This is a situation which requires a physical, internal exam and possibly an ultrasound to determine if the IUD is still in the right place or if it could be causing the pain. The bleeding change could be normal progression in perimenopause, but it also could be related to the IUD. A GYN would be the most appropriate provider to see.
Good luck to you,
Sandy Greenquist, CNM
Menopause Clinician
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