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    Next Choice Side Effects
    An_250107 posted:
    I took Next Choice/Morning After Pill about a month ago 12/22 right after my last period. Around 1/11 I began have mild spotting, which lasted about 3 days, I read this was normal after taking the pill. On 1/19 I started bleeding again more heavily. I though this was my usual period, however I had three days of really intense abdominal pain, cramps, bloating, and lower back pain. These symptoms are gone now but I'm still bleeding a week later when my normal periods are about three days. I also noticed the blood is very dark in color sometimes brown or almost greyish and always on one side of the tampon. Is this common with the morning after pill or could there be something else wrong?
    Jane Harrison Hohner, RN, RNP responded:
    Dear An: The easy part first, OK? It is very common for women using birth control pills to have a "period" which looks more like dark motor oil sludge than bright red menstrual bleeding. The synthetic progesterone in the pills creates a thinner lining inside the uterus. This creates a decreased amount of flow. This more scant flow will appear as a dark brown color, and thick consistency. This more scant flow may only color one part of a tampon, too. In your specific case your emergency contraceptive pill (ECP) delivered a large dose of synthetic progesterone as part of the treatment.

    You are correct, it is also common for the ECP to interrupt one's generally regular cycles. It MIGHT also be that you have not yet resumed regular ovulations. Given that ECPs work by impacting ovulation, the time in one's cycle when ECPs are used might influence when menstruation is likely to return. Two small studies have shown that when a Plan B type is used about three days before ovulation, onset of flow may be delayed. When taken closer to ovulation, or later, periods came earlier or near their expected time (Okewole, 2007 & Hapangama, 2001).

    Bottom line, you should rule out an undetected pregnancy as the unlikely cause for your erratic bleeding. If the test is negative (which I would hope and expect) you could choose to self monitor for another month to see if your cycle resets itself naturally. If it does not, or if you have persisting pelvic pain ( eg ovarian cyst or pelvic infection), see your GYN as either of these can prompt erratic bleeding as well.


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