<s>[INST] I ve been having some horrible pains in my lower back and front pelvis area. When I use the restroom I barely go, it hurts and there is dark brown blood when I wipe. I thought maybe I m about to start but I ve had no signs and I m on mirena so I don t have them much. I ve also been swelling alot and itching for almost a year now. Can t find the cause. So anything sound like an easy fix? [/INST] Hi,You first need to have your mirena checked that its in place. If it is, you should be examined for PID vaginal infection, cysts etc. Do an pelvic ultrasound. Use vaginal washes and probiotics for the itching. Its likely due to infection. </s>