some cases stop them entirely. The copper IUD does not cause weight gain, acne, or hormonal side effects because it has no hormones. Hormonal IUDs can cause hormonal side effects in some users, including acne and breast tenderness.

Copper IUDs are available without hormones. If you want an IUD and need to avoid hormones for medical reasons (breast cancer history, blood clots, hormone sensitivity), a copper IUD is an option.

Where to get it

You cannot get a copper IUD through telehealth. Insertion requires an in-person visit with an OB-GYN, family medicine doctor, midwife, nurse practitioner, or physician assistant. In-person clinics and Planned Parenthood centers often offer sliding-scale fees and accept Medicaid. You can also search our provider directory for clinics near you that offer copper IUD insertion.

Adapting to the copper IUD

Your body may take three to six months to adapt, and cycles might be heavier or longer during this time. In one prospective study of new copper IUD users, bleeding decreased approximately 23% from month 1 to month 6 after insertion (Sanders et al., PLOS ONE 2018). If bleeding stays heavy, talk to your clinician. Heavier periods can lead to low iron, and they may suggest a blood test or an iron supplement. A heating pad and over-the-counter pain relievers help with cramping in the first few months.