Non-hormonal intrauterine contraceptive device
Updated · Methodology
First line
Long-acting non-hormonal contraception for 5–10 years. Per SEGO 2023, first-line for women with hormonal contraindications, breastfeeding, or hormone intolerance. Also available as emergency contraception within 120 h post-coitus (>99% efficacy).
Sources
ICD-10: Z30.0 · ICD-11: QA21
First line
Contraception during breastfeeding. MEC 2015 category 1 from day 1 postpartum (category 2 in first 4 weeks – perforation risk). No effect on lactation – no systemic copper, no hormones. Ideal choice when avoiding hormones.
Sources
ICD-10: Z30.0 · ICD-11: QA21
First line
Emergency contraception within 120 h post-coitus. Per SEGO 2023 and FSRH 2017, the most effective method (>99% efficacy), especially with BMI ≥30, late presentation, and concurrent need for long-acting method. Office insertion.
Sources
ICD-10: Z30.0 · ICD-11: QA21
T-shaped plastic device with copper coil (380 mm² surface). Copper ions are toxic to sperm and ova, induce local endometrial inflammation that prevents implantation. Contains no hormones – does not affect ovulation or milk supply. Lifespan 5–10 years depending on model. Pearl Index 0.6 perfect-use.
Remove as soon as possible if pregnancy occurs.
Hormone-free, copper not systemically absorbed. WHO MEC 2015 category 1 from day 1 postpartum. No effect on milk volume or composition. Ideal choice for breastfeeding women avoiding hormones.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
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Copper intrauterine device is evaluated for the following indications with varying evidence strength: Contraception during breastfeeding (evidence tier A), Emergency contraception (evidence tier A), Contraception (evidence tier A). See the full indication matrix with dosing and citations above on this page.
Common side effects of Copper intrauterine device (≥ 1 in 100): Heavier and longer menses, Menstrual cramps (first 3–6 months), Pelvic pain on insertion. See the Safety section for uncommon and serious reactions.
Remove as soon as possible if pregnancy occurs.
Hormone-free, copper not systemically absorbed. WHO MEC 2015 category 1 from day 1 postpartum. No effect on milk volume or composition. Ideal choice for breastfeeding women avoiding hormones.
Copper intrauterine device is contraindicated in: Pregnancy; Acute PID; Uterine cavity anomalies; Cervical or endometrial cancer; Unexplained uterine bleeding. Full list in the Safety section.
Black cohosh (Cimicifuga racemosa), Dong quai (Angelica sinensis), Etonogestrel + Ethinylestradiol (vaginal ring), Levonorgestrel (intrauterine system)