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Contraception

Myth busters, GYNO style: does the copper IUD affect copper levels in the blood?

I’m not sure where some of the GYNO myths start, but according to my colleagues, there are a lot of questions circulating about the safety of the copper IUD with respect to copper in the blood stream.

“Will my copper IUD affect copper levels in my blood” is a reasonable question, especially knowing that individuals with Wilson’s disease, a disorder of copper metabolism, develop serious and irreversible neurological and liver problems from excessive copper deposits in the tissues.

Several studies from the 80’s and 90’s have looked at the issue (nothing recent because copper IUDs have been around for a long time).

What the science tells us is there is a local increase in copper levels in the lining of the uterus and in the fallopian tubes (meaning the copper IUD releases copper). That makes sense as copper affects sperm capacitation, a step the sperm need to complete so they can penetrate the egg). Therefore, for the copper IUD to work the copper has to reach the area of the reproductive tract where fertilization happens (typically the fallopian tube). However, in these studies there was no change in copper levels in the blood.  One study also looked at level of ceruloplasmin, the protein that carriers copper in the blood, and it stayed the same as well. (1) If excessive copper were getting into the blood, the body would also make more ceruloplasmin to compensate.

Regardless, if you have Wilson’s disease, you should not have a copper IUD. However, for everyone else, the copper IUD does not affect copper levels in the blood.

Myth busted. The copper IUD really is 10 years of worry free contraception.

 

1) Wollen AL et al. The localization and concentration of copper in the fallopian tube of women with or without an intrauterine copper device. Acta Obstet Gynecol Scand 1994;73:195-9.

Discussion

9 thoughts on “Myth busters, GYNO style: does the copper IUD affect copper levels in the blood?

  1. I believe that it is due to two episodes of House MD:

    http://en.wikipedia.org/wiki/Damned_If_You_Do

    and

    http://en.wikipedia.org/wiki/The_Socratic_Method_(House)

    Posted by Med School Odyssey | November 15, 2011, 7:17 pm
  2. HI Everybody, I’ve had an IUD for 8 years! Check out these reviews!

    http://www.medications.com/mirena/25670
    http://www.mothering.com/community/t/916122/copper-iud-and-side-effects/180

    Posted by leslie | August 13, 2012, 2:37 pm
  3. This is untrue. The study of Paragard users whose abstract is posted here (http://www.contraceptionjournal.org/article/PIIS0010782405000752/abstract) clearly states, “In IUD users, mean blood Cu level was significantly higher than in nonusers, 216.63 vs. 107.47 μg/dL (p≤.001), and above the normal blood Cu level range of 80–160 μg/dL.”
    Posting false information under the guise of “myth-busting” is dangerous and unfair to women who are trying to understand health problems as related to the copper IUD.

    Posted by nixy | September 15, 2012, 9:51 am
    • This abstract only reports serum copper levels which is insufficient to draw a conclusion. Ceruloplasmin levels are also required. So, it is hard to draw any conclusion. Several studies have looked at serum levels of Cu and ceruloplasmin and found no change. There is also a study looking at breast milk reporting no change in Cu levels. So, it is hard to know what to make of an outlier study that doesn’t appear to be using all the tests that are required.

      Posted by Dr. Jen Gunter | September 16, 2012, 11:58 am
      • The studies I have found, this among them, universally find that Paragard,the only copper IUD available in the US, currently has much higher release rates of copper, including into the blood, than other copper IUDs. Please reconsider your stance that the copper IUD does not change copper levels in the blood.

        The studies you reference from the 1980s and 1990s are not with the Paragard, and in addition it is not the case, as you state, that there have been no studies since then. As a scientist, you must be open to changing your mind with the advent of new evidence. Even a statement that some studies have found that the copper IUD does in fact affect the copper blood level but that you believe the jury to still be out, would be much more supportable.

        Further, although you are replying to my previous comment, it is not yet published.

        Posted by nixy | September 16, 2012, 12:32 pm
      • Sorry, forgot to publish your comments. Hazards of doing from a mobile device.

        The study your reference adds nothing to the body of literature as ceruloplasmin levels were not measured. Total copper levels are essentially useless. It is the free copper that matters.

        Posted by Dr. Jen Gunter | September 20, 2012, 7:29 pm
      • Do you have any sources to support the claim that CU levels are ‘useless’? I am happy to provide a number of studies saying otherwise.

        Posted by nixy | September 20, 2012, 7:32 pm
  4. I’ve been concerned about the copper levels in my body that may be causing other symptoms as none of my Physicians have commented on my blood levels. However they weren’t testing for that. I’ve recently become aware of a Copper 7 that I had inserted 35 years ago that a Dr. told me he removed. He was not very professional, and I’ll never forget the experience. A couple of months later I became pregnant, carried full term with no complications and delivered vaginally. My menstrual periods were always easy with only mild cramping that weren’t considered out of the usual. Obviously this doesn’t make sense since the IUD was supposed to prevent pregnancy but now at 57 I’m sure it’s imbedded somewhere (?) in my body. An ultrasound for unrelated reason spotted the IUD. Now I’m having another one that concentrates on where it is so my GYN can remove it. My GYN was sceptical at my claims of having it removed prior to my pregnancy and granted 35 years ago is a while back, but I remember the timeline very clearly. I’d appreciate any thoughts/opinions about my case and I’m curious if you’ve ever heard of a similar case?
    Sincerely,
    Connie

    Posted by Connie | November 17, 2012, 5:40 pm

Trackbacks/Pingbacks

  1. Pingback: Did the makers of ParaGard photoshop the IUD for advertising? « Dr. Jen Gunter - November 16, 2011

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