Non-penetrative sex after treatment for ectopic pregnancy?

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I was diagnosed with an ectopic pregnancy 5 days ago. Fortunately, I caught it early enough that I was able to successfully treat it with just a single dose of methotrexate. At the time of my treatment, my hCG levels were well over 1000. Yesterday, I had my blood retested (the 4-day mark) and discovered my hCG levels dropped all the way down to 143.

I had a lot of abdominal pain the first 2-3 days after treatment as well as heavy bleeding. My doctor did an ultrasound and said there was bleeding in the tube (normal) as well as some blood clots (normal), but nothing had ruptured. Now, on day 5, my abdominal pain has almost entirely disappeared, although I am still bleeding quite a bit.

That being said - I know I should still probably avoid penetrative sex. However, I am wondering if it is safe to have non-penetrative sex or any kind of physical intimacy that results in an orgasm but does not include penetration at this time? Essentially, I want to know if orgasming itself will cause any damage to my fallopian tube or treatment?

Thank you in advance for your help :slight_smile: this has been an emotional and painful experience for me and I appreciate any and all support.

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Dear heather,

I am so sorry to hear of your ectopic pregnancy and loss,

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. 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.

As you have mentioned, there are other ways to be intimate and as long as it is not penetrative, you should be fine.

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 regarding trying to conceive following methotrexate, we and many medical professionals advise that if you have had treatment using Methotrexate (whether one or two injections), 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.

Sending much love,

Karen x

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Hi Heather

I wanted to ask this question a few weeks ago and never got round to it so I’m so glad to see your post here.

I asked my gynaecologist about penetrative sex after a single dose of methotrexate and she said it was fine and that I could carry on as usual. My levels were low however so perhaps for someone with heavy bleeding and a higher Hcg it could be different. Mine started at only 107 and I’m at 29 now. I started bleeding 10 days after the methotrexate injection. We had penetrative sex during my non bleeding week and will only resume once bleeding has stopped. The first week after methotrexate I avoided all forms of sex just to be safe but apparently it was ok all along.

You have to do what feels right for you, unless your Dr specifically says no :wink:

Xxx