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What Causes Breast Tenderness Post Methotrexate Intake?
Question: Good afternoon. Unfortunately I found out 10 days ago, that my pregnancy was ectopic. I had the MTX shot in the hospital last wednesday, and because my HCG levels kept going up rapidly, They gave me another shot this Wednesday. Following that day I had tremendous pelvic pain, to the point that I could not move an inch at all, and could not sit, or breath normally... it lasted for 3 hours. On Friday and today I feel better. No pain. I have had no bleeding or spotting since I received the first shot of MTX on Wednesday September 13th.
I am concerned if that is normal. I still have strong breast tenderness.
I had an ectopic pregnancy last year also, where my fallopian tube raptured and I had internal bleeding for a few days. The pain was very similar to what I experienced 2 days ago.
Is it normal not to bleed after the shots at all, and have that almost unbearable pain?
Thank you.
I am concerned about tube rapture. I have to go to the hospital tomorrow to check blood/hcg. Is it possible for them to see with an ultrasound if everything is ok, or if my tube raptured?
Thank you for your help XXXXXXX
I am concerned if that is normal. I still have strong breast tenderness.
I had an ectopic pregnancy last year also, where my fallopian tube raptured and I had internal bleeding for a few days. The pain was very similar to what I experienced 2 days ago.
Is it normal not to bleed after the shots at all, and have that almost unbearable pain?
Thank you.
I am concerned about tube rapture. I have to go to the hospital tomorrow to check blood/hcg. Is it possible for them to see with an ultrasound if everything is ok, or if my tube raptured?
Thank you for your help XXXXXXX
Brief Answer:
If you feel that level of pain again you should ideally go to the ER
Detailed Answer:
Hello, and I hope I can help you today.
It is normal after receiving methotrexate for an ectopic to have some pain after treatment, as the pregnancy can still continue to grow for a few days until the methotrexate kicks in. In addition, once the pregnancy starts to die, you may experience more pain. It is not unusual to still have pregnancy symptoms until your hormone level goes down to zero.
However, any ectopic pregnancy still has a risk of rupture until your hormone level starts dropping. so if you do have another episode of severe abdominal pain that does not go away on its own or radiates to your right shoulder, or feel if you feel dizzy, short of breath, begin feeling nauseous or vomiting, you should go to the emergency room as these can all be symptoms of tubal rupture. An ultrasound can easily diagnose tubal rupture, as it can see blood in the abdomen, so your doctors could preform one tomorrow if necessary when you go back for your blood work.
I recommend that you avoid strenuous activities until you have your hormone level repeated, and if you experience any of the symptoms I mentioned that you seek emergency care so they can check an ultrasound and your blood count to rule out tubal rupture.
Otherwise, I hope you respond to the medication and that you are able to get better without needing surgery. If you have any further questions, please do not hesitate to contact me.
Best wishes,
Dr. Brown
If you feel that level of pain again you should ideally go to the ER
Detailed Answer:
Hello, and I hope I can help you today.
It is normal after receiving methotrexate for an ectopic to have some pain after treatment, as the pregnancy can still continue to grow for a few days until the methotrexate kicks in. In addition, once the pregnancy starts to die, you may experience more pain. It is not unusual to still have pregnancy symptoms until your hormone level goes down to zero.
However, any ectopic pregnancy still has a risk of rupture until your hormone level starts dropping. so if you do have another episode of severe abdominal pain that does not go away on its own or radiates to your right shoulder, or feel if you feel dizzy, short of breath, begin feeling nauseous or vomiting, you should go to the emergency room as these can all be symptoms of tubal rupture. An ultrasound can easily diagnose tubal rupture, as it can see blood in the abdomen, so your doctors could preform one tomorrow if necessary when you go back for your blood work.
I recommend that you avoid strenuous activities until you have your hormone level repeated, and if you experience any of the symptoms I mentioned that you seek emergency care so they can check an ultrasound and your blood count to rule out tubal rupture.
Otherwise, I hope you respond to the medication and that you are able to get better without needing surgery. If you have any further questions, please do not hesitate to contact me.
Best wishes,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
thank you so much Dr Brown.
I feel better now just knowing that they can in fact check with ultrasound if my tube is still healthy. (I only have this one tube left, and no live birth so far :(
Is it normal not to bleed at all throughout this process?
Last year I needed emergency surgery by the time they found out my pregnancy was ectopic, -and although it was devastating emotionally because I would love to have children so much and I am 36- physically and mentally it was a different -maybe easier process. This is so much of a waiting and guessing period.... paying attention to every little thing not knowing what is normal and what is not....I never really have anxiety, but these past 10 days, I feel like my heart is racing 24/7 and I cannot breath.. :(
I feel better now just knowing that they can in fact check with ultrasound if my tube is still healthy. (I only have this one tube left, and no live birth so far :(
Is it normal not to bleed at all throughout this process?
Last year I needed emergency surgery by the time they found out my pregnancy was ectopic, -and although it was devastating emotionally because I would love to have children so much and I am 36- physically and mentally it was a different -maybe easier process. This is so much of a waiting and guessing period.... paying attention to every little thing not knowing what is normal and what is not....I never really have anxiety, but these past 10 days, I feel like my heart is racing 24/7 and I cannot breath.. :(
Brief Answer:
You will bleed eventually once your hormone levels go down
Detailed Answer:
Hello again,
I can only imagine how difficult the uncertainty must be, however your best chances for saving this tube is to try to be patient and let the Methotrexate do its job. It has only been 3 days since your second shot, so you may not yet be shedding the lining in your uterus (called decidua) because your HCG levels have not fallen enough. I do not know how high your levels were to begin with, but if they were over 15,000 or if the pregnancy was over 4 cm or had a heartbeat, it can take a while before your levels start to fall significantly.
The bottom line is that you will be able to get more information tomorrow. You will eventually start to bleed once your hormone levels start to fall.
Feeling anxious about your condition is perfectly understandable, and having your heart race from anxiety is common.
If you find it too agonizing to continue to wait and see what happens with the methotrexate, your ectopic could always be managed with surgery. You should discuss that option with your doctor if your levels have not fallen significantly when your lab work is repeated tomorrow.
I really hope you feel better soon, and anytime if you need reassurance you can always go to the emergency room for evaluation.
I am always available if you need any further advice.
Regards,
Dr. Brown
You will bleed eventually once your hormone levels go down
Detailed Answer:
Hello again,
I can only imagine how difficult the uncertainty must be, however your best chances for saving this tube is to try to be patient and let the Methotrexate do its job. It has only been 3 days since your second shot, so you may not yet be shedding the lining in your uterus (called decidua) because your HCG levels have not fallen enough. I do not know how high your levels were to begin with, but if they were over 15,000 or if the pregnancy was over 4 cm or had a heartbeat, it can take a while before your levels start to fall significantly.
The bottom line is that you will be able to get more information tomorrow. You will eventually start to bleed once your hormone levels start to fall.
Feeling anxious about your condition is perfectly understandable, and having your heart race from anxiety is common.
If you find it too agonizing to continue to wait and see what happens with the methotrexate, your ectopic could always be managed with surgery. You should discuss that option with your doctor if your levels have not fallen significantly when your lab work is repeated tomorrow.
I really hope you feel better soon, and anytime if you need reassurance you can always go to the emergency room for evaluation.
I am always available if you need any further advice.
Regards,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you for your kind words. you have been very helpful.
Thank you again so much!
All the best, XXXXXXX
Thank you again so much!
All the best, XXXXXXX
Brief Answer:
You are very welcome
Detailed Answer:
You are very welcome and I hope everything works out. If you have finished your query, please close the question and post a review of you are satisfied with my services.
Take care,
Dr. Brown
You are very welcome
Detailed Answer:
You are very welcome and I hope everything works out. If you have finished your query, please close the question and post a review of you are satisfied with my services.
Take care,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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