How do people feel after methotrexate? Thank you!

Hi everyone, I am new to this forum and thank you it’s really helpful as I don’t know anyone else who has gone through an ectopic pregnancy. This is my first pregnancy and it was diagnosed ectopic (in my left ovary) this day last week. As my levels were quite low (349) at my first bloods we were hoping they might decrease on their own because I have been bleeding for two weeks now. I was an inpatient so they could monitor the levels closely and had concerns about rupture. Unfortunately the levels remained static (but n pain which was good) so I had the methotrexate injection yesterday evening! I really hope it works and I don’t need to have surgery or another injection. I’m just wondering how people felt in the first few days? The bleeding doesn’t seem to be getting any heavier/cramps are not that bad! Just worried maybe it’s not working or does it take a few days to kick in? Sorry I should have asked the docs all these questions but I found being in the hospital very upsetting and no one was particularly helpful unfortunately. Thanks so much ! X

Dear Aoife,

I am so sorry to hear of your ectopic pregnancy and loss. Do not apologise for asking questions here. The boards are a safe place to ask any questions, share feelings or even just to vent.

The action of Methotrexate is not instantaneous, and your doctors are looking to see a drop in your hCG value of at least 15% between days four and seven.

I too had methotrexate, my bleeding and abdominal pain worsened around day four after the injection and I was shocked by how exhausted I felt, but this was all normal.

We advise that you do not do any heavy lifting or strenuous exercise whilst your levels are reducing as sadly there is still a risk of rupture with lowering levels of hCG. Therefore, if you experience any severe pain or bleeding, please contact your local EPU or seek urgent medical advice.

We have more information about methotrexate injection here-

https://ectopic.org.uk/patients/treatment/

I am afraid it is difficult to predict how long it will take for your hormone levels reach non-pregnant levels. As we are all individual, our bodies respond differently to the drug and it depends on factors like how high levels reached and our unique physiology. What I can say is that it can take a number of weeks and, while it can take some time, it is not as invasive a procedure as surgery. Also, in terms of chances of future successful pregnancies, studies do not show a significant difference between treatment routes, whether surgical, medical using methotrexate or expectant management (allowing time for the body to resolve the pregnancy itself).

Take things easy, 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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Hi Karen,

Thanks so much for getting back to me, I really appreciate it! I wasn’t sure what to expect so that is really helpful to know. Hopefully they will continue to drop! Thanks again xx

Good luck I hope it works.

There is a list of side effects here:

https://ectopic.org.uk/patients/treatment/

I just received my second methotrexate injection yesterday. This is my second ectopic after a salpingostomy this spring. After reading multiple forums, it seems like everyone varies in their response. Some people experience very mild side effects and can return activities of daily living and work immediately.

Personally, it hit me pretty hard. The most debilitating symptoms were fatigue, nausea, and abdominal pain. I took all of last week off of work and am taking this next week off of work as well.

Hopefully your side effects are minimal!

Hi Portland 24,

Thank you so much for getting back to me! I’m really sorry to hear you have been through all of that, I really hope you are doing ok. You are so right to take the time off work. Yesterday I was in agony with the pains in my left side but they are less extreme today! I am absolutely exhausted too! I went in for my day 4 bloods and they have remained static still… was really hoping they might decrease. What had your day 4 bloods said? I really hope this second dose works for you!

My hcg has also remained relatively static with only minor fluctuations, up and down.

First methotrexate: 305

day 4 356

day 7 426

second methotrexate (a day after day 7 lab): 340

I’ll get my “second” day 4 labs drawn tomorrow. If there is a slight increase in my hcg I am not going to read into it too much because that happens. Hopefully it will decrease by more than 15% by day 7.

I’m glad your pain has decreased somewhat. Thinking positively about your numbers, this process is crappy enough as it is! So much anxiety with waiting, and the symptoms are so uncomfortable.

Thanks so much for getting back to me! Yeah mine are similar numbers to you!

Best of luck with this injection, really hope it goes well for you. I know it’s the waiting that’s such a killer !! Finding the whole process really emotionally draining… I’ve just set up my own business too so it’s hard to take time off etc but I think I might have to again this week if I’m getting the second injection. Take care, wishing you the best of luck with it all xx