Heavier Periods With a Copper IUD: Do They Settle?What Studies Show
PeriodsArticleA copper IUD can make periods heavier, longer and more painful. In a study of 1,947 first-time users followed for a year, bleeding and pain during periods tended to ease over time, though spotting between periods didn't. A Cochrane review of 21 trials found anti-inflammatory painkillers and a few other options may help, on low-quality evidence. Here is what to expect and when to get checked.
In this article
With a copper IUD, or copper coil, periods can get heavier, longer or more painful, and some people get bleeding between periods.1 UK advice says this may improve after a few months.1 Here is what the research says about how much it settles and what helps.
Does it settle?
A study followed 1,947 women using a copper IUD for the first time, for one year.2
- During periods, most bleeding and pain problems eased over time.2
- Between periods, spotting and pain complaints didn’t go away, and the number of days with them actually increased.2
The authors’ summary: some problems improve with time, while others don’t.2
What helps
A Cochrane review looked at 21 trials with 3,689 women testing ways to treat or prevent heavy bleeding and pain with IUDs.3 Copper IUD users tend to bleed more, and this is a common reason people have them removed.3 Among the findings:
- Mefenamic acid, an anti-inflammatory painkiller, reduced blood loss more than tranexamic acid in one trial.3
- Tolfenamic acid, another anti-inflammatory, may help prevent heavy bleeding, on very low-certainty evidence.3
- Ibuprofen didn’t clearly reduce blood loss in one small prevention trial.3
Most trials had a high risk of bias, so none of these results is solid.3 See ibuprofen and naproxen for heavy periods.
What to do
- Track your periods for the first few months: how many days, how many products, how much pain.
- Ask about anti-inflammatory painkillers around your period, if they’re safe for you.
- Check your iron if bleeding is heavy or you feel tired. See iron pills for heavy periods.
- Talk about switching if bleeding stays heavy after the first months. See three review questions for copper IUD bleeding.
Try: “I had a copper IUD fitted four months ago and my periods are still much heavier and longer than before. Is this likely to settle, and what can I take or try in the meantime?”
Period, Handled covers this in Chapter 6, “Heavy,” in a section called “How Heavy Is Heavy?” Its Period Scorecard records bleeding days, product changes and pain each period, so you can see whether things are settling. See the book.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Anti-inflammatory painkillers aren't safe for everyone; ask a pharmacist first. Get urgent help for severe belly or pelvic pain, fever, unusual discharge, or signs of pregnancy with an IUD, and see a clinician for very heavy bleeding, dizziness or tiredness. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- NHS, 2024Side effects of an IUD (intrauterine device) or copper coil (opens in a new tab)ab
- Contraception journal (via PubMed Central), 2009Side effects from the copper IUD: do they decrease over time? (opens in a new tab)abcd
- Cochrane Database of Systematic Reviews (abstract via PubMed), 2022Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine-device use (opens in a new tab)abcdef
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