Pain 7 days post Methotrexate

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1

Hey ,

I am currently going through an ectopic pregnancy diagnosed at 7 weeks pregnant. I had methotrexate 7 days ago. I just wanted to see if any one has had similar experiences/symptoms.

I have been absolutely floored with fatigue. I feel like I’m floating around in a haze and just struggling to focus and function normally.

I’ve had ongoing bleeding but I’ve had that since the day I found out I was pregnant at 4 weeks. It’s been a little fresher lately but nothing major.

Last night I woke up with excruciating pain in my right side (where ectopic is) and shooting pain down my rectum. We were about to head to ED then it just subsided and resolved. It lasted about 40 minutes.

For reference my hcg levels have been:

2900 Day of Methotrexate administration

1780 Day 4

916 Day 7

Also how long have people taken off work? I’ve had a week off and due to go back on Monday for a run of 4 night shifts in a really physical job and I just cannot imagine working normally.

Thanks guys,

Ash

2

Hi Ash,

First of all, I’m so sorry for your loss xxx

I had my MTX shot 29th Nov and that first 10 days was like an ongoing heavy duty hangover it was horrendous. I had 2 weeks off work as my company give you two weeks leave for miscarriage/ectopic etc and because it’s an office job I decided against further sick leave. But I was unable to manage any exercise, some days I couldn’t walk at all so I’d definitely speak to your employer about additional time and make sure you take it easy.

Between the 29th Nov and 15th Jan I went to A&E 4 times for pain and for increased bleeding, it turns out the excruciating pain was from a cyst bursting which is very common and a few of the ladies here have experienced the same.

I stopped bleeding about 10 days after my HCG levels were at not pregnant levels and unfortunately I still suffered pain last weekend where I couldn’t walk and I’ve had a scan showing no ectopic and no cyst! Apparently it could be ovulation pain which I’ve never experienced or it’s scarring/trauma.

It sounds SO negative here sorry, just telling you how it’s been for me! But remember we’re ALL different and there are people on here that had MTX after me and reached not pregnant HCG levels before me and vice versa but you’ve had great drops on your HCG so far! Mine increased between 0 and day 4 :slight_smile: so chin up and we’re always here!!

Xxxx

3

Dear Ash,

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

I think lots of people are completely shocked by how exhausted you can feel following Methotrexate. This coupled with the diagnosis of ectopic pregnancy and loss of your baby can be very overwhelming, so please do take the time you need to recover both physically and emotionally.

Whilst I do not wish to alarm you, following Methotrexate there remains a risk of rupture even with declining and low levels. We therefore advise to avoid any heavy lifting or strenuous exercise until your hCG levels are nearing pre pregnancy levels (so the low 100 figures).

Your work sounds very demanding physically, so if there isn’t another role you could do that would mean you weren’t doing physical tasks and night shifts, I’d think about taking some additional time off. In addition, it is worth bearing in mind that experiencing ectopic pregnancy is a very frightening experience and many women need to take time to help them deal with the psychological/emotional impact of the loss of their baby, being diagnosed with a life-threatening condition and undergoing treatment. Please speak to your GP about having further time off work if required.I

I have added more information on methotrexate from our website here-

https://ectopic.org.uk/treating-an-ecto … thotrexate

We will be here for you for as long as you need,

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards

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Further information is available at ectopic.org.uk

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4

Thank you both for sharing your experiences and advice! That been really helpful.

I’m glad the fatigue isn’t in my head, it’s really floored me.

Ironically I’m a midwife so lifting patients and getting into tricky positions is what I’m worried about going back to work but I feel dramatic taking more time off!

It’s hard to be patient to get that HCG to 0. The whole thing is just so dragged out!

Thanks again guys x

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Hi Ash,

I’m sorry for your loss and what you’re going through. I was also surprised at high extremely tired I was for weeks following Methotrexate. I wish the clinic where I was treated had told me more about what to expect! The ETP was the first resource I found that validated my fatigue.

I was also diagnosed at 7-8 weeks and ended up needing two shots of MTX (Feb 14 and Feb 22) because my HCG levels got stuck around 1800-1600 a week post injection. I was extremely tired and had a lot of bleeding for a week after the first shot. A few days after my second shot I was actually starting to feel better, but ended up with pain levels that landed me at the emergency. They didn’t find anything worrisome and suggested pains might be from ‘the MTX doing its work’. Since then, I’ve been exhausted, and only really started bouncing back a bit on energy this week, i.e., a month post first MTX… Now I’m at 7 HCG and hoping to be discharged at my next bloodwork.

I wasn’t really told I should expect to take any time off, just that I might get cramping + tired + bleeding for a few days after the first injection. My office job is flexible so I ended up mostly doing short days to manage my fatigue. Kinda wish they told me more about fatigue - I would have felt validated to take more time off if I had known what to expect.

I hope you are feeling better by now, and that however you feel you can take the time and space to care for yourself <3

Cam x