Hi, so I had my first methotrexate injection on the 20th of March which they was an initial drop in my hcg from day 1- day4 from 184 to under 100. Can’t remember the actual figure but day 4-7 they had rose a little but was told its considered static.
After another blood test 48 hours later they was still static so I had another injection on the 29th of March.
Hcg dropped from 103 to 68 and then down 33 and last blood test they was at 9.
So from my first injection I had a bleed and continued to bleed until about 2 days after the second injection and nothing since until today which is just over 2.5 weeks since my second injection and I have started to bleed again. Is this my period or something to do with methotrexate still?
Any info to help clarify this would be greatly appreciated 
Dear Naomi,
I am so sorry to hear of your ectopic pregnancy loss,
The bleed you have experienced so close to your treatment is not classed as your first period. This bleed occurs as your hCG levels have fallen. According to a study for women who had methotrexate treatment for an ectopic pregnancy in a Fallopian tube, periods generally return to normal after an average of 24 days (range of 24–38 days) from the pregnancy ending (hCG levels at pre-pregnancy levels)
If you are planning on trying to conceive again, it is also important to take folic acid supplements for 12 weeks once you have been discharged from your EPU, before trying to conceive.
Sending much love,
Karen x
The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information
If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.
Further information is available on our website.
Email us: ept@ectopic.org.uk
We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.
Take a look at our newsletters and subscribe to our mailing list.
Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team
Naomi2023:
Hi, so I had my first methotrexate injection on the 20th of March which they was an initial drop in my hcg from day 1- day4 from 184 to under 100. Can’t remember the actual figure but day 4-7 they had rose a little but was told its considered static.
After another blood test 48 hours later they was still static so I had another injection on the 29th of March.
Hcg dropped from 103 to 68 and then down 33 and last blood test they was at 9.
So from my first injection I had a bleed and continued to bleed until about 2 days after the second injection and nothing since until today which is just over 2.5 weeks since my second injection and I have started to bleed again. Is this my period or something to do with methotrexate still?
Any info to help clarify this would be greatly appreciated
Hey,
I can share my experience. My etopic pregnancy, i bled from 6 weeks pregnant, 8 weeks pregnant had mtx injection, then bled another 10 weeks. During this my HCG dropped down to 16 whilst I was bleeding, I bled another 2 weeks. Then I stopped bleeding for exactly 2 weeks and then bled again This new bleed was definitely my period as my body ovulated around my hcg at 0. This reflects what the nurse said also.
It is definitely confusing and everyone is different. The way I’ve interpreted it is you bleed during the pregnancy loss, when the body stops bleeding is because your body has expelled the pregnancy and is around a HCG of 0, around that you ovulate and then you get your period in a few weeks. They said it can be 2 to 6 weeks time.
Hey, thanks for the reply. Only just seen this. The bleed was infact my period as I had to have an internal done due to the bleeding as the doctor was concerned with the heavy bleed and said it looks like it is my period as they wasn’t any active bleeding there. I tracked ovulation from this bleed and ovulated as i usually did before my pregnancy.
I did have a bleed with the first methotrexate injection but then nothing for a couple of weeks so I must of ovulated when my hcg was very low and then had my period a few weeks later. Thankyou for helping me and I’m very sorry that you had to go through it all X X