ParaGard is typically inserted in a health care provider's office.
During the procedure
Your health care provider will insert a speculum into your vagina and cleanse your vagina and cervix with an antiseptic solution. Then he or she will use a special instrument to gently align your cervical canal and uterine cavity, and another tool to measure the depth of your uterine cavity. Next your health care provider will fold down ParaGard's horizontal arms and place the device inside an applicator tube. He or she will insert the tube into your cervical canal and carefully place ParaGard in your uterus. When the applicator tube is removed, ParaGard will remain in place. Your health care provider will trim ParaGard's strings so that they don't protrude too far into the vagina and may record the length of the strings.
During ParaGard insertion, you may experience dizziness, fainting, nausea, low blood pressure or a slower than normal heart rate (bradycardia). Rarely, it's also possible for the IUD to perforate the uterine wall or cervix.
After the procedure
After every period, check to feel that ParaGard's strings are protruding from your cervix. Don't pull on the strings. Four to six weeks after ParaGard is inserted, your health care provider may re-examine you to make sure the device hasn't moved and check for signs and symptoms of pelvic inflammatory disease, which can cause tubal damage or infertility.
While you're using ParaGard, contact your health care provider immediately if you have:
- Signs or symptoms of pregnancy
- Unusually heavy vaginal bleeding
- Foul vaginal discharge
- Worsening pelvic pain
- Severe abdominal pain or tenderness
- Unexplained fever
It's also important to contact your health care provider immediately if you think ParaGard is no longer in place. Call your doctor if:
- You have breakthrough bleeding or bleeding after sex
- Sex is painful for you or your partner
- The strings are missing or suddenly seem longer
- You feel part of the device at your cervix or in your vagina
Your health care provider will check the location of ParaGard and remove it if necessary.
ParaGard is usually removed in a health care provider's office. Your provider will likely use forceps to grasp the device's strings and gently pull. The device's arms will fold upward as it's withdrawn from the uterus. Light bleeding and cramping is common during removal. In some cases, removal may be more complicated. For example, if ParaGard has become embedded in your uterine wall, you may need local anesthesia and cervical dilation or hysteroscopy to have the IUD removed.
Jan. 21, 2012
- Dean G, et al. Approach to intrauterine contraception. http://www.uptodate.com/home/index.html. Accessed Nov. 3, 2011.
- Kottke M. Nondaily contraceptive options: User benefits, potential for high continuation and counseling issues. Obstetrical & Gynecological Survey. 2008;63:661.
- Dean G, et al. Management of problems related to intrauterine contraception. http://www.uptodate.com/home/index.html. Accessed Nov. 3, 2011.
- Carusi DA, et al. Insertion and removal of an intrauterine contraceptive device. http://www.uptodate.com/home/index.html. Accessed Nov. 3, 2011.
- ParaGard (prescribing information). Pomona, N.Y.: Duramed Pharmaceuticals Inc.; 2006. http://www.paragard.com. Accessed Nov. 3, 2011.
- The intrauterine device. http://www.acog.org/publications/faq/faq014.cfm. American Congress of Obstetricians and Gynecologists. Accessed Nov. 3, 2011.
- Intrauterine contraceptives. In: Zieman M, et al. A Pocket Guide to Managing Contraception. Tiger, Ga.: Bridging the Gap Communications; 2010:82.
- Birth control methods fact sheet. U.S. Department of Health and Human Services. http://www.womenshealth.gov/publications/our-publications/fact-sheet/birth-control-methods.cfm. Accessed Nov. 3, 2011.
- Emergency contraception. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/faq/faq114.cfm. Accessed Nov. 3, 2011.
- Castellsague X, et al. Intrauterine device use, cervical infection with human papillomavirus, and risk of cervical cancer: A pooled analysis of 26 epidemiological studies. The Lancet Oncology. 2011;12:1023.