Learn about single-hand placement with a built-in loading tip

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Healthcare Provider Resources

Once Paragard is properly loaded, the next step is placement.

To begin, apply gentle traction to the tenaculum to orient the uterus in an axial position.

While holding the button forward, pass the loaded insertion tube through the cervical canal until Paragard just touches the fundus of the uterus. This will ensure placement of Paragard is in the highest possible position within the uterus. The blue flange should be at the cervix in the horizontal plane. The button should remain in the forward position.

Hold the inserter at the fundus while you slide the button all the way back. Do not stop at the starting line as it is not used for deployment.

This will release the T-arms of Paragard high in the uterine fundus.

Gently and slowly withdraw the inserter from the uterus and cervical canal.

After placement, only the threads should be visible protruding from the cervix. Trim the threads so that 3 to 4 cm protrude into the vagina.

Measure the protrusion of the threads and record the length, date of device placement, and Paragard lot number in the patient’s chart.

If you are concerned that Paragard is not in the correct position, check the placement of the device. This can be done with ultrasound, if necessary.

If Paragard is not positioned completely within the uterus, remove it and replace with a new Paragard. Do not reinsert an expelled or partially expelled Paragard.

As a follow up to placement, examine the patient after her first menses to confirm that Paragard is still in place.

You should be able to see or feel only the threads. The length of the visible threads may change with time, but no action is needed unless you suspect partial expulsion, perforation, pregnancy, or breakage.

If you are unable to find the threads in the vagina, check that Paragard is still in the uterus. The threads can retract into the uterus or break, or Paragard can break, perforate the uterus, or be expelled. Gentle probing of the cavity, x-ray, or sonography may be required to locate Paragard.

If Paragard has been partially expelled or has perforated the uterus, remove the device. Do not reinsert a used Paragard.

Paragard Placement Training Video featuring single-hand placement with a built-in loading tip

See video on PARAGARD removal

Paragard must be removed no later than 10 years after placement, but may be removed at any time prior to this. A new Paragard can be placed at the time of removal if continued contraceptive protection is desired. To remove Paragard, begin by visualizing the cervix using a speculum. Remove Paragard with forceps, pulling gently on the exposed threads. The arms of Paragard will fold upwards as it is withdrawn from the uterus. Once removed, make sure Paragard is intact. Breakage or embedment of Paragard in the myometrium can make removal difficult. Analgesia, paracervical anesthesia, cervical dilation, a grasping instrument like alligator forceps, or hysteroscopy may assist in removing an embedded Paragard. Removal of Paragard may be associated with some pain, bleeding, or vasovagal reactions like syncope, bradycardia, and seizures, especially in patients with a predisposition to these conditions.

If you have any questions about the product or procedure, please contact us at 1-877-727-2427 or visit hcp.paragard.com. Continue watching for a review of the Indications, Usage, and Important Safety Information for Paragard. Refer to the full Prescribing Information for more detail regarding preparations for placement, warnings, contraindications, adverse reactions, and other important information regarding Paragard.

Paragard Placement Process

See video on PARAGARD removal

Paragard must be removed no later than 10 years after placement, but may be removed at any time prior to this. A new Paragard can be placed at the time of removal if continued contraceptive protection is desired. To remove Paragard, begin by visualizing the cervix using a speculum. Remove Paragard with forceps, pulling gently on the exposed threads. The arms of Paragard will fold upwards as it is withdrawn from the uterus. Once removed, make sure Paragard is intact. Breakage or embedment of Paragard in the myometrium can make removal difficult. Analgesia, paracervical anesthesia, cervical dilation, a grasping instrument like alligator forceps, or hysteroscopy may assist in removing an embedded Paragard. Removal of Paragard may be associated with some pain, bleeding, or vasovagal reactions like syncope, bradycardia, and seizures, especially in patients with a predisposition to these conditions.

If you have any questions about the product or procedure, please contact us at 1-877-727-2427 or visit hcp.paragard.com. Continue watching for a review of the Indications, Usage, and Important Safety Information for Paragard. Refer to the full Prescribing Information for more detail regarding preparations for placement, warnings, contraindications, adverse reactions, and other important information regarding Paragard.

Paragard Removal Training Video

Documents

Paragard Placement Training Guide
Paragard | Single-Hand Inserter Training Guide
CDC Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use

Patient Counseling

Get the free Patient Counseling sheet for your office. Download this tool now

Ordering & Reimbursement Resources

General

Paragard Ordering Guide
Paragard Reimbursement Guide

Buy and Bill

Paragard Buy and Bill Volume Discount Pricing

Specialty Pharmacy

Paragard Specialty Pharmacy Request Form

Reimbursement

How to Appeal an Under-Reimbursed Claim
Sample Letter of Appeal for Payment HCPCS J7300
Price Increase Letter to Health Plans
Price Increase Letter to Healthcare Providers
Benefits Verification Worksheet

Patient Resources

Birth Control Options Chart

Download

Paragard Patient Brochure

Download

Paragard Patient Fact Sheet

Download

Prescribing Information

Paragard Full Prescribing Information
Paragard | Single-Hand Inserter Training Guide
Paragard Patient Information – English/Spanish

INDICATIONS AND USAGE

Paragard is a copper-containing intrauterine system (IUS) indicated for prevention of pregnancy in females of reproductive potential for up to 10 years.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • The use of Paragard is contraindicated when one or more of the following conditions exist:
    • Pregnancy or suspicion of pregnancy, abnormalities of the uterus resulting in distortion of the uterine cavity, acute pelvic inflammatory disease (PID), postpartum or postabortal endometritis in the past 3 months, known or suspected uterine or cervical malignancy, uterine bleeding of unknown etiology, untreated acute cervicitis or vaginitis or other lower genital tract infection, conditions associated with increased susceptibility to pelvic infections, Wilson’s disease, a previously placed IUS that has not been removed, hypersensitivity to any component of Paragard including to copper or any of the trace elements present in the copper component of Paragard.

INDICATIONS AND USAGE

Paragard is a copper-containing intrauterine system (IUS) indicated for prevention of pregnancy in females of reproductive potential for up to 10 years.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • The use of Paragard is contraindicated when one or more of the following conditions exist:
    • Pregnancy or suspicion of pregnancy, abnormalities of the uterus resulting in distortion of the uterine cavity, acute pelvic inflammatory disease (PID), postpartum or postabortal endometritis in the past 3 months, known or suspected uterine or cervical malignancy, uterine bleeding of unknown etiology, untreated acute cervicitis or vaginitis or other lower genital tract infection, conditions associated with increased susceptibility to pelvic infections, Wilson’s disease, a previously placed IUS that has not been removed, hypersensitivity to any component of Paragard including to copper or any of the trace elements present in the copper component of Paragard.

WARNINGS AND PRECAUTIONS

  • Ectopic Pregnancy: Evaluate for possible ectopic pregnancy in any female who becomes pregnant while using Paragard.
  • Intrauterine Pregnancy: Failure to remove Paragard increases the risk of miscarriage, sepsis, premature labor, and premature delivery.
  • Sepsis: Severe infection or sepsis, including Group A Streptococcal Sepsis (GAS), have been reported following insertion of IUSs, including Paragard.
  • Pelvic Inflammatory Disease and Endometritis: Remove Paragard in cases of recurrent PID or endometritis, or if an acute pelvic infection is severe or does not respond to treatment.
  • Embedment: Partial penetration or embedment of Paragard in the myometrium can make removal difficult; surgical removal may be necessary. Breakage of an embedded Paragard during non-surgical removal has been reported.
  • Perforation: Partial or total perforation of the uterine wall or cervix may reduce contraceptive efficacy and result in pregnancy. Delayed detection or removal of Paragard may result in migration outside the uterine cavity, adhesions, peritonitis, intestinal penetration, intestinal obstruction, abscesses and/or damage to adjacent organs. Increased risk when the uterus is fixed, retroverted or not completely involuted during the postpartum period. If perforation does occur, locate and remove Paragard promptly.
  • Expulsion: Partial or complete expulsion of Paragard has been reported, resulting in the loss of contraceptive protection. The risk of expulsion may be increased when the uterus is not completely involuted at the time of insertion. Remove a partially expelled Paragard.
  • Wilson’s Disease: Paragard may exacerbate Wilson’s disease.
  • Bleeding Pattern Alterations: Paragard can alter the bleeding pattern and result in heavier and longer menstrual cycles with intermenstrual spotting.
  • Magnetic Resonance Imaging (MRI) Safety Information: Non-clinical testing has demonstrated that Paragard is MR Conditional.
  • Medical Diathermy: Avoid using high medical RF transmitter devices in females with Paragard.

ADVERSE REACTIONS

  • Adverse reactions reported in clinical trials include anemia, backache, dysmenorrhea, dyspareunia, expulsion (complete or partial), prolonged menstrual flow, menstrual spotting, pain and cramping, and vaginitis.

INDICATIONS AND USAGE

Paragard is a copper-containing intrauterine system (IUS) indicated for prevention of pregnancy in females of reproductive potential for up to 10 years.

Please see full Prescribing Information for Paragard and Paragard | Single-Hand Inserter.