I believe in the pamphlet of side effects that is given to the physician, migraines are listed as a potential side effect, and serious enough to consider removal. I think I read that on this board, and I know other women have experienced this as well. Painful sex is also a side-effect that many women have experienced. Search especially Medications.com "Mirena painful sex" which is where I have seen this side-effect listed the most. If you have any qualms, I would get it removed. I let my symptoms sneak up on me for many months before I finally had it removed, am 8 months post removal, and feel like I've definitely recovered somewhat, but some issues linger. The sooner you have it out, the sooner you can begin to get better!