Why do I have severe cramps months after getting an IUD?

Question

Hi doctor,

I am a 29-year-old female, and I need advice regarding issues with my intrauterine device (IUD). I had the Mirena IUD inserted four months ago, and I have been having a terrible experience since then. The cramping has been so intense that I had to miss three days of work last month. Additionally, I have been bleeding almost every day—not just light spotting, but heavy bleeding with large clots at times.

My boyfriend has mentioned that he can feel the strings during intercourse, which is both embarrassing and painful for us. Lately, I have also noticed an unusual odor and greenish vaginal discharge, which was not present before the IUD insertion. I experience constant lower back pain and frequent dizziness.

I checked and can still feel the IUD strings myself, so I believe it is still in place. However, something does not feel right. I took three pregnancy tests last week, and all of them were negative. Despite that, I continue to have pregnancy-like symptoms, including nausea, tender breasts, and bloating.

Could the IUD have been inserted incorrectly? Are these symptoms considered normal, or could there be an infection? I am unable to afford the removal of the device at this time because my insurance does not cover an alternative birth control method for another year.

Please advise me on what steps I should take regarding this IUD. I am truly at my wits' end.

Please help me.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Severe cramping after the insertion of the Mirena intrauterine device (IUD) could be caused by several factors, including the possibility of improper placement. The most important next step is to undergo a pelvic or transvaginal ultrasound to determine whether the Mirena is correctly positioned, has become displaced, or has perforated the uterus.

The heavy bleeding with clots you are experiencing may be due to any of the above reasons or potentially due to an infection introduced at the time of insertion.

The pregnancy-like symptoms you are experiencing—such as nausea, breast tenderness, and bloating—are likely side effects of the hormone (progesterone) released by the Mirena and are not indicative of an actual pregnancy.

At this point, I strongly recommend having an ultrasound scan performed as soon as possible. The results of this investigation will guide the next steps in your management.

Possible causes to consider:

Displacement or perforation of the uterus by the Mirena.
Pelvic inflammatory disease (PID).

Recommended investigations: Pelvic ultrasound scan (preferably transvaginal).

Please proceed with the scan and share the findings for further evaluation and management.

Feel free to ask if you need any more clarification or help with your questions.

Thank you.