FAQ
Everything worth knowing regarding copper IUDs

The copper IUD is a long-term, hormone-free contraceptive method for women. Intrauterine device, or IUD for short, is the medical name for the copper IUD.

The copper IUD consists of a plastic body with a fine copper wire wrapped around the stem. Some models also have copper sleeves around the side arms. Small amounts of copper ions are continuously released from the copper wire into the uterus. The sperms’ mobility is significantly impaired by this, and they do not reach the egg to be fertilised or do not reach it in sufficient numbers to fertilise it. In addition, the copper leads to a foreign body reaction which changes the mucous membrane of the uterus.

The choice of a suitable copper IUD depends mainly on the woman’s physical conditions (e.g., length and size of uterus). A discussion with your doctor and an appropriate examination can provide clarity as to which size and shape is most suitable. Especially women who have not yet had children have a small uterus. Our products Mona Lisa® Cu375 SL and Mona Lisa® NT Cu380 Mini can be suitable variants here.

The copper IUD requires a prescription, which is why the gynaecologist has to prescribe it for the patient. If the gynaecologist does not have it in stock, it must be obtained from a pharmacy.

You do not need to use any additional contraceptives while the copper IUD is in the uterus. However please be aware that a copper IUD does not protect against sexual transmittable diseases.

The copper IUD is effective immediately after insertion into the uterus. The copper IUD is a safe contraceptive method. Depending on the model, it can remain in the uterus for 5 to 10 years.

Unlike the hormonal IUD, the copper IUD does not release hormones. Small amounts of copper ions are released from the copper wire and/or copper sleeves into the uterus, which changes the lining of the uterus and the mucus at the cervix. The sperms’ mobility is severely impaired and they do not reach the egg to be fertilised or do not reach it in sufficient numbers to fertilise it.

Mona Lisa IUDs must not be used for:

• Malignant diseases in the genital area
• Heavy bleeding during menstruation
• Vaginal bleeding
• Pregnancy or Genital tract infections
• Sexually transmitted diseases during the last 12 months (except bacterial vaginitis, repeated herpes infection, hepatitis B)
• Abortion with an infection during the past 3 months
• Pelvic inflammatory disease
• Malformations of the uterus (congenital or acquired)
• Copper allergy

The risk of becoming infertile after insertion of the copper IUD is not increased.

Normally the insertion of the IUD is not painful, but the sensation of pain varies from woman to woman. If necessary, medication can be used to relieve pain and/or serve as a local anaesthetic.

Experience to date indicates that, in general, it is highly unlikely that other medications will interfere with the contraceptive effect of copper IUDs. However, published reports suggest reduced efficacy with long-term use of non-steroidal anti-inflammatory drugs particularly acetylsalicylic acid and corticosteroids. Short-term use of non-steroidal anti-inflammatory drugs in the treatment of painful menstruation does not seem to affect the contraceptive effect of the copper IUD.

The following side effects may occur after insertion of the copper IUD:

• heavier menstrual bleeding and slight intermenstrual bleeding
• anaemia
• dysmenorrhoea
• pain in the lower abdomen or sacral area as well as pelvic infection
• dizziness after insertion

You can get more information about possible side effects from your gynaecologist during your consultation.

In a few cases, copper can lead to clinically-relevant allergic reactions. The extent to which people who are allergic to nickel may react to copper from metal alloys due to cross-reactivity is currently unknown.

Study results have shown that copper IUDs have no effect on breastfeeding performance, duration of breastfeeding and lactation or quantity and quality of breast milk. However, breastfeeding at the time of insertion and insertion up to 36 weeks after giving birth were associated with an increased risk of perforation.

Yes, the follow-up is recommended in any case to ensure that the copper IUD is correctly placed for its intended duration. The IUD is checked for the first time one month after insertion, but no later than the first menstrual cycle. Subsequently, annually during the regular check-up or if clinically necessary.

Neither the partner, nor the woman should feel the copper IUD during sexual intercourse, as it is inserted into the uterus. In rare cases, the partner may feel the removal thread of the copper IUD. If the partner or the woman herself feels the copper IUD, it is recommended to contact the responsible gynaecologist immediately.

You can use a menstrual cup and tampons if you have a copper IUD. There have been isolated reports of IUD expulsion in women who use a menstrual cup, yet there is no certainty about whether the expulsion is caused by the menstrual cup. There is a possibility of suction on the IUD if the menstrual cup is not removed correctly. Please consult your doctor regarding the correct use of the menstrual cup.

The following points would have to be considered when participating in vibration training (EMS/ PowerPlate):

• Vibration training is only permitted in consultation with your responsible gynaecologist, as there is an increased risk of expulsion of the IUD.
• If the responsible gynaecologist approves the training, the use of vibration training is recommended at the earliest a few weeks after the insertion of the IUD.
• It is recommended to do a routine self-check of the copper IUD’s thread to ensure correct position of the IUD.

Non-clinical tests have shown that Mona Lisa IUDs are MR safe, to a certain degree. A patient with a Mona Lisa IUD in-situ can be safely scanned in an MR system with a static magnetic field up to 3 Tesla. The declaration signed by the manufacturer can be found under “Quality systems”.

The copper IUD can be removed at any time. Needless to say, the patient can also decide to remove the IUD prior to the expiry of the recommended wearing time.

The removal of the copper IUD is performed by the gynaecologist and involves a brief procedure. This can take place during a normal examination appointment with the gynaecologist. Please do not remove the copper IUD yourself. The copper IUD is removed by pulling the removal threads, using special instruments and in a way similar to that of a tampon.

As the copper IUD does not interfere with the woman’s hormonal balance, you can become pregnant immediately after removal as part of your natural cycle.