Ladies who have had Methotrexate (question)

csspencer

Ok, so I had a dose of it yesterday, and I really don't know what to expect physically. The dr told me I may have some cramping, and some spotting, that once my level go negative that AF may take a while to show, she told me specifically what the medicine does, but she really didn't say anything else. I asked her what I should expect, and she really didn't have an answer for me. Will I start to bleed, should I expect any pain? I had a m/c back in January that was pretty traumatic, will I experience anything like that?

I guess I should have asked more questions last night, I just was still in shock about everything. I have to go back to the ER Sunday for another dose, since my HCG levels were so high. I guess I could ask the dr I see then.

Anyway, thanks! And I promise once I'm out of this little funk, I'll be a very supportive member of the board, I just need to grieve some first.

Mrs.E.07

First of all, I'm so sorry for your loss.

When I got my MTX injection, my dr said the same thing, that she couldn't really tell me what to expect, because everyone reacts differently. Is your pregnancy ectopic? Mine was intrauterine but close to the tube, so she said I might bleed out into my tube (wouldn't notice it), or vaginally. She said some people bleed a lot, some don't bleed at all. And that she had no idea how long it would take for my HCG to reach 0.

When I got the shot, my HCG was 4500. 2 days after the shot, I had some ovulation-like pain on my left side (where the pregnancy was). A week after the shot, my HCG was down to 1300. About 5 days after the shot, I started to get period cramps and period-like bleeding. It got worse and worse until 7 days after the shot, when I passed a golf-ball sized something. After that, the cramps almost disappeared.

I bled on and off for about a month, and I wasn't allowed to use tampons. 2 months out, I was finally cleared for exercise and sex again (but with condoms, we have to TTA for 3 months after the MTX), even though my HCG was not 0, it was 12. I go back in a few weeks for another blood draw. So my HCG has been dropping, but slowly. My dr is very happy with it, but I feel like it's taking FOREVER! I also ovulated a week ago, so that's nice to feel like my body is back on the right track.

Good luck, and PM me if you have any more questions.  I'm sorry you have to go through this.

killian09

Hi csspencer-

Our loss histories are similar.  I'm so sorry you are going through this.  My experience after MTX was pretty different than my natural m/c, in three main ways: much less external bleeding, no contractions/labor-like pain (my ectopic pg was painful in a different way), and I knew it was coming before all hell broke loose. My second loss was a horrible horrible experience, but it wasn't as traumatic as my first m/c. 

My HCG was around 10,000 and rising when I got my first dose--I was 7.5 weeks--and 1 dose of MTX did work for me. So it can be effective even at higher levels of HCG.  I also didn't really have symptoms of an ectopic pg until I went into the doc and they did an u/s.  

I had a worse experience with MTX than most, so I'll tell you what happened in case it helps you feel prepared, but know that many women take it without all this drama.

1 day after taking it, I spiked a fever of 102 and was EXTREMELY dizzy and couldn't really sit up/get out of bed. I used tylenol to control the fever and it was gone by the next day.

2 days after taking it, I had an intermittent burning sensation in my abdomen, but it wasn't too bad.

3 days ater, I had pain that escalated into the worst pain of my life.  (It was at least as bad as my very painful natural m/c, but without the moments of relief one gets from the release of the contractions.)  I took 2 percocet at home as prescribed, but they felt like sugar pills.

I went in the ER, and it turns out that I did not have a rupture.  Rather, the ectopic pg was "resolving" and there was lots of blood in my abdomen as a result.  Free blood in your abdomen can cause severe pain--it's very irritating when not contained into vessels and arteries.  They gave me a large dose of morphine and admitted me to the gyn service for 1 day so they could watch me and make sure I didn't rupture, and then they sent me home.  Ectopic pg often cause more internal rather than external bleeding, b/c the fallopian tubes will drain into the abdomen.  

From there, the pain lessened.  I could consistently manage it with percocet at home.  By week 2, I went back to work.  I was still more fatigued than usual by the MTX, but I wasn't in pain.

I only had 1 episode of heavy bleeding, and it was something like 1 pad/hour over a couple hours, and it coincided with the day I went to the ER.  (It was nothing near as much bleeding as I had during my natural m/c).  

If you experience heavy bleeding or severe pain (i.e. tylenol isn't helping), then please call your doctor.  They may need to evaluate you to make sure you aren't rupturing and don't require emergency surgery.  However, know from my experience that while it's important to get evaluation, experiencing severe pain doesn't necessarily mean that you  had a rupture.

I hope that helps.  Feel free to PM me if you have any other questions or want to talk.  I have my FX for you that the MTX works and it isn't painful for you.  (As I said, my doctors told me it was unusual to have as much pain as I did.)

csspencer

Both of you have a PM.

And again, thank you for your help.