Hello,

Thanks for writing to us. I am happy to help you.

First of all, mirena is a levonorgestrel containing IUD. It is more than 99.5% effective at preventing unwanted pregnancy.

But, there are several side effects or complications in case of mirena used for long time. These include pelvic infection, abdominal pain, missed period, change in bleeding pattern, ovarian cyst, ectopic pregnancy (most serious effect) etc.

Your clinical features are mostly suggestive of presence of ovarian cyst or old ectopic pregnancy if you had gotten regular period previously.

Therefore, complete physical examination including pelvic & speculum examination is needed to carry out to reach in pin point diagnosis.

Here, I can suggest to undergo one ultrasound scan (USG) for lower abdomen and blood test for beta hCG level at the earliest.

If above tests do not signify anything, then some investigations like blood test for thyroid profile & clotting factor abnormality, hormone level assay, vaginal swab test and endometrial biopsy may be needed to exclude other causative agents.

Treatment depends upon underlying etiology. You may need to remove the mirena for proceeding to next line management.

So please consult with gynecologist at the earliest for taking suggestive measures according to investigation.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish your good health & take care yourself. Maintain genital hygiene properly.

Regards,
Dr Soumen.

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Hello,

Thanks for follow up query.

Headache or light headedness may be due to effect of mirena (leads to hormonal imbalance) or migraine/ stress/anxiety/ panic disorder/anemia/ low blood sugar etc.

Here, you need to check up blood sugar & Hemoglobin level including eye power also. In addition, psychological counseling/ therapy may be helpful regarding this.

You should drink more water, avoid salt/ spicy/ fatty foods, eat more XXXXXXX vegetables or fruits and sleep adequately. These are certainly useful measures to get relief from above said condition.

If you do not have any clarifications, you can close the discussion and rate the answer.

Be well and stay healthy.

Regards,
Dr Soumen

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