### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello... I m 23 years old... have three children already... for the past month or so I have been having every pregnancy symptom you could think of... but I didn t think nothing of it until I missed my period & today I m two weeks late. I ve taken 3 hpt in the past couple of weeks but they all have been negative. I have also been experiencing a lot of pain and pressure in my pelvic area. Today my husband and I tried to have intercourse but I was afraid that it would hurt due to the pain that I ve been in. Sure enough we had to stop because I had the worst pain in my life; I never had pain like that in all three of my previous labor! I had extreme sharp pain and pressure in my pelvic area, I could barely move. My husband helped me to the shower were I could only sit because it hurt too bad to stand and I let the hot water fall on me to try and ease the pain. The pain wa so bad that I threw up in the shower. When I got done, I set on the toilet because of all the pressure and it sorta felt like something was going to fall out of me. I ended up having to get my husband to help me to the bed so that I could lay down because the pain was so unbearable that I turned pale and cold and I was sure that I was going to past out, but never did, thank God. That was this morning and for the rest of the day I have been resting in bed and taking Motrin. I only feel a little pain while I m laying down but when I get up, I get the pressure in my pelvis area and I get so dizzy and lightheaded. What could this possibly be? I plan on seeing my doctor but I have to wait until after the holidays. I also have the Mirena IUD . Thank you for your help!

### output:

Hello, MIRENA IUD is very much effective in preventing unwanted pregnancy with failure rate less than 1%. Pain around pelvic region may be due to pelvic infection, endometriosis, PID associated with insertion of IRENA. Do a pelvic USG with some hormones test & blood for TC/DC/ ESR and a urine test for R/E, M/E to rule out underlying pathology. Also, you have to undergo some clinical and pelvic examination. Check tail end of thread to make sure that IRENA is properly placed and not displaced. Use some anti-spasmodic medicine like Tab Chat Doctor.  Avoid stress, take healthy diet, control body wt and need proper sleep. 