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Is all this normal?

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Alyssa Dyan
Posts: 3
Joined: Wed Oct 27, 2021 10:44 pm

Is all this normal?

Post by Alyssa Dyan »

Hello this is my second ectopic. My right tube was removed in May. Now ive been given methrotrexate almost 4 weeks ago. I have most pain on my right side, they claim it's from a cyst. Sometimes I have what I describe as ovulation pains or dull shooting type pains on the left (ectopic) side. It's been like that for several weeks, what would cause that? Also at almost 3 weeks ost mtx I had a heavy bleed that lasted 1.5 hours and lost around 6 golf ball size clots. Dr said that was uterine lining. Then the bleeding just stopped like nothing happened. Will that be all I bleed? Friday my levels were down to 502 from 2559. Is it still unsafe to have sex? Thanks for the advice!

Alyssa Dyan
Posts: 3
Joined: Wed Oct 27, 2021 10:44 pm

Re: Is all this normal?

Post by Alyssa Dyan »

Alyssa Dyan wrote:
Wed Oct 27, 2021 10:58 pm
Hello this is my second ectopic. My right tube was removed in May. Now ive been given methrotrexate almost 4 weeks ago. I have most pain on my right side, they claim it's from a cyst. Sometimes I have what I describe as ovulation pains or dull shooting type pains on the left (ectopic) side. It's been like that for several weeks, what would cause that? Also at almost 3 weeks post mtx I had a heavy bleed that lasted 1.5 hours and lost around 6 golf ball size clots. Dr said that was uterine lining. Then the bleeding just stopped like nothing happened. Will that be all I bleed? Friday my levels were down to 502 from 2559. Is it still unsafe to have sex? Thanks for the advice!

EPT Host 20
Posts: 2412
Joined: Thu May 31, 2012 10:58 pm

Re: Is all this normal?

Post by EPT Host 20 »

Dear Alyssa,
I am so sorry to hear of your ectopic pregnancies and losses. To experience one loss is difficult, to deal with multiple losses is heartbreaking and my heart truly goes out to you.

It is normal to feel discomfort following Methotrexate injection, I did too and I found that it worsened about a week after my injection. You can take paracetamol for the pain, per box instructions, but we advise that You avoid any anti-inflammatory medications such as ibuprofen.
The bleeding also sounds normal and your doctors are right, that this will be the endometrial tissue, so it can be heavy or clotty. This bleed is not classed as your period. Unfortunately I am not medically trained so if the pain or bleeding worsens or you are concerned, please seek medical advice.

Your periods can take a while to re-establish and they can re-start once hCG levels have fallen below about 100mIU/mL and most women find that their period arrives some time in the four weeks after their hCG levels have fallen to 0 if treated with Methotrexate

Sadly, there is still the chance of rupture with low or declining hCG levels. Regarding intercourse, we advise avoiding anything that increases intra-abdominal pressure, which would include sex. You should take things very easily in the early weeks of treatment and doctors often suggest allowing the body to recover and the first period to arrive before having penetrative sex again - which is around six weeks.

Some couples, however, feel they want to have sex before this time and, ultimately, the decision about when to have penetrative sex again is a very personal one for you and your partner and should be based on when you both feel ready. I absolutely understand wanting to get back to normal on a number of levels - I did too after my ectopic pregnancy - although it is important to bear in mind that your physical recovery needs time especially during your medical treatment and to allow for your body to heal.

As a gentle reminder following Methotrexate, you should wait until your hCG levels have fallen to below 5mIU/mL (your doctor will advise you when this is through blood tests) and then take a folic acid supplement for 12 weeks before you try to conceive. This is because the Methotrexate may have reduced the level of folate in your body which is needed to ensure a baby develops healthily. The Methotrexate is metabolised quickly but it can affect the quality of your cells, including those of your eggs and the quality of your blood for up to three months after it has been given. The medicine can also affect the way your liver works and so you need to give your body time to recover properly before a new pregnancy is considered. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as hare lip, cleft palate, or even spina bifida or other NT defects. This is why the "wait" and then taking folic acid for 12 weeks before trying to conceive is so important.

Above all, allow time to grieve, to heal both physically and emotionally.
We will be here for you for as long as you need.
Sending much love,
Karen x

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Alyssa Dyan
Posts: 3
Joined: Wed Oct 27, 2021 10:44 pm

Re: Is all this normal?

Post by Alyssa Dyan »

Update: I went to the ER Saturday morn because of moderate cramping on my left side only. The said my mass had reduced but i had alot of free fluid and maybe a blood clot by my left ovary. My hemoglobin was good though so my ob decided to admit me and monitor and they gave me my 2nd shot. By night my hemoglobin fell a little and so did my hcg. By morning my hemoglobin raised again and my ultrasound showed no increase in fluid, maybe even less and my mass was smaller. By eve my hemoglobin raised even more so they sent me home. They are thinking either my large cyst ruptured on the right side causing the fluid or my tube shoved the mass out and bled some. Anyone had this experience? I'm home resting and feeling awful from 2nd dose of mtx.

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