I had my Mirena removed just after 5 years. It was slightly painful to have it removed, but not so bad. I intended to have it replaced, and did in fact have it replaced at that same visit, but immediately following insertion of the new IUD (which was quite painful, btw) I felt like I was going to pass out, and the feeling did not come and go. A half hour later I still felt lightheaded, nauseous and unable to sit up, and was having cramps reminiscent of periods. I finally requested that it be removed then and there, since the way I was feeling had not improved. Now I'm trying to figure out what's next.