Period and cramping after methotrexate

Preparing For Your Next Pregnancy
1

Hello!
I was wondering people’s experiences after methotrexate and whether you had any cramps after hcg was below 5? And how long until you had a first period?

I was given one round of methotrexate on 10th Jan and my hcg got to 7 on the 8th Feb. A couple of days after the injection I had slight cramping that only lasted a couple of hours. Last week, 13th & 14th Feb I have had on and off cramping, like more intense period cramps.
Is this normal- is it to early for period to be coming or could this be ovulation pain?

I have my follow up in a few weeks just feel there was no information given around periods and after care from my consultant.

Would love to hear others views and experiences
Thanks so much x

2

Hi Jmhaworth,

I am so sorry that you have suffered an ectopic pregnancy and you are going through this worrying time.

Experiencing some pain after an ectopic pregnancy is normal as your body has been through a great deal over the last few months. The pain maybe your body may be preparing to ovulate and many women experience ovulation pain when they did not before their ectopic pregnancy - including myself. You also may have a heightened perception because of the sad loss that you have had to go through.

The initial bleeding we experience following Methotrexate injection is due to the hCG levels reducing. This spotting can go on for several weeks but usually settles.

Your menstrual periods after an ectopic pregnancy can take a while to re-establish. They can restart any time between four and ten weeks after treatment. Most find that their first period arrives sometime around week six or seven after surgery, or, if treated without surgery, at some time in the four weeks after their hCG levels have fallen to below 100 mIU/mL. 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.

If the pain persists, I suggest keeping a pain diary noting when the pain appears, the intensity on a scale of 0-10 and anything that helps the pain eg resting, hot water bottle, paracetamol etc. Visiting your doctors with this information helps them to assess how best to manage your symptoms.

From the bottom of my heart, please be kind to yourself through your recovery. We are here for you whenever you need it.

With good wishes,

Michele

The Ectopic Pregnancy Trust

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