Bleeding and spotting after three years on mirena

Patient : Ive had mirena for three years withhout any periods (except the initial month of bleeding wheni got in put in) last year i started having spotting and bleeding happening randomly and horrible pains in my ovaries, i went to the doctor and found out i had a urinary tract infection as well as a bladder infection. Its been a year since that and all of a sudden im bleeding more frequently and the blood is alot brighter, i dont have any horrible cramps or pains, and i cant afford to see a doctor(no insurance) is this something that is normal?( my doctor is a midwife, and she said if i bled again to come in immediately)
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