Progesterone Injections: Who, What, When, Where, Why, and How

Progesterone Injections

Trying to get pregnant but not having any luck? Your progesterone may be to blame.

Progesterone is one of the most important hormones in pregnancy. But sometimes your body may need a boost of this vital hormone to increase your odds of a healthy conception. This boost comes in the form of progesterone injections – one of the most effective forms of progesterone supplements. 

Curious if this is something you need?

Read on to learn all about progesterone injections for pregnancy: why progesterone is important, the different types of progesterone injections, who benefits from taking these injections, how to administer the injections, the side effects, and more. 

Why is progesterone so important?

Let’s get clear on the hormone progesterone and why it’s a star of the pregnancy show so you can answer your question about whether progesterone is needed to get a positive pregnancy test. 

Progesterone is a sex steroid hormone that is integral to your menstrual cycle and conception. 

This hormone is produced by your ovaries and corpus luteum to prep your uterus for a potential pregnancy. Think of it like your body’s nester that is responsible for making your uterus a safe, healthy, and happy home for your future developing fetus.

Once you’ve conceived, progesterone keeps your pregnancy on the right track. It:

  • Halts ovulation so you don’t get pregnant again
  • Prevents uterine contractions
  • Keeps your immune system from rejecting the fetus
  • Stimulates breast tissue development to prep your breasts to produce milk and breastfeed

TLDR: if you don’t have the right level of progesterone in your body, you won’t be able to get pregnant or stay pregnant.

Who needs progesterone injections?

It’s natural for your progesterone levels to go up and down during your cycle and during pregnancy. They tend to be low during your follicular phase, and then rise in ovulation and your luteal phase to prep you for a baby. 

However, some women are more prone to issues that may cause their hormone levels to be less than desirable for conception. And this can lead to miscarriage. 

Enter: the progesterone injection – the superhero of progesterone problems. 

What is a progesterone injection used for? 

These injections are used to help supplement the body’s production of this vital sex hormone to increase the chances of a successful pregnancy. 

But women with irregular cycles who need a ‘lil luteal phase support aren’t the only ones who can reap the benefits of an injection. 

Here are the other times when these injections come in clutch.

  • Women who are at high risk of miscarriage or have a history of recurrent miscarriage. Progesterone injections during pregnancy help keep a healthy level of progesterone in the body and may be the key to preventing a miscarriage.
    If you are at high risk of miscarriage, you’ll want to start taking injections from post-ovulation until week 16 of pregnancy. 
  • Women with a history of preterm births, meaning one child born before 37 weeks.
    You can start taking injections at 16-20 weeks of pregnancy, once a week until your 36th week.
  • Women with a shortened cervix. Studies show that women with a short cervix have a chance of early preterm delivery.
    If your cervix is short, a progesterone shot can help reduce the chances of preterm birth.
  • Women who struggle with infertility and are undergoing IVF. Why do IVF patients need progesterone?

    For extra hormonal support.
    Research shows that turning to progesterone injections with IVF to supplement your lower progesterone levels can increase your chances of a successful pregnancy. In the case of IVF, these shots are typically given daily. 
  • Women who don’t have their period. Low levels of progesterone can lead to a lack of period, a.k.a. amenorrhea.
    Studies show that a progesterone shot can help with this. 
  • Women undergoing hormone replacement therapy (post- and peri-menopausal). Injections help treat menopause symptoms and also counteract the effects of estrogen.  
  • Women experiencing abnormal uterine bleeding. Studies show that excessive bleeding can be helped with the use of a progesterone shot.

What are the different types of progesterone injections?

There are two main categories of injections you need to know: 

  • Intramuscular
  • Subcutaneous
Intramuscular

This is the most common type of progesterone injection. It is administered straight into the muscle, most commonly your buttocks. 

The intramuscular injection (IM) is a mix of progesterone (17 alpha-alpha-hydroxyprogesterone caproate, a.k.a. 17-OHP) dissolved in an oil medium (typically sesame or peanut oil).

We hate to be the bearers of bad news but note that the needles used for the intramuscular shots are quite large so that the thick, viscous oil actually gets into your muscle. But they get the job done by delivering your body the progesterone it needs to support a healthy pregnancy. 

Subcutaneous

This provides an alternative to the intramuscular option. 

The subcutaneous (SC) injection is administered via a smaller needle below the surface of your skin and doesn’t go as deep as the IM one. 

You’re probably wondering about the efficacy of an IM vs. SC and which injection is used for conceiving. Studies show that a subcutaneous shot is just as effective as an intramuscular one for aiding with pregnancy.

For this article, we will focus our attention on the IM injection

Where should progesterone be injected?

Intramuscular injections are given into a large muscle, most commonly the upper-outer area of the buttocks. The outer thigh and upper arms work, too – they just aren’t always the first choice.

These shots should be administered by a healthcare professional or at home after you’ve been given instructions on how to DIY by your doctor. 

How to inject progesterone at home

Since going to the doctor every day or even every week isn’t our idea of convenience (and we are guessing it’s not yours, either), it’s important to know how to do the injections at home. 

Your doctors should walk you through the process, but here’s a refresher for you.

Step 1: Wash your hands thoroughly with soap and water.

Step 2: Load the syringe per package instructions. 

Step 3: Find the injection site. Aim for the upper outer part of your buttocks where there aren’t any visible veins. 

Step 4: Clean the site with an alcohol swab.

Step 5: Insert the needle perpendicular to the skin in one clean, steady, and smooth motion. 

Step 6: Pull the plunger a little. There shouldn’t be any blood.

Step 7: Once you’ve ensured there’s no blood, push the plunger all the way through.

Step 8: Take the syringe out.

Step 9: Take a gauze and put firm pressure on the injection site.

Step 10: Swap the gauze out for a warm compress.

Step 11: Discard the needle into a sharps container. 

What happens if you inject progesterone in the wrong spot?

We don’t want to scare you, but it is important that you administer your injection in the right area: the upper outer quadrant of your buttocks.

If you inject it too low, you can cause damage to your sciatic nerve, which can lead to numbness, tingling, and sometimes even muscle weakness.

If you inject it too high, you risk getting too close to the hip bone, which can result in pain and bruising. 

If you experience increasing pain, numbness, tingling, bruising, bleeding, or anything else that looks or feels amiss, seek medical attention from your healthcare provider. 

How to make progesterone shots less painful

We know that getting an injection is no walk in the park. It is painful!

However, we have some tips that can help lessen the pain to make them more manageable. 

  • Ask your partner, friend, or family member to administer the shots if it’s just too painful and/or scary to do yourself (no shame in this).
  • Make sure you inject in the right area, per our discussion earlier.
  • Give the shot site a nice little massage before and after the shot to help with absorption.
  • If you feel any lumps, bumps, or knots in an area of your buttocks, avoid injecting there and move elsewhere – do not inject into these bumps. 
  • Alleviate some of the pain afterward by using a heating pad.
  • Alternate which side you inject each time to give one side a break and minimize your risk of tissue damage.
  • If you cannot move past the pain of the shots, ask your healthcare provider for alternate options.

What are progesterone injection side effects?

The number one side effect of these injections is a reaction at the shot site. That’s thanks to the thick liquid (progesterone + oil) that requires a thick needle, which causes more pain.

Other side effects of progesterone shots during pregnancy that some women experience are lumps, bumps, and/or swelling at the site and panniculitis or inflammation of the subcutaneous fat. 

If you’re wondering how to get rid of lumps from progesterone injections, steer clear of injecting in this area at the first sign of bumps. 

Other side effects of these shots include allergic reactions, a sudden severe headache, mood swings, sleep issues, drowsiness, dizziness, changes in sex drive, nausea and vomiting, and breast tenderness.

Always talk to your doctors about your medical history and any concerns you have about side effects. It’s always better to err on the safe side!

So… What is the best form of progesterone?

If the thought of needles has you running for the hills, don’t worry – there are other options for progesterone medication. 

One of those options is oral progesterone, which is the easiest of the options but is also the least effective. 

Another option is vaginal progesterone – a suppository used to boost your levels.

The verdict is mixed on whether intramuscular or vaginal progesterone is more effective.

Some studies uncovered that when compared to vaginal progesterone, patients who opted for IM injections had a greater number of live births and fewer miscarriages. 

Then, on the other side, we’ve got studies that show IM and vaginal progesterone are equal in efficacy. Vaginal is often preferred simply because it’s more convenient.

Another study supports this with similar findings that show patients struggle more with the administration and discomfort of intramuscular shots.  

And again, yet another study shows that pregnancy rates were similar between vaginal and IM injections, but women preferred the vaginal thanks to its lower pain levels. 

Though there is more research done on IM since it has been around longer, your choice of progesterone medication really comes down to personal preference and the advice of your healthcare providers. 

How to use progesterone injections with Inito?

Progesterone injections increase the amount of progesterone in your system, which has a domino effect on your PdG (urine metabolite of progesterone) levels.

Since Inito measures PdG – the metabolite of progesterone in your urine to confirm ovulation, this may lead to a false positive ovulation result. 

To avoid this when using Inito, wait for confirmed ovulation before you start your progesterone injections. 

TLDR

  • Progesterone preps the uterus for conception, prevents uterine contractions, supports the immune system, and stimulates breast tissue development. 
  • Women who may need a progesterone injection include women at risk of miscarriage, those with a history of preterm births, luteal phase defects, short cervix, those undergoing IVF, experiencing amenorrhea, undergoing hormone replacement therapy, or having abnormal uterine bleeding.
  • There are two types of injections: intramuscular (IM) and subcutaneous (SC).
  • IM injections are the most popular and should be given on the upper outer buttocks.
  • The most common side effects of a progesterone injection involve pain, swelling, and bumps at the injection site.
  • You may also experience sudden severe headaches, sleep problems, dizziness, nausea, mood swings, and more. 
  • You can reduce pain and side effects by massaging the injection site, staying away from injecting into lumps, using a heating pad after injection, and switching up your injection sides from day to day.
  • Other progesterone supplementation options include oral and vaginal.
  • Studies show that IM and vaginal progesterone vary in effectiveness – some claim that IM is more effective, while others claim vaginal medications are.
  • Progesterone supplements may affect your Inito hormone readings and give a false positive ovulation confirmation result. 
  • To avoid this, wait until ovulation is confirmed to start taking your progesterone supplements.
  • Always consult your healthcare provider before starting any supplementation. 

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