Hello. I m Dr. Christensen. I m sorry you re having problems. Although it isn t possible to pinpoint the cause of your bleeding and cramping without an examination, there are several possibilities: Next Choice, like all forms of emergency contraception, is a hormonal medication. Menstrual irregularities -- delayed or skipped periods, spotting, mid-cycle bleeding, or abnormally light or heavy periods -- are common in women who use these medications. If you take emergency contraception several times during one cycle or during successive cycles, your risk for side effects increases. Typically, these side effects subside within a few days to a week, and most women resume their normal menstrual pattern within a cycle or two...unless they use emergency contraception again. Although emergency contraception is 95% effective for preventing pregnancy when taken within 24 hours of intercourse, it is much less effective if a woman has already ovulated when she takes her pill. So it s possible, although unlikely, that you conceived following your first sexual encounter, and your current bleeding could be due to a miscarriage. (The period you had following your first course of Next Choice may have actually been implantation bleeding.) If you did conceive, your current bleeding could also be a manifestation of an ectopic (tubal) pregnancy. A third possibility is a pelvic infection. Most such infections are due to sexually transmitted diseases, which are more likely if you re not in a monogamous relationship. (You didn t mention if you have more than one partner.) In any event, it sounds like your bleeding is fairly significant. If you re soaking more than one tampon or pad per hour for more than 24 hours, a medical evaluation is in order. Likewise, you should see your doctor if you become lightheaded, if you develop severe pelvic pain, fever or foul-smelling vaginal discharge, or if your bleeding persists for more than one week. I hope that answers your questions, and I hope things settle down soon!