LUNA Explains : Non-hormonal Emergency Contraception

In addition to “conventional” contraception, you may need to use emergency contraception after risky sex.

There are several methods of emergency contraception: if you do not wish to use hormonal treatment (e.g. the emergency contraceptive pill or “morning-after pill”), you can opt for non-hormonal emergency contraception, i.e. the emergency insertion of a copper IUD after risky sex.

The copper intrauterine device (IUD), also known as the copper “coil”, is a T-shaped contraceptive device, 3 to 4 cm long, made of soft plastic with a copper wire wrapped around it. There are different models of copper IUDs adapted to the different anatomical conditions of women (size of the uterus).
The copper acts on the spermatozoa by making them less mobile and less viable in the uterus. This action is intended to prevent them from moving up the fallopian tube, which houses the egg that can be fertilised. The higher the copper content, the greater the toxic effect on the sperm.
The IUD also causes an inflammatory reaction in the uterus, which changes the lining of the endometrium, which will then prevent a fertilised egg from settling in the uterus. (Article link: see article Copper IUD).
The copper IUD used as emergency contraception can be inserted up to 5 days (120 hours) after risky sexual intercourse

The copper IUD is prescribed by a general practitioner, a midwife or a gynaecologist.
During the initial consultation, the health professional will ensure that there are no contraindications. The copper IUD can be offered to all women, whether or not they have already had children, provided that the following risks are ruled out (WHO recommendations) :

– a genital infection of the uterus or fallopian tubes that is ongoing or less than 3 months old
– a malformation of the uterus, a large fibroid or other anatomical anomaly of the uterus that could lead to a deformation of the uterine cavity that would prevent insertion of the IUD
– untreated cervical or endometrial cancer
– genital tuberculosis
– Vaginal bleeding of which the cause is not identified (suspected serious pathology)
– hypersensitivity, allergy to copper or to one of the components of the IUD
– an STI or a known risk of contamination for less than 3 months

During the second consultation, the doctor may perform a hysterometry: he will evaluate the depth, shape and sensitivity of your uterus with a graduated rod. He will then insert the IUD into the uterus. The insertion is done in a booth and is quick: it takes about two minutes. It can be painful for some women. It is possible to take a painkiller or a relaxant before the insertion if you are apprehensive.

The insertion of a copper IUD must be subject to regular gynaecological monitoring: 1 to 3 months after insertion, a check-up is recommended to ensure that it is correctly positioned and that this contraception is well adapted.
Then, as with all contraception, a visit to the gynaecologist once a year is recommended.

The main advantages of the copper IUD are its simplicity, effectiveness and duration of use.

It also has other features that can meet the wishes and needs of patients :

– It does not contain hormones. For women who do not wish to undergo hormonal treatment, and the potential side effects that may be associated with it, the copper IUD may be a relevant solution.
– It is long term (5-10 years), convenient, and less restrictive than taking the pill daily, while considering the risks of forgetting.
– The copper IUD can be removed at any time, and has no impact on fertility after its removal: i.e. you can become pregnant in the days following its removal, unlike other contraceptive methods such as progestogen injections, which require several months’ delay before pregnancy can be achieved again.

The main disadvantage of the copper IUD is that it can lengthen the period and make the flow heavier, especially in the first few months after the copper IUD is inserted. However, if your periods are short and light, the difference will not be noticeable.
After the insertion of a copper IUD you may also experience some light bleeding for a few days, as well as pain in the lower abdomen.
Complications such as the risk of expulsion or perforation of the uterus are rare events.

The price of a copper IUD is approximately 30 euros. It is reimbursed up to 65% by the Assurance Maladie, and your health insurance company can supplement this reimbursement. If you are under 26, you will not have to pay for the IUD and its insertion.