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Lisa, MSN, FNP-BC, CCRN, Nurse Practitioner
Category: Health
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Experience:  Board Certified Family Nurse Practitioner
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I have cramping on my right side under my naval. It is in the

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I have cramping on my right side under my naval. It is in the place where I normally feel menstrual cramps but this is far worse. It has happened off an on for the past few months but this is definitely the worst. I currently have a Mirena and am due to have it removed and a new one put in as of May. I'm concerned about my level of pain. I have take over the counter pain medication and it is no longer helping.
Submitted: 6 years ago.
Category: Health
Expert:  Lisa, MSN, FNP-BC, CCRN replied 6 years ago.



Thank you for writing in today. I want to provide you with the best possible information, so I have a few questions. I will explain the questions in my answer. Do you have unprotected sex, meaning no condoms? Any risk for sexually transmitted infections? Any nausea, vomiting, profuse sweating? Can you tell me about the pain over the last 24 hours? Any vaginal discharge or spotting? Any abdominal bloating? Since you have a mirena, when did you last check the placement string? Do you still have periods with Mirena? Please let me know. Lisa

Customer: replied 6 years ago.
Thank you for your quick response. I do have unprotected sex yes. I do not think that I have any STI's but I cannot be sure as my annual is scheduled for next month. I do not have any nausea, vomiting or profuse sweating. The pain just started within the last 2 hours. It's not getting any worse, but it's definitely not getting any better. I do not have any abnormal vaginal discharge or spotting. I haven't noticed any abdominal bloating. I check my strings once a week. They seem to be in place. I have VERY light periods with my Mirena. I had my period approximately two weeks ago.
Expert:  Lisa, MSN, FNP-BC, CCRN replied 6 years ago.



Thank you for responding to the questions. Based on your information presented initially, I would have some immediate concerns. Ectopic pregnancy, IUD perforation, Pelvic Inflammatory Disease, Appendicitis, and Ovarian cysts. If your IUD string is still present, perforation is not likely. Since you aren't having any real discharge or concern regarding sexually transmitted infections, it is more doubtful that this is related to pelvic inflammatory disease. Based on your response, I suspect that this is most likely related to an ovarian cyst. Ovarian cysts can be very, very painful. Unfortunately, Mirena tends to increase the incidence of cysts in some women. However, with this being said, given the limits of this format, I can't substitute as a provider, so I can't tell you for certain that this is an ovarian cyst. Since appendicitis and ectopic pregnancy (and yes they can happen with the Mirena), if your pain is severe, it would be best to be evaluated. I hope this helps. Please let me know if you have additional questions or need clarification. Lisa

Customer: replied 6 years ago.
After I sent my last reply I did take my temperature .. it's 99.6 . I usually run about 98.0. I'm not sure if this means it could be one or the other..? I will make an appt right away in the morning.
Expert:  Lisa, MSN, FNP-BC, CCRN replied 6 years ago.
An elevated temp can be the body's response to pain. As for when you need to be seen, I can't really advise you, since I can't substitute as a provider; however, I will stress that if your pain becomes intolerable or other symptoms worsen, such as temp, or new symptoms develop, you may want to consider evaluation sooner than the morning. I hope this helps. Have a good night. Lisa
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