### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, I am a 20 year old female, I dont know if it makes any difference but I have the birth control Mirena . I used to have a lot of spells when I was younger 12-15, (my cardiologist told me) my heart rate would go up to about 150 and then drop down very suddenly to almost a complete stop, and thats when I would lose balance and become completely useless and fall. (No diagnosis) It stopped (for the most part) until a few months ago, I havent been falling, but getting extremely dizzy, having hotflashes, all of a sudden becoming very nauseated. If I eat, I feel like im going to be sick and it all seems to be happening as one (within minutes of each other) Im sorry this is so long, but im confused and sick of being told that its in my head.

### output:

Hi, thanks for asking in Chat Doctor. The symptoms you are experiencing are definitely not imaginative but due to IRENA. IRENA is an intrauterine contraceptive device (IUD) containing long acting progesterone. It is highly effective, but results in some unwanted side effects like nausea, vomiting. Bloating, dizziness, headache and hot flushes (all of which you are experiencing). Mood swings is another common side effect reported with IRENA. The advantages of IRENA are; 1.  It acts directly (local action) on uterine endometrium (lining of uterus) 2.  It does not suppress ovaries and so does not affect progesterone levels. 3.  The blood loss during menstruation is not heavy. The fainting attacks you had when you were young could be postural hypotension (sudden fall in BP) due to vasovagal attack. Your present symptoms are not related to that but are due to the progesterone present in IRENA. Hope this helps.