How do i tell if my mirena (levonorgestrel) is out of place?

Check strings: You can confirm that your Mirena (levonorgestrel) iud is in the proper location by regularly making sure you can feel the iud strings in your vagina. If you cannot feel the strings, or if you develop bad cramps, or increased bleeding, see your clinician. They will confirm that your iud strings are visible and proper length. If not, they can perform an u/s to confirm proper location, followed by xray if needed.