Any tips for progesterone injections?

Hi all, I started 2x weekly progesterone injections (4mL each time in the upper butt cheek) a few weeks ago and I am struggling so much with muscle soreness and pain afterwards. I have tried doing it myself, having my husband do it, I take a hot shower right before then foam roll before and after and sit on a heating pad for a while. Every time i have horrible, debilitating muscle pain for 24 hours after, I am limping and just in tears. Not an injection site issue, but severe muscle soreness. It’s worse in my right hip. Has anyone had this issue? 

I’ve considered maybe a shorter needle or smaller dosage? 

I try to relax my muscle each time but it does twitch every time I inject the needle. 

TIA for any tips!

Re: Any tips for progesterone injections?

  • @ckmb_1250 I have never tried giving them to myself, but I had similar issues at first. Now, after my husband injects it, he massages the area thoroughly and that has really helped a lot.
    Me: 37  DH: 37
    Dx: MFI: Low Morph, Low Mot, Very High ASAB (97%)
    TTC since 2017, Dx in 2019
    --delay due to DH working out of state + COVID--
    June 2020 - IVF cycle #1 w/ICSI & PGS: 12 ER, 12 M, 7 F, 3 Frozen (1 day 6 blast, 2 day 7blast), 2 Normal (1d6 XX, 1d7 XY)
    August 2020 - FET #1: 8/24 (6d XX) Beta #1: 240, Beta #2: 1565
  • @ckmb_1250 I don't have any personal experience with taking a progesterone yet but as a nurse I would never give a 4ml injection in any one site unless absolutely necessary. Depending on the persons size I rarely do more than 2 or 2.5 ml in any one site even the gluteal muscle due to pain. The gluteal muscle can take up to 5ml of fluid but generally that is a one time injection not multiple. You may also want to ensure you are using a long enough needle to get into the muscle and make sure you are getting past the fat layer. 

    Just my two cents :) 
    Me: 34 DH: 43
    Our Journey for #1
    2014 -- Started TTC casually
    2017 -- Discovered MFI but didn't move forward with treatment due to expense and grad school
    Spring 2019 -- Started with RE and confirmed MFI 
    Fall 2019 -- 3 cycles of Clomid and TI, 3 BFNs, discovered hostile cervical mucus was also contributing
    Spring/Summer 2020 -- 3 cycle of IUI, 3 BFNs
    Nov 2020 - First IVF with 3 little frosties, had to change to freeze all due to OHSS
    Feb 16, 2021 - FET #1 - BFP! Beta #1 100 Beta # 2 541 EDD 11/4/2021

    [Deleted User]
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  • I had the same debilitating muscle pain after progesterone shots while preparing for my first FET. Can’t remember which side it was but it was the same side that I had a huge problem with. Didn’t matter whether I injected myself or when the nurse at my clinic did it. I was limping in pain. Luckily my clinic only requires Progesterone shots for the first 4 days and then progesterone suppositories after that. Can you switch to suppositories? It’s a bit messy but it doesn’t hurt and it’s been shown to be about as effective as shots. My clinic’s protocol used to be Compounded progesterone, 200 mg twice a day, but recently switched to 300 mg twice a day. I ended up using Endometrin instead, 200 mg x3 for 600 mg per day. 
    Me: 41  DH: 46
    Unexplained infertility/AMA, polycystic ovaries, insulin resistance
    FET#1(July 2017): eSET of first of 4 PGS-normal embryos, DS born 3/30/2018
    FET#2(Oct/Nov 2019): eSET  
    [Deleted User]
  • I would talk to your doctor or nurse about your symptoms.  They are the only once who could change your dose or mode of progesterone.  Maybe they would have you do two 2ml shots, or maybe another type altogether.  My last protocol didn't take shots at all! (Just trigger and suppositories thereafter)...

    ...but when I did have PIO, I couldn't do heat.  The heating pad just made everything more sensitive, more tender, and inflamed.  Foregoing that and sticking with just massaging the area helped a lot.  I also found giving each side a full 48 hours to recover helped, so each night I would do L, L, and then switch and do R, R, L, L etc.  That way the one side got a bit more of a break between and wasn't so tender.
  • If you're using sesame oil PIO (standard mode of delivery), it's very thick and takes some force to inject which may make it feel more painful. You could ask for ethyl oleate PIO which is a lot thinner and easier to inject (but I think may be more expensive). I would also split up the dose between two injection sites and never use the same spot twice in a row.

    I'm not sure of its indication in pregnancy, but you could also get a lidocaine cream to spread on the site after the injection that may provide some relief. I think they sell some OTC as muscle pain relief cream/gel, but you could also get a prescription. Ask your doctor before that though since I'm not sure that it's safe for pregnancy (it probably is, I just don't want to steer you wrong!). 

    What gauge needle are you using, btw? My pharmacy sent me the wrong gauge ones once and I used them without realizing that they were way wrong for the injection. I paid for that mistake! OUCHIE!

    I used PIO (ethyl oleate because we discovered I was allergic to the sesame oil one) for 12 weeks, same dosage per day, and it was super uncomfortable even with all of my precautions. I also developed painful knots and lumps at injection sites that took several weeks to go away after I stopped the PIO. But they did go away!
    ~~ Our Story in Spoiler! TW loss/child~~
    Fall 2012 -- started TTC
    Summer 2015 - no BFP yet, labs normal, referred to RE
    Fall 2015 - Summer 2016 - Further testing all normal. 3 IUI's -- BFN. Recommended move to IVF. Planned cycle for fall 2016.
    September 2016 - Surprise natural BFP. MMC @ 8 weeks. RE expressed confidence that we just needed the 'right' embryo.
    Fall 2016 - Spring 2017 -- Break from TTC
    June 2017 - Started IVF; egg retrieval for freeze all cycle. 9 mature eggs retrieved, 5 fertilized. 2 4BB embies on ice.
    August 2017 - FET transfer both embies. BFP.  Twin pregnancy confirmed by ultrasound. EDD 4/28/18
    September 2017 - Twin B stopped developing; Twin A doing perfectly! Graduated from RE @ 10 weeks
    March 2018 - Baby Girl born via C/S due to pre-eclampsia -- strong and healthy!

    TTC #2
    January/Feb 2021 - Freeze-all IVF cycle 
    March 2021 - FET of 1 PGS normal female embryo. BFP! Beta #1 156,  #2 472, #3 1241, #4 5268 EDD 12/5/21 - Christmas baby!

    "When all is lost then all is found."

    [Deleted User]
  • edited October 2020
    Same as @mbradfo2 I was allergic to the sesame oil and switching to a different base helped with the redness, itching and swelling, but not the pain or soreness.  They gave me olive oil instead.
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