Last update Nov. 26, 2024

Intrauterine Copper Contraceptive (Cu-IUD)

Compatible

Safe product and/or breastfeeding is the best option.

Intrauterine devices (IUDs) are T-shaped flexible plastic devices that are inserted into the uterus. They can be lined with copper wire or levonorgestrel. They have a contraceptive effect, and can even be used as emergency contraception. (MSD Manual 2023, ACOG 2011)

IUDs with copper do not affect the concentration of plasma ceruloplasmin or copper in breast milk. (Rodrigues 2001)

No growth problems have been observed in infants of mothers using an IUD with copper or with Levonorgestrel. (Berry 2016, Bahamondes 2013, Shaamash 2005, Diaz 1997)

No problems of production or duration of breastfeeding have been observed (Bjarnadóttir 2001, Díaz 1997, Sivin 1997, Sinchai 1995, Croxatto 1982), except for some cases of increased prolactin with or without galactorrhea. (Berry 2016, Giampietro 1984, Mehta 1977)

Several medical societies and expert authors consider safe the use of IUDs during breastfeeding. (Berry 2016, Berens 2015, Rowe 2013, CDC 2013 & 2011, CLM 2012, Prescrire 2009, FFPRHC 2004) and many advise its insertion in the immediate postpartum period. (WHO 2015, Mwalwanda 2013, Amir 2011)

There is a slightly increased risk of IUD expulsion with breastfeeding (Eggebroten 2017), especially if insertion is done during the immediate postpartum period (ACOG 2016 ), so it is preferable to insert after 4 weeks postpartum.

Most anti-inflammatory drugs, or local or general anesthetics that might eventually be needed to insert or remove the IUD, are compatible with breastfeeding.

Alternatives

We do not have alternatives for Intrauterine Copper Contraceptive (Cu-IUD) since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Group

Intrauterine Copper Contraceptive (Cu-IUD) belongs to this group or family:

Tradenames

Main tradenames from several countries containing Intrauterine Copper Contraceptive (Cu-IUD) in its composition:

List of 6 tradenames
  • Diu-Safe Cu/375™. Contains other elements than Intrauterine Copper Contraceptive (Cu-IUD) in its composition
  • GyneFix™. Contains other elements than Intrauterine Copper Contraceptive (Cu-IUD) in its composition
  • Multiload™. Contains other elements than Intrauterine Copper Contraceptive (Cu-IUD) in its composition
  • Paragard T380A™. Contains other elements than Intrauterine Copper Contraceptive (Cu-IUD) in its composition
  • TT 380™. Contains other elements than Intrauterine Copper Contraceptive (Cu-IUD) in its composition
  • UT 380™. Contains other elements than Intrauterine Copper Contraceptive (Cu-IUD) in its composition

References

  1. Manual MSD Dispositivo intrauterino (DIU) on line 2023 Consulted on Nov. 22, 2023 Full text (link to original source)
  2. MSD Manual. Intrauterine Devices (IUDs). on line. 2023 Consulted on Nov. 22, 2023 Full text (link to original source)
  3. Eggebroten JL, Sanders JN, Turok DK. Immediate postpartum intrauterine device and implant program outcomes: a prospective analysis. Am J Obstet Gynecol. 2017 Jul;217(1):51.e1-51.e7. Abstract
  4. American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice. Committee Opinion No. 670: Immediate Postpartum Long-Acting Reversible Contraception. Obstet Gynecol. 2016 Aug;128(2):e32-7. Abstract
  5. Berry-Bibee EN, Tepper NK, Jatlaoui TC, Whiteman MK, Jamieson DJ, Curtis KM. The safety of intrauterine devices in breastfeeding women: a systematic review. Contraception. 2016 Dec;94(6):725-738. Abstract Full text (link to original source)
  6. Berens P, Labbok M; Academy of Breastfeeding Medicine. Protocolo clínico de la ABM n.º 13: Anticoncepción durante la lactancia, revisado en 2015. Breastfeed Med. 2015 Full text (link to original source) Full text (in our servers)
  7. OMS. Criterios médicos de elegibilidad para el uso de anticonceptivos Quinta edición. Who Library. 2015 Full text (link to original source) Full text (in our servers)
  8. WHO. Department of Reproductive Health and Research World Health Organization. Medical eligibility criteria for contraceptive use: 20 years of global guidance. WHO/RHR/15.07. 2015 Abstract Full text (link to original source) Full text (in our servers)
  9. Mwalwanda CS, Black KI. Immediate post-partum initiation of intrauterine contraception and implants: a review of the safety and guidelines for use. Aust N Z J Obstet Gynaecol. 2013 Abstract
  10. CDC. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013 Abstract Full text (link to original source) Full text (in our servers)
  11. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  12. Bahamondes L, Bahamondes MV, Modesto W, Tilley IB, Magalhães A, Pinto e Silva JL, Amaral E, Mishell DR Jr. Effect of hormonal contraceptives during breastfeeding on infant's milk ingestion and growth. Fertil Steril. 2013 Abstract Full text (link to original source) Full text (in our servers)
  13. CLM - Comité de Lactancia Materna de la AEP. Preguntas frecuentes sobre lactancia materna. Folleto. 2012 Full text (link to original source) Full text (in our servers)
  14. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Abstract
  15. ACOG. ACOG Practice Bulletin No. 121: Long-acting reversible contraception: Implants and intrauterine devices. Obstet Gynecol. 2011 Jul;118(1):184-196. Abstract
  16. Centers for Disease Control and Prevention (CDC). U S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Recomm Rep. 2010 Abstract Full text (link to original source) Full text (in our servers)
  17. Prescrire [No authors listed]. Intrauterine devices: an effective alternative to oral hormonal contraception. Prescrire Int. 2009 Abstract
  18. Shaamash AH, Sayed GH, Hussien MM, Shaaban MM. A comparative study of the levonorgestrel-releasing intrauterine system Mirena versus the Copper T380A intrauterine device during lactation: breast-feeding performance, infant growth and infant development. Contraception. 2005 Abstract
  19. FFPRHC: Faculty of Family Planning & Reproductive Health Care. Guidance (July 2004): Contraceptive choices for breastfeeding women. J Fam Plann Reprod Health Care. 2004 Abstract Full text (link to original source) Full text (in our servers)
  20. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  21. Rodrigues da Cunha AC, Dorea JG, Cantuaria AA. Intrauterine device and maternal copper metabolism during lactation. Contraception. 2001 Jan;63(1):37-9. Abstract
  22. Bjarnadóttir RI, Gottfredsdóttir H, Sigurdardóttir K, Geirsson RT, Dieben TO. Comparative study of the effects of a progestogen-only pill containing desogestrel and an intrauterine contraceptive device in lactating women. BJOG. 2001 Abstract
  23. Díaz S, Zepeda A, Maturana X, Reyes MV, Miranda P, Casado ME, Peralta O, Croxatto HB. Fertility regulation in nursing women. IX. Contraceptive performance, duration of lactation, infant growth, and bleeding patterns during use of progesterone vaginal rings, progestin-only pills, Norplant implants, and Copper T 380-A intrauterine devices. Contraception. 1997 Abstract
  24. Sivin I, Díaz S, Croxatto HB, Miranda P, Shaaban M, Sayed EH, Xiao B, Wu SC, Du M, Alvarez F, Brache V, Basnayake S, McCarthy T, Lacarra M, Mishell DR Jr, Koetsawang S, Stern J, Jackanicz T. Contraceptives for lactating women: a comparative trial of a progesterone-releasing vaginal ring and the copper T 380A IUD. Contraception. 1997 Abstract
  25. Sinchai W, Sethavanich S, Asavapiriyanont S, Sittipiyasakul V, Sirikanchanakul R, Udomkiatsakul P, Chantaeyoon P, Roybang K, Trakankamol J, Suti S, et al. Effects of a progestogen-only pill (Exluton) and an intrauterine device (Multiload Cu250) on breastfeeding. Adv Contracept. 1995 Jun;11(2):143-55. Abstract
  26. Giampietro O, Ramacciotti C, Moggi G. Normoprolactinemic galactorrhea in a fertile woman with a copper intra-uterine device (copper IUD). Acta Obstet Gynecol Scand. 1984;63(1):23-5. Abstract
  27. Croxatto HB, Díaz S, Peralta O, Juez G, Casado ME, Salvatierra AM, Durán E. Fertility regulation in nursing women. II. Comparative performance of progesterone implants versus placebo and copper T. Am J Obstet Gynecol. 1982 Sep 15;144(2):201-8. Abstract
  28. Mehta S, Pawar V, Joshi J, Kora S, Rajani U, Virkar KD, Raikar RS, Sheth AR. Serum prolactin levels in women using copper IUDs. Contraception. 1977 Mar;15(3):327-34. No abstract available. Abstract

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