Hello, and I hope I can help you today. I am glad that the Mirena IUD has been able to help your pain so far for almost 2 years. However, because the Mirena is effective for five years, a new pain symptom may not necessarily be being caused by the IUD. Before removing the IUD, I recommend that you have a physical examination and consultation with a GYN doctor. You should have an ultrasound to actually determine if your ovary problem is back and whether it is the cause of your pain. There are other causes of pelvic pain that should be ruled out before ultimately deciding to remove the IUD. If you do decide to remove the IUD, continuous oral contraceptives; meaning birth control pills that you take every day, can sometimes be more effective than the hormonal IUD in treating endometriosis. I suggest you discuss these issues with your local GYN physician. So in summary, I suggest having an evaluation of your pain and the IUD itself by your physician and together deciding whether removal is the best course of action and what alternatives for your treatment are available. I hope I was able to adequately answer your question today, and that my advice was helpful. Best wishes, Dr. Brown