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

### input:
I had the Mirena IUD inserted 4 weeks ago. Since then, I have not stopped bleeding. I have a sharp downward shooting pain that starts right below my belly button. I also have lower back pain , both medial and lateral of my spine . The pain appears to be worse on the left side however. In addition, the ribs on my left side are tender and painful to touch. My OB/GYN suggested the IUD b/c I have been on Nuvaring for 5 years and had debilitating migraines for the past 3 years. Since the Mirena, the headache has switched from the right side of my head to the left. Is it time to consider removing the IUD?

### output:

Hallow Dear, You seem to have shifted from one agony into another. After IRENA, continuous bleeding for 4 weeks with the pain in abdomen is suggestive of:1. Infection2. The uterus is not tolerating it and is trying to push it out3. Partial perforation: This should not cause such a bleeding. If it is perforating, it has to be out of your uterus. X-ray/Ultrasonography will diagnose this complication. What is your obstetric history? Did you have any previous pregnancies?  The women who never had any previous pregnancies are more likely to be intolerant the intrauterine devises, though it is not a rule. If your uterus cannot tolerate it, better get it removed. Even if there is infection causing pain and bleeding, better remove the device and be under antibiotics. Please report to your Gynecologist who will examine you clinically and take the decision. Please do not ignore this problem.