I have had the Mirena IUD since January 2006, so for about 18 months. The insertion was HORRIBLE and painful. i was very unprepared for the pain, and had to call someone to come pick me up because I couldn't drive. Also had severe nausea and felt like I might pass out. For the first few months I had continuous bleeding/spotting. Even now, my cycles are very short and I will have spotting for two weeks at a time. I began having pain during the time of ovulation probably a year ago, and it has progressively gotten worse. I found out today that I have developed functional ovarian cysts as a result of the Mirena. They are harmless except for the pain, and are supposed to go away on their own. I will go back in 2-3 months to see how the cyst looks. If it is not gone, or I have more, I will likely have the Mirena removed. I have also experienced decreased sex drive, difficulty achieving orgasm, and moodiness, all of which have gotten progressively worse over time. I like the convenience of the Mirena, and was hopeful because of the low dose of hormones, but I am feeling more and more that it is not for me. I haven't ever been satisfied with any type of birth control though, so am not sure what I will do instead.