Copper IUD (Cu-T 380A)
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Direct answer
Cu-T 380A is a copper-bearing intrauterine device with 380 square millimetres of copper surface, licensed for up to ten years of contraception. It works mainly through copper-induced inflammation and spermicidal effects in the uterine cavity that prevent fertilisation, and it is also an effective emergency contraceptive when inserted within five days of unprotected sex.
What you must remember
- Mechanism: Copper ions are spermicidal and cause a local inflammatory reaction that hinders sperm and the embryo. It does not reliably suppress ovulation.
- Duration: Ten years of effective use for Cu-T 380A.
- Efficacy: Pearl Index below 1, making it one of the most effective reversible methods.
- Postpartum insertion: Within 48 hours of delivery, or after about four weeks, according to WHO eligibility guidance.
- Emergency use: Insertion within five days of unprotected intercourse is the most effective emergency option.
- Absolute contraindications: Pregnancy, active pelvic infection or purulent cervicitis, gestational trophoblastic disease and uterine or cervical malignancy.
- Side effects: Heavier and longer menses, dysmenorrhoea and anaemia, which are the main reasons for removal.
A stepwise insertion pathway
The exam usually presents a woman requesting a copper IUD, and the steps below show what must be done before and after insertion.
- Exclude pregnancy and infection: Confirm no pregnancy and no active infection, and screen for sexually transmitted infection where indicated.
- Time the insertion: Insert during menses or within about seven days of its start, within 48 hours after delivery or after four weeks, or immediately after a first-trimester termination.
- Insert aseptically: Sound the uterus, place the device to the fundus with the inserter and trim the strings to about 3 cm.
- Advise and follow up: Check the strings after the first period and counsel the woman to return for fever, pelvic pain or missing strings.
- Remove or replace: Remove the device at expiry or on request, and replace it after ten years if contraception is still wanted.
Counselling at insertion should cover the bleeding pattern, the strings and the warning signs, since these decide whether the method is continued.
Where the exam tries to catch you
Copper IUD questions often test contraindications and the difference between expected bleeding and a warning sign.
- Trap: Believing the copper IUD stops ovulation. Correct: It works mainly through copper toxicity to sperm and the endometrial environment, and does not suppress ovulation.
- Trap: Inserting a copper IUD during fever or purulent discharge. Correct: Active pelvic infection is an absolute contraindication until it has been treated and resolved.
- Trap: Accepting heavy bleeding as a benign effect without review. Correct: Heavy bleeding with anaemia needs evaluation to exclude endometrial pathology, and removal is considered if it is intolerable.
Frequently asked questions
How long does the Cu-T 380A copper IUD remain effective?
The Cu-T 380A copper IUD remains effective for up to ten years. It can be removed at any time, and fertility returns quickly after removal, so a replacement device can be placed at the end of its licensed period if contraception is still wanted.
When can a copper IUD be inserted after delivery?
A copper IUD can be inserted within 48 hours after delivery or after about four weeks postpartum, according to WHO eligibility guidance. Insertion between these times is avoided because of the higher risk of expulsion and infection.
Is the copper IUD effective for emergency contraception?
The copper IUD is the most effective emergency contraceptive when inserted within five days of unprotected intercourse. It also provides ongoing contraception afterwards, which is an advantage over emergency pills.
Which conditions contraindicate Cu-T 380A insertion?
Pregnancy, active pelvic infection or purulent cervicitis, untreated cervical or uterine malignancy, and unexplained vaginal bleeding contraindicate Cu-T 380A insertion. A distorted uterine cavity is also a contraindication, because the device may not be retained.