I had my appointment today, and when I told her about my most recent episode, she said as horrible as it was for me, it's still within "normal". My responded to pain stimuli and that's why I became nasueous, sweaty, and faint.

She did check me well with a trans-vaginal ultrasound as well as manual manipulation and she was happy with the results. So out came the old IUD and in went the new.

She said it's unlikely endometriosis at my age, and never mentioned the ovarian cysts and didn't seem at all concerned, just empathetic for my pain.

She did also say that it could have been that my IUD was sitting too low and that could have produced more cramping.

So, a guarded "yay", and hopefully no more horrible pains.