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Have had mirena coil fitted. Experiencing abdominal and pelvic pain, feeling bloated. What to do?

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General & Family Physician
Practicing since : 2001
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Hi I have had the mirena coil fitted in 2009. I have been experiencing interminttent abdominal pain / pelvic pain for about a year. pain lasting for about 3 weeks at a time. Recently I have also been feeling bloated (about 3 months or more). For the past few weeks I been feeling fatigue. I have also had frequent bouts of thrush.
Posted Fri, 24 Aug 2012 in Women's Health
Answered by Dr. Michelle Gibson James 1 hour later
Hi XXXXXX, welcome to health care magic, I am sorry that you are not feeling well.

The mirena coil can be associated with pelvic pain secondary to pelvic inflammatory disease (PID) which is an infection of the uterus and the other organs of reproduction such as ovaries or the fallopian tubes. This infection , however,though it can occur at anytime ,more commonly occurs in the first few weeks of placement and you stated that you had your coil placed 3 yrs ago.
PID would cause symptoms such as lower abdominal pain usually dull or aching, vaginal discharge, in some cases vaginal bleeding. Some women can feel really ill and have fever, nausea and vomiting. It is treated by antibiotics.

Another cause of pain specifically related to the coil would be perforation of the uterus but this would be associated with severe pain.

There are other causes of pelvic pain, if the pelvic pain last longer than 3 months then a doctor would say it is chronic pelvic pain.
There are alot of causes and to determine the exact cause you need to consider seeing a doctor for a full history and examination of the abdomen and pelvis.

The possible causes are: (1) endometriosis which is a condition where parts of the normal endometrial tissue (tissue found on the inside of the uterus) is implanted in other parts of the pelvis
(2) adhesions - this usually occurs in persons who had previous surgery, basically different parts of the body become adherant to each other due to scar tissue on the inside
(3) the presence of cysts which are sacs with fluid
(4)infection of the uterus , falloopian tubes, ovaries
(5) chronic or repeated urinary tract infection
(6)interstitial cystitis which is inflammation of the bladder not due to infection
(7) any problems related to the muscles in the abdomen or the pelvis
(8) any problems of the gastrointestinal tract can cause repeated pain such as constipation, inflammation of the bowel
(9) presence of stones in the urinary tract like kidney stones

To find out which of these is causing the pain a doctor would ask the exact location
, how it feels, how long it lasts, what makes it worse and what causes an improvement, any symptoms associated with the pain such as loss of appetite, nausea, vomiting, urinary complaints, constipation, vaginal discharge etc

On examination , would check the area involved for any tenderness, abnormal masses. May perform a vaginal examination based on the site of the pain. The investigations would depend on the findings.

In terms of the bloating,the most common causes are constipation, gastroesophageal reflux, certain foods ( fruits and vegetables though very good can lead to bloating), lactose intolerance, overeating.
It can be treated with antiacids, avoiding carbonated drinks, eat slowly, avoid chewing gum, avoid vegetables such as cabbage, turnips, beans,lentils and brussel sprouts.
If you do this and the problem remains then you should consider consulting your GP.

Thrush is the presence of yeast infection in the mouth. In adults it can occur as a result of using antibiotics, in asthmatic as a result of the inhalors, in diabetics because their immunity is impaired and in other persons whose immunity may not be at the fullest.
It is easily treated with oral antifungal medication
If you are getting repeated episodes you need to consider seeing you GP for him or her to do some blood tests to figure out why your immune system is not fighting it off.

I hope this information is helpful to you, feel free to ask any additional questions
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