Copper IUD (Copper T) in South Africa: Hormone-Free Birth Control Guide
- Samantha Pieterse
- 6 days ago
- 10 min read
If you’ve been looking for a long‑term, hormone‑free contraceptive, the copper IUD, often called the Copper T, might be your match. This small, T‑shaped device is made of flexible plastic wrapped in copper wire and is placed inside the uterus by a trained healthcare provider. Once in position, it quietly does its job around the clock, offering protection from pregnancy for up to 10 years, depending on the brand.
Still Weighing Up Your Birth Control Options?
You might also like our guide to birth control pills for a daily‑dose approach, or our Mirena® hormonal IUD overview if you’re curious about a hormone‑releasing alternative.
What is the Copper IUD and How Does it Work?
The copper IUD is a small, flexible, T‑shaped plastic frame that has fine copper wire wound around it. Once it is placed inside the uterus, it continuously releases tiny amounts of copper ions. These copper ions are the real “active ingredient.” They make the uterine environment hostile to sperm in two main ways:
Impaired sperm mobility and survival
Copper is toxic to sperm cells. The ions interfere with sperm movement, making them sluggish and less able to swim through cervical mucus to reach the fallopian tubes. They also reduce sperm’s ability to fertilise an egg, even if they make it that far.
Changes to the uterine and cervical environment
The presence of copper triggers a local inflammatory response in the uterine lining (endometrium). This is not harmful to your body, but it’s highly unfriendly to sperm and eggs. The change also makes the endometrium less receptive to implantation should fertilisation occur.
Because of these effects, the copper IUD starts working immediately after insertion. There’s no waiting period for it to become effective. This is why it’s also used as the most effective form of emergency contraception if placed within 5 days of unprotected sex.
Unlike hormonal contraceptives, the copper IUD doesn’t release any synthetic hormones into your system. This means it won’t affect ovulation, your natural hormone cycle, or cause hormone‑related side effects like mood changes or breast tenderness. For many women, that makes it an appealing choice, especially if they’ve had unwanted side effects from hormonal contraception in the past or have medical reasons to avoid it.
Thinking about an IUD?
We can help you decide if a hormonal or non‑hormonal option would suit you better.
👉🏻 Book your contraceptive consultation and we’ll walk you through it.
Copper IUD vs Mirena®
Both the copper IUD and Mirena® are highly effective, but they’re quite different.
Feature | Copper IUD | Mirena® |
Hormones | No | Yes (levonorgestrel) |
Duration | 5–10 years | 5 years |
Period changes | Can be heavier | Usually lighter or absent |
Emergency contraception | Yes (if inserted within 5 days) | No |
Good for heavy periods | Not usually | Yes |
For a full breakdown, see our Mirena® IUD guide.
How Reliable is the Copper T for Birth Control?
When fitted correctly, the copper IUD is more than 99% effective at preventing pregnancy, which means fewer than 1 in 100 women will conceive each year while using it. That makes it one of the most effective forms of reversible contraception available today, alongside the hormonal IUD and contraceptive implant.
Its reliability comes from two things:
No user‑error factor
Unlike daily birth control pills, monthly injections, or condoms, the copper IUD works continuously in the background. You can’t “forget” to use it, which is why it’s consistently effective.
Immediate protection
The copper IUD starts preventing pregnancy as soon as it’s inserted, so there’s no waiting period. This is true whether it’s placed during your period, mid‑cycle, or even within five days of unprotected sex for emergency contraception.
It’s also long‑acting, meaning that once inserted, it protects you for 5–10 years, depending on the brand, without the need for refills or top‑ups.
What affects effectiveness?
While the copper IUD is extremely reliable, its protection can be reduced if:
It slips out of place or is expelled
It’s inserted incorrectly
It’s removed without switching to another contraceptive method
For peace of mind, it’s a good idea to have your IUD checked once a year to confirm it’s still positioned correctly.
Tip: Protect your investment in reliable birth control, book your annual women’s wellness visit to make sure your IUD is still perfectly placed and doing its job.
Pros & Cons of the Copper T (Loop) Birth Control
Pros:
Hormone‑free
Long‑lasting (5–10 years)
No daily effort
Can be used while breastfeeding
Works as an emergency contraception
Cons:
Periods may be heavier or crampier, especially in the first 3–6 months
Doesn’t protect against STIs
Must be inserted and removed by a trained provider
Side Effects of The Copper T
Like any medical device, the copper IUD can cause some side effects, especially in the first few months as your body adjusts. Most are temporary and improve over time.
Common in the first few days:
Cramps and lower backache
These are usually similar to period cramps and can last for a few hours to a couple of days after insertion. Over‑the‑counter pain relief and a warm compress can help.
Light spotting
A little bleeding between periods is common in the first week or two.
Changes to your period:
Heavier flow
Many women find that their periods are heavier for the first 3–6 months.
More cramping during periods
Period cramps can be stronger during this adjustment phase. These changes are due to the local inflammatory effect of the copper in your uterus and usually improve with time.
Rare but important to know:
Device expulsion
In a small number of cases, the IUD can partially or completely slip out of the uterus. If this happens, it won’t protect against pregnancy. You may not feel it happen, but sometimes you’ll notice longer strings or the device itself.
Perforation of the uterus
Very rarely (fewer than 1 in 1,000 insertions), the IUD can push through the wall of the uterus during insertion. This usually happens at the time of placement, and at Mums & Bums, we will check to make sure the IUD is positioned correctly.
If you ever have severe pain, very heavy bleeding, foul‑smelling discharge, or signs of infection (fever, chills, pelvic pain), contact your healthcare provider right away.
Copper IUD Insertion: What to Expect
Consultation for the Copper T
During your visit, we will discuss whether the copper T is the right contraceptive method for you. You are welcome to use this opportunity to ask questions and address any concerns.
Medical History: We will ask you questions about your medical history, including any previous pregnancies, details of your menstrual cycle, and any medical conditions or allergies you may have.
Pre-Insertion Preparation
The timing of the insertion can be important. While we don’t mind where you are in your cycle, it may be more comfortable to schedule the insertion during your period. This is because your cervix is naturally more open, making the process easier and less painful.
Medications: We suggest taking a pain reliever (like ibuprofen) an hour before the appointment to help manage discomfort during and after the procedure.
Arrival: Arrive at your appointment early to complete any necessary paperwork and relax before the procedure.
The Insertion Procedure
Examination: We perform a pelvic exam to check the position and size of your uterus and cervix.
Positioning: You’ll lie on the bed with your legs bent at the knees and your feet flat on the bed, similar to a pap smear.
Cleaning and Numbing: A speculum will be inserted so that we can see your cervix; this is a device that is used to open the vagina (in the same way that is done during a pap smear. We then clean your cervix and apply a numbing gel to minimize discomfort.
Measuring the Uterus: We will use a small instrument to measure the depth of your uterus, ensuring the proper placement of the copper T.
Inserting the Device: The copper T® IUD, a small T-shaped device, is inserted through the cervix and into the uterus using a thin, flexible tube. During this part of the process, you may feel some cramping or discomfort.
Final Adjustments: The provider will trim the strings of the IUD to about 2-3 cm, which you’ll be able to feel high in your vaginal canal.
I know this all sounds very scary, but at Mums & Bums, we really strive to make this appointment as quick and comfortable as possible. The entire procedure takes no more than 5 minutes, including a Pap smear if necessary.
Post-Insertion Care
Rest and Recovery: After the insertion, you might experience cramping and spotting. Rest and use over-the-counter pain relievers as needed.
Follow-Up Appointment: Schedule a follow-up visit 6 weeks after the IUD insertion to ensure it is properly placed and to address any concerns.
📅 Considering getting an IUD?
See our available appointment times and choose what works for you.
Copper IUD Removal: What to Expect
Consultation for Copper T Removal
During your visit: We will discuss the removal of your copper T IUD. Whether you’re planning to switch birth control methods, trying to conceive, or approaching the end of its effective period, this is the time to share your reasons and ask any questions.
Medical History: Please inform us of any changes in your health or reproductive plans since the insertion of your copper T.
Pre-Removal Preparation
The timing of the removal can be flexible. Let us know the best time for you, especially if you're planning to switch contraceptives or trying to conceive.
Medications: We suggest taking a pain reliever (like ibuprofen) an hour before the appointment to help manage discomfort during and after the procedure.
Arrival: Arrive at your appointment early to complete any necessary paperwork and relax before the procedure.
The Removal Procedure
Positioning: You’ll lie on the bed with your legs bent at the knees and your feet flat on the bed, similar to a pap smear.
Locating the Strings: We will use a speculum to open your vagina and locate the IUD strings.
Gentle Removal: By gently pulling on the strings, the IUD’s arms will fold up as it slides out of the uterus through the cervix. This part of the process usually only takes a few seconds and may cause mild discomfort or cramping.
Final Check: We will ensure the entire device has been removed and check for any signs of complications.
Post-Removal Care
Immediate Aftercare: You might have some light spotting and mild cramping after the removal. Rest and use over-the-counter pain relievers as needed.
Monitoring Symptoms: Pay attention to your body’s response over the next few days. Light spotting and mild cramping are normal, but if you experience severe pain or heavy bleeding, contact your healthcare provider.
Frequently Asked Questions About the Copper T Birth Control
Can You Feel the Copper IUD?
You shouldn’t feel it day‑to‑day. Your partner shouldn’t either, although in rare cases they may feel the strings during intercourse, but these soften over time.
Can You Get Pregnant with a Copper IUD?
It’s rare but possible. Sometimes the IUD may move, slip out, or just fail despite correct placement. This is where those viral “baby born with Copper T in hand” photos come from, while the photo we’ve all seen is fake, this can happen, although it’s very uncommon.
If you’ve missed a period or feel pregnancy symptoms, book a quick check‑up so we can confirm and make sure your IUD is still in place.
Who Should Avoid the Copper IUD?
While the copper IUD is safe and effective for most women, there are certain situations where it may not be the best choice. Your healthcare provider will assess your medical history and current health before deciding if it’s suitable for you.
You might need to avoid the copper IUD if:
You already have heavy or very painful periods
The copper IUD can make menstrual flow heavier and cramps stronger, especially in the first few months, which can be difficult if you already struggle with these symptoms.
You have certain uterine abnormalities
Unusual uterine shapes or fibroids that distort the cavity can make IUD placement difficult or less effective.
You currently have a pelvic infection
Insertion should be delayed until the infection is fully treated to avoid worsening it.
You are allergic to copper
This is rare, but if you have a known copper allergy, you should not use a copper IUD.
In rare cases, we may also advise against a copper IUD if you have unexplained vaginal bleeding, very low iron levels (anaemia worsened by heavy periods), or a history of IUD‑related complications.
Tip: If you’re unsure whether you fall into any of these categories, a contraceptive counselling session can help you weigh up your options and find the method that suits your health and lifestyle.
Copper IUD as Emergency Contraception (Plan B)
The copper IUD is also the most effective form of emergency contraception available. If it’s inserted within 5 days (120 hours) after unprotected sex, it can prevent pregnancy in over 99% of cases. This makes it significantly more reliable than the morning‑after pill, which is less effective the longer you wait after intercourse.
Why it works so well:
The copper IUD’s ability to block sperm function starts immediately upon insertion. Copper ions create a toxic environment for sperm, preventing them from fertilising an egg. It also affects the uterine lining, making it highly unlikely for a fertilised egg to implant. This dual action means it can work even if ovulation has already occurred.
Who might choose this option:
Women who want the highest possible protection against pregnancy after unprotected sex
Those who also want a long‑term contraceptive going forward (once in, it protects for 5–10 years)
Women who may not be suitable candidates for hormonal emergency contraception pills
Unlike the morning‑after pill, the copper IUD’s effectiveness doesn’t decline if you’re closer to ovulation, and it works for women of all body weights.
📍If you’re in that 5‑day window, call us immediately so we can prioritise your appointment and ensure the IUD is inserted as soon as possible for maximum protection.
Is the Copper IUD Right for You?
The copper IUD is the most effective, low‑maintenance, hormone‑free birth control available in South Africa. It offers long‑term protection for up to 10 years, works immediately after insertion, and can even be used as emergency contraception. While it’s not ideal for everyone, it’s a safe and reliable choice for many women.
If you’re considering the copper IUD, the best next step is to discuss your medical history, lifestyle, and future pregnancy plans with a healthcare provider. This ensures you choose the method that works best for your body.
At Mums & Bums
We provide contraceptive counselling, insertion and removal of both hormonal and non‑hormonal IUDs, and personalised advice to help you choose what’s best for your health and lifestyle.
💬 Book your contraceptive consultation today or browse our women’s health services.
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