What is Copper IUD?
A Copper IUD, also called a copper intrauterine device, is a long-term, nonhormonal, reversible type of birth control that is inserted into the uterus by a healthcare professional. The device is made of a T-shaped plastic wrapped in a spiral of copper [1].
What Does Copper IUD Do?
The copper IUD releases copper ions, which locally become toxic to sperm. They change the composition of the uterus lining and cervical mucus and alter the vaginal microbiome so that sperm can less easily survive. Because of the copper, cervical mucus becomes more viscous, making it more difficult for sperm to swim. As the sperm enter the uterus, they try to swim through the toxic copper ions, which makes the sperm lose their direction and swim up and away from the uterus rather than into it, thus preventing fertilisation [1].
For instance, the copper inside the body is oxidised to black copper oxide, dissolved by amino acids in the endometrial fluid [2]. The release of copper falls off exponentially, from the initial range of 1.6-4.7 mmol/day to, after 3-5 months, about 0.16-0.63 [2].
Benefits of Copper Iud
One of the primary benefits of the Copper IUD is its high effectiveness in preventing unwanted pregnancies. Within the first year of use, it's over 99% effective; by the 10th year, it's closer to 98% effective [1].
The other major benefit of the Copper IUD is that it’s hormone-free. Users will still have a monthly period, a critical health indicator for women. Avoiding hormones also allows users to avoid side effects often associated with hormonal birth control, such as a decrease in sex drive, nausea, mood swings and breast tenderness [1].
The Copper IUD similarly provides a long-lasting contraceptive effect. Copper release, which enhances the contraceptive impact, drops exponentially from about 1.6-4.7 mmol/day at inception to about 0.16-0.63 after 3-5 months [2].
Moreover, if desired, the Copper IUD is a non-invasive, removable form of contraception, meaning that the user could discontinue its use at any time if they wanted to become pregnant or use a different form of contraception.
Finally, the Copper IUD is an affordable form of contraception since the insertion only provides contraception for up to 10 years, which makes it a very long-term, low-cost solution to birth control [1].
Reasons For Copper IUD Removal
Several factors can contribute to removing a copper intrauterine device (IUD).
Another reason is that the removal of copper IUD is attributed to either excessive bleeding or pain. One study found that uterine length longer than 70 mm and IUD provider skills were associated with a decrease in the risk of removal related to bleeding and pain [3].
Furthermore, pregnancy is another risk factor in the presence of a copper IUD. Another study reported that 33.76 per cent of pregnancies had foetal loss according to maternal desire; therefore, pregnancy with a copper IUD in utero is a risk factor for IUD removal [4].
Young maternal age, abnormal amount of menstrual flow, and dysmenorrhea before IUD insertion are also risk factors for copper IUD expulsion, which can lead to its removal [5].
Other risk factors for removal of the copper IUD include excessive or irregular menstrual bleeding, painful cramping, anaemia, heart valve problems, known or suspected copper allergy, and blood clotting disorders. A history of pelvic inflammatory disease, an abnormal Pap smear, an abnormal cervix, uterus, fallopian tubes or ovaries, and conditions such as leukaemia or AIDS can increase the likelihood of removing the IUD [6].
Can Copper IUD Removal Influence Weight Loss?
The link between removing a Copper IUD and weight loss appears to be indirect. Copper IUDs, unlike hormonal IUDs, do not produce and release hormones into a person’s body and are, therefore, unlikely to cause variations in weight either while in place or post-removal [7].
Still, several studies have found that both hormonal and non-hormonal IUD users gained meaningful amounts of weight over a decade or more [8]. In these studies, it was never proven that the IUD was a cause of the weight gain.
Changes in appetite and energy levels following the removal of an IUD might also affect weight. However, in either direction: if appetite was suppressed during the period that the IUD was in place, a woman might gain weight when it is removed if her appetite returns to normal; if fatigue and lack of energy led her to reduce exercise while the IUD was in place, she might lose weight when it is removed if her energy returns to normal. A few studies have been conducted to explore some of these issues, but they are open to various interpretations; it would be beneficial to carry out further systematic studies [7].
Yet, given the current state of the literature (or perhaps the absence of literature) on IUD-induced weight changes, it is difficult to say how weight might change following the removal of the IUD. Some people report losing weight after IUD removal, while others note weight gain or gain weight following removal and continue to struggle to lose it [7].
Above all, while some women may experience such weight changes early after the copper IUD is removed, these changes are likely related to a myriad of other factors and not to the mere surgical removal of an IUD. Current evidence is insufficient to allow a definitive conclusion.