Should I go to the hospital?

I have been having pretty bad cramps/pains for months in my stomach and pelvis. I last went to the gyno in January I believe. I have complained about these pains before. Back in 2022 I had them and they ended up discovering a couple small cysts that they said would rupture on their own and go away and they did. Now the pains are worse than back then. I went for another ultrasound last year and nothing showed up. The last time I went to the gyno I had them check my IUD they said it was in place and suggested the pains were likely to do with my gastro tract rather than uterine issues and just dismissed me. I also have experienced regular nausea, trouble focusing, iratic mood swings, occasional dizziness and headaches and last week I was bleeding somewhat heavily but only for a few minutes. Could I have had a miscarriage? Should i just make another appointment or go to the ER?