Chronic lower abdominal pain had mirena (levonorgestrel) fitted for 4 years now, not pregnant ?

Many causes : Chronic lower abdominal pain can have many causes. If it started when the Mirena (levonorgestrel) was inserted that could be the culprit. It also could be due to a back or musculoskeletal problem. The bladder is another possible cause. Start with a full history and exam by your PCP or your GYN to help sort out the cause so you can move forward toward a solution. Hope this helps and you feel better soon.