This is partially a vent post and also partially seeking advice...So I've had the Mirena for almost 2 years (will be 2 years in February 2020) and have had uterine/back/vaginal cramps on and off during that time. At first I thought it was the normal adjustment period, but the last few months it feels like the pain has gotten worse and slightly more frequent. It happens sometimes after sex but sometimes just randomly, especially at night. I mentioned it at my pap smear appointment a couple weeks ago and the NP said she could see the strings and it looked like the IUD was in place, but she recommended getting an ultrasound just to check.

Well I went today and it was sort of an ordeal. I had a bad experience at my pap smear (no one told me the NP was running over an hour behind so I was left naked on the exam table until after the office closed!) and I'd also never had an ultrasound before so was expecting just an external one like pregnant people get. No one told me it would be internal/vaginal, and I was sort of caught off guard when the tech handed me a wand and was like "okay put that in"!

Anyway, the tech said that the main part of the IUD seemed to be in place (it was at the fugal level I think she said?) but that one of the arms looks like it's not in the lining anymore and in the muscle? She said I should talk to my doctor, but in cases like these the Mirena isn't less effective and doesn't need to be removed unless I decide the pain is too bad, or the doctor recommends it for whatever reason.

So I have to make a follow up appointment which I'm not particularly looking forward to, and I'm still sort of confused about what's happened. I've only ever heard of IUDs expelling down through the vagina or migrating onto the uterine wall/completely moving somewhere it shouldn't be. I didn't know it was possible for only the arm to be out of place. I'm also not clear whether the arm has been pushed like...through the uterine wall into the muscle, like is there a hole there now?

I'm not inclined to get the IUD taken out unless my NP recommends it - I'm much happier with the IUD than I was with the pill, and the pain isn't that consistent or all that bad. But I'm wondering whether getting the IUD taken out will be more painful, like will the muscle get ripped out?

Was the tech correct, and the Mirena is still effective, so I don't need to use backup birth control between now and my follow up appointment?

Anyone with experience with this? I've tried Googling but haven't had much luck, and want to feel better between now and my next appointment.