Hi Everyone,
I'm looking to see if anyone has had a similar experience to me. I started experiencing bleeding nearly 2 weeks ago and went straight to the EPU as I had a miscarriage 2 months earlier. After 3 days they said they found a mass near my right ovary which was an ectopic pregnancy.
I chose to have methotrexate which was administered the day after. My levels on day when I was diagnosed 1189 which went to 1700 on day 4. I had very little in terms of side effects with methotrexate, just very tired and occasional spotting.
On the morning of day 6 I kept getting bad groin/pelvic pain but I thought it may be a side effect. In the evening it go worse and then I felt dizzy, sick and had a pain in my pelvis and shoulder.
My husband and I went to A&E. After 4 hours we got triaged to gynaecology and then, finally, at 5am they admitted me.
The consultant came to see me the next day and the pain had subsided but I could still feel discomfort on my right side. They took me for an internal scan after pestering them and they found some fluid in my pelvis. The consultant said we'd do a wait and see approach rather than go for surgery as my hcg had come down to 1000. They said it's led by me and my decision and this could be due to the methotrexate.
I'm not in masses of pain, just a bit of discomfort. I don't have blood on my pad but there is quite a lot when I wipe. I've also had a few clots now.
I'm not sure what to do as they're going to take my lead. Thing is, I'm not in horrific pain and I don't want a surgery I don't need.
Has anyone been in a similar position?
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Bleeding in pelvis after methotrexate
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Re: Bleeding in pelvis after methotrexate
Dear Bexb,
I am so sorry to hear of your ectopic pregnancy loss,
I would like to think they mean that they will also keep a close eye on your symptoms. As your levels were reducing and pain had settled, they may be continuing to watch, but I would be mindful of the fluid in your abdomen. I hope they are going to closely monitor you with more bloods and a scan to review the fluid.
I would advise getting back in touch with them urgently if any of your symptoms worsen or you are concerned,
Sending much love,
Karen x
The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information
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I am so sorry to hear of your ectopic pregnancy loss,
I would like to think they mean that they will also keep a close eye on your symptoms. As your levels were reducing and pain had settled, they may be continuing to watch, but I would be mindful of the fluid in your abdomen. I hope they are going to closely monitor you with more bloods and a scan to review the fluid.
I would advise getting back in touch with them urgently if any of your symptoms worsen or you are concerned,
Sending much love,
Karen x
The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information
*************************************************************************
If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.
Further information is available on our website.
Email us: ept@ectopic.org.uk
We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.
Take a look at our newsletters and subscribe to our mailing list.
Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team
*************************************************************************
Re: Bleeding in pelvis after methotrexate
Hi,
So sorry to hear this is what you have been going through.
I’m messaging here as I believe this story resonates with mine.
I had methotrexate at 2037 hcg. My blood tests were tracked until I was at 5.5 hcg. I had a lot of fatigue with this drug, and a manageable amount of infrequent abdominal pain.
However, I had pain in my right shoulder, vomiting and diarrhoea, which led me to EPU to get a scan (I was referred via A&E), uncovering a similar mass. This was a mass next to my right ovary and looked the size of my ovary. It had started to leak a tiny amount of blood into my pelvis.
Despite having methotrexate and my hcg being near back to normal, a decision was made for me to have surgery to remove my right tube along with the mass. Admittedly the doctors did query whether to do the surgery because my vitals and blood tests were coming back in a good position.
The reason we landed on the surgery was because the doctors couldn’t put a timeline on if and when this mass would be cleared. They also felt if I tried to get pregnant again post the 6 month methotrexate wait, they would kick themselves if it happened on the right and they didn’t move the damaged tube and mass to begin with. I also didn’t want to go home and fear constant rupture. Having an expected surgery for me was better than being rushed for emergency surgery.
So sorry to hear this is what you have been going through.
I’m messaging here as I believe this story resonates with mine.
I had methotrexate at 2037 hcg. My blood tests were tracked until I was at 5.5 hcg. I had a lot of fatigue with this drug, and a manageable amount of infrequent abdominal pain.
However, I had pain in my right shoulder, vomiting and diarrhoea, which led me to EPU to get a scan (I was referred via A&E), uncovering a similar mass. This was a mass next to my right ovary and looked the size of my ovary. It had started to leak a tiny amount of blood into my pelvis.
Despite having methotrexate and my hcg being near back to normal, a decision was made for me to have surgery to remove my right tube along with the mass. Admittedly the doctors did query whether to do the surgery because my vitals and blood tests were coming back in a good position.
The reason we landed on the surgery was because the doctors couldn’t put a timeline on if and when this mass would be cleared. They also felt if I tried to get pregnant again post the 6 month methotrexate wait, they would kick themselves if it happened on the right and they didn’t move the damaged tube and mass to begin with. I also didn’t want to go home and fear constant rupture. Having an expected surgery for me was better than being rushed for emergency surgery.
Re: Bleeding in pelvis after methotrexate
So sorry to hear you’re in this situation too.
I had a similar reaction to methotrexate, though my initial HCG levels were much higher (2500 on day one of MTX which shot up to 4470 on day 4)
I’ll type out my story (sorry if it’s quite long) but if any of it resonates with you I’d say just please please go back into A&E and get seen. It’s much better to waste a few hours and know you’re fine than suffer and potentially make yourself ill. It turned out I’d been slowly rupturing for 5 days but because it was intermittent pain and I had no shoulder pain I naively assumed I wasn’t in enough pain for it to be a rupture. Both me and my partner were like “oh if I was rupturing surely I’d be in a ball on the floor” However what can be another sign of internal bleeding is intense pain in the groin area (I felt like someone was stabbing me in the pirenium) and struggling to empty your bladder or bowels without pain.
After my MTX my HCG went up again day 7 slightly so we decided to repeat on day 9, and decide from there about another dose. In between day 7&9 like you I had some very intense groin pains and some light bleeding but it came and went and my day 9 blood had dropped by 1000 so I assumed that it was just the MTX working. We did a scan that saw some fluid in my abdomen but they said that can be normal and as the pain had subsided we decided to see how I went.
We continued faffing with bloods for a week as HCG had plateaued again when i again got the intense groin pains. I could barely walk to the toilet but as soon as I’d emptied my bowels it eased off. I did ring the hospital but because they were busy they didn’t seem that fussed and just advised me to go to a&e if it got worse. Because my HCG had dropped last time and the pains came and went I wrongly assumed that this was just the MTX finally working. It stopped over the weekend and I even went in for another blood test on the Monday where I was just mildly uncomfortable but felt fine.
Between Monday afternoon and Tuesday evening everything suddenly got a lot more intense and the pain had moved over to the location of the ectopic. When they rang me with my bloods (dropped by 2000!) I was so uncomfortable but again, didn’t feel like I was in enough pain to go to a&e so thankfully they said to come in. Vitals were fine and they gave me some codeine and booked me in for a scan the next morning. Again, by the Wednesday morning scan I was in no pain without painkillers so I was expecting to just be on my way. Instead the ultrasound tech couldn’t actually see my tube as there was so much fluid & clotting in my abdomen and it took him ages to get a decent picture.
One emergency surgery later I’m now down a tube but at least finally on the mend. I feel like such a muppet for powering though it and I’m very lucky that I’m otherwise healthy and no long term damage done!
I don’t want to stress you out or scare you in any way. And it’s so annoying how they put the decision back on you with how to proceed with treatment. There’s absolutely nothing wrong with waiting a few more days to see how your body reacts just remember that just because you’re not having “textbook” symptoms doesn’t mean you’re fine. You know yourself and if you don’t feel right at any point during the wait it’s worth getting seen to be safe. Even if you do end up down the surgery route they won’t just take your tube unless it’s absolutely necessary. Mine started as just a look to see what the heck was going on and the surgeon explained that if I just needed cleaning up then that’s all they’d do.
Sorry for the essay, hope you’re coping as well as you can at this difficult time and I have everything crossed for you that the MTX is working and you’re on the mend for Xmas.
I had a similar reaction to methotrexate, though my initial HCG levels were much higher (2500 on day one of MTX which shot up to 4470 on day 4)
I’ll type out my story (sorry if it’s quite long) but if any of it resonates with you I’d say just please please go back into A&E and get seen. It’s much better to waste a few hours and know you’re fine than suffer and potentially make yourself ill. It turned out I’d been slowly rupturing for 5 days but because it was intermittent pain and I had no shoulder pain I naively assumed I wasn’t in enough pain for it to be a rupture. Both me and my partner were like “oh if I was rupturing surely I’d be in a ball on the floor” However what can be another sign of internal bleeding is intense pain in the groin area (I felt like someone was stabbing me in the pirenium) and struggling to empty your bladder or bowels without pain.
After my MTX my HCG went up again day 7 slightly so we decided to repeat on day 9, and decide from there about another dose. In between day 7&9 like you I had some very intense groin pains and some light bleeding but it came and went and my day 9 blood had dropped by 1000 so I assumed that it was just the MTX working. We did a scan that saw some fluid in my abdomen but they said that can be normal and as the pain had subsided we decided to see how I went.
We continued faffing with bloods for a week as HCG had plateaued again when i again got the intense groin pains. I could barely walk to the toilet but as soon as I’d emptied my bowels it eased off. I did ring the hospital but because they were busy they didn’t seem that fussed and just advised me to go to a&e if it got worse. Because my HCG had dropped last time and the pains came and went I wrongly assumed that this was just the MTX finally working. It stopped over the weekend and I even went in for another blood test on the Monday where I was just mildly uncomfortable but felt fine.
Between Monday afternoon and Tuesday evening everything suddenly got a lot more intense and the pain had moved over to the location of the ectopic. When they rang me with my bloods (dropped by 2000!) I was so uncomfortable but again, didn’t feel like I was in enough pain to go to a&e so thankfully they said to come in. Vitals were fine and they gave me some codeine and booked me in for a scan the next morning. Again, by the Wednesday morning scan I was in no pain without painkillers so I was expecting to just be on my way. Instead the ultrasound tech couldn’t actually see my tube as there was so much fluid & clotting in my abdomen and it took him ages to get a decent picture.
One emergency surgery later I’m now down a tube but at least finally on the mend. I feel like such a muppet for powering though it and I’m very lucky that I’m otherwise healthy and no long term damage done!
I don’t want to stress you out or scare you in any way. And it’s so annoying how they put the decision back on you with how to proceed with treatment. There’s absolutely nothing wrong with waiting a few more days to see how your body reacts just remember that just because you’re not having “textbook” symptoms doesn’t mean you’re fine. You know yourself and if you don’t feel right at any point during the wait it’s worth getting seen to be safe. Even if you do end up down the surgery route they won’t just take your tube unless it’s absolutely necessary. Mine started as just a look to see what the heck was going on and the surgeon explained that if I just needed cleaning up then that’s all they’d do.
Sorry for the essay, hope you’re coping as well as you can at this difficult time and I have everything crossed for you that the MTX is working and you’re on the mend for Xmas.
