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

### input:
hi i had a baby in march, used the mini pill until beginning of may and then had a mirena coil fitted, i carried on taking the mini pill for a further 7 days after the coil was fitted as doctor suggested i do. 2 days after i had coil in i had a little spotting which was fine and then 2 weeks after i had some bleeding but not alot. i havnt had any bleeding at all since that so a good 9/10 weeks ago. i was supposed to return 6 weeks after the coil fitting to check it was still in place, but with a new born baby that was poorly i didnt go for the check unfortunately. for the last couple of weeks i have had a very strong sense of smell, very overpowering at times and its making me feel very sick and i have also tody been sick, i have had no bleeding as i explained for about 9 weeks now, also tired and gaining weight. is this normal for the mirena coil or could it be something else? thanks

### output:

Hello, and I hope I can answer your question. The IRENA coil normally produces irregular bleeding in the first few months of use, so those symptoms are completely normal.  However, your fatigue, weight gain and feeling sick make me concerned that your IUD may not be working properly (you never went back for the re-examination) and that you may have gotten pregnant.  The device can fall out occasionally, especially in women who have given birth recently. I suggest you do a pregnancy test right away. If the test is positive, you should see a doctor immediately, as there is a risk of a tubal or ectopic pregnancy if you get pregnant with an IUD. An ectopic pregnancy is an emergency and can even result in death without proper treatment. If you are not pregnant, I would still advise you to see a health care provider to check that the IRENA is working properly and evaluate your other symptoms. I hope this advice was helpful, and that you feel better. Sincerely, 