Hi,
I found out about my EP on Nov. 9th and was given MTX shot on Nov. 11th. My HCG levels came down to 1 by the end of November.
It’s been almost a month now, and I haven’t gotten my first period yet. When can I expect it?
Also, I haven’t been working out at all and giving my body a break. When can I start exercising again? And what kind of simple workouts are advisable?
Thanks 
Dear MJ11,
Your periods can take a while to get back to a rhythm that is more usual for you. I also found that my periods changed for a few months after my loss. Most women find that their period arrives some time in the four weeks after their hCG levels have fallen to 0 if treated with Methotrexate however this can be extended for up to 10weeks. Your first period may be more painful or less so than usual, heavier or lighter, last for longer or shorter than usual – there really is no set pattern. You should be able to manage the discomfort with over-the-counter pain relief and should not be soaking a pad in less than an hour. If this is not the case, you should seek medical attention
When resuming exercise, we advise activities like gentle walking or swimming are usually safe as long as your hCG levels are low, as these are non-impact sports. Perhaps start off with gentle excercise and then work up to your normal exercise levels.
If you are planning to try to conceive again, can I offer a gentle reminder regarding Methotrexate and folic acid. We advise that you should wait until your hCG levels have fallen to below 5mIU/mL (which you say your have) and then take a folic acid supplement for 12 weeks before you try to conceive. This is because the Methotrexate may have reduced the level of folate in your body which is needed to ensure a baby develops healthily. The Methotrexate is metabolised quickly but it can affect the quality of your cells, including those of your eggs and the quality of your blood for up to three months after it has been given. The medicine can also affect the way your liver works and so you need to give your body time to recover properly before a new pregnancy is considered. A shortage of folate could result in a greater chance of a baby having a neural tube defect such as hare lip, cleft palate, or even spina bifida or other NT defects. This is why the “wait” and then taking folic acid for 12 weeks before trying to conceive is so important.
Sending much love,
Karen x
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Thank you for the informative reply, Karen.
I got my first period on 29th December (finally) post MTX shot.
But I bled only on the first day. There was little spotting on 30th December but today (31st December) there has been no spotting.
Is this normal? I experienced no menstrual cramps as well. Is there anything I should be worried about at this stage?
My first period was exactly the same as yours. The nurse told me that your periods can change after an EP and become longer/shorter than usual. She said so long as my periods are regular it doesn’t matter how long I bleed for x
Louise123:
My first period was exactly the same as yours. The nurse told me that your periods can change after an EP and become longer/shorter than usual. She said so long as my periods are regular it doesn’t matter how long I bleed for x
Thank you, Louise.
I am glad I am not the only one experiencing this. I had some on and off spotting yesterday and today as well. But your message has helped me relax quite a bit.
Will see how my next menstrual cycle goes.