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

### input:
I am a female, 44 years old. For the past 5-6 days I have been having almost constant dull cramping in the lower abdomen area (no particular side) . I also occasionally have a throbbing sensation in the groin area. I have been to my ob-gyn and had a pelvic exam and had urine tested for infections. The doctor could not find anything wrong. He did not do an ultrasound or send me for further screening. My IUD Mirena is due to be removed (over 5 years) in the next couple of weeks and has been in since 2009 (over 5 years). Any ideas as to what this could be...I am concerned. My ob-gyn thinks I need to see a gastrointestinal doctor. Thanks.

### output:

Hi ! Good afternoon. I am Chat Doctor answering your query. From your history, it seems that the IUD IRENA is the culprit in your pain in lower abdomen. As you are already due to remove it soon, you might be relieved completely after its removal. If I were your treating doctor, I would have removed it along with a vaginal swab culture sensitivity test, and would prescribe a broad spectrum antibiotic covering both aerobic and anaerobic organisms. This would relieve your symptoms. As presently you do not have any gastrointestinal symptoms, I would defer referral to any gastroenterologist the time being. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. Wishing you an early recovery. Chat Doctor.