PCOS Treatment Intramuscular Injections of Progesterone in Oil By Nicole Galan, RN Updated on February 01, 2024 Medically reviewed by Monique Rainford, MD Fact checked by Maddy Simpson Print Table of Contents View All Table of Contents Purpose How to Inject Post Injection Side Effects Precautions Storage Alternatives Injections of progesterone in oil are often prescribed as part of the process of in vitro fertilization (IVF) to increase the odds of becoming pregnant. Progesterone injections help make the lining of the uterus thicker to prepare for the fertilized egg. There are some common side effects, such as redness at the injection site. Most side effects are mild, but if there are any concerns, other options for progesterone medications are available. This article explains why a progesterone in oil injection is important during pregnancy. It also offers tips on how to self-administer intramuscular injections of progesterone. Illustration by Michela Buttignol for Verywell Health Purpose of Projesterone Oil Injections Progesterone is a sex hormone that plays a key role in maintaining a healthy pregnancy. It helps to build up the uterus lining so it can receive the fertilized egg. It also maintains the lining to support and nourish the embryo throughout the pregnancy. Injections of progesterone in oil may be prescribed right after your IVF procedure to help your body prepare for pregnancy. Your healthcare provider will provide instructions for daily intramuscular injections beginning the day after your egg retrieval up until you take a pregnancy test. When you have a positive pregnancy test, you may be asked to continue the injections for 10 weeks. You can stop the injections when your placenta begins to produce progesterone at about 10 weeks. It can be difficult to give yourself injections. However, knowing that you may be helping your chances of a healthy pregnancy should make the discomfort a little easier to tolerate. And remember, it’s only temporary. How to Inject Progesterone Oil Before giving yourself daily injections, decide what time of day to start them, whether it's morning, afternoon, or evening. Injections should be given at about the same time every day. The following sections give tips on how to do the progesterone injections. If you find it's still difficult for you to inject yourself, ask a friend or family member for help. If that isn't an option, call your doctor's office and ask for a tutorial. Where to Inject Intramuscular injections will usually be given in the upper, outer part of the buttocks. In some cases, your healthcare provider may advise you on other areas to inject. Don't forget to rotate your injection sites, likely from the right side of the body to the left, each day. Never inject your medication into the same spot repeatedly. This can increase your chances of tissue damage. Make sure you palpate (gently feel) your muscles before choosing a site. Sometimes progesterone in oil can accumulate in your muscle, causing little knots or bumps, known as panniculitis. Your injection should not go into one of these bumps and it should be at least an inch away from a knot to avoid pain and to help the absorption of progesterone. Preparing the Injection Site To numb the area before the injection, you can use an ice pack on the area for 30 seconds. Your healthcare provider may also give you a prescription of Emla (lidocaine) cream to help numb the area. If so, apply an amount the size of a penny. Don't rub in the cream. Cover it with a bandage and wait one hour before removing the bandage and wiping off the cream. Before injecting the progesterone, wash your hands and wipe the injection area with an alcohol wipe or pad. Injecting the Medication Follow the directions you've been given by your healthcare provider. They may include the following steps: Clean the rubber stopper of the vial of progesterone in oil with an alcohol wipe.Attach the needle to the syringe.Pull the plunger of the syringe back to the 1 milliliter (mL) line.Insert the needle into the progesterone vial. Inject 1 mL of air into the vial.Keeping the needle in the vial, turn the vial upside down. Make sure the needle tip is in the liquid.Pull back on the plunger to get 1 mL of fluid (or the amount directed by your healthcare provider).Remove the needle from the vial. If your healthcare provider gave you another needle for the injection, replace the one on the syringe.Stretch the injection site with your fingers (after making sure to clean the area with an alcohol wipe).Use a quick, firm motion to inject the needle into the area.Slowly press the plunger to inject the medication. How to Reduce Intramuscular and Subcutaneous Injection Pain After a Progesterone Injection Once you've injected yourself and removed the needle, use heat or a heating pad to warm the injection site. Because the progesterone is contained in the oil, it can take a while to absorb into your muscles. The heat will warm and thin the oil, helping boost absorption. You should also gently massage the area after the injection is complete. This can also help the progesterone get absorbed. Side Effects Possible side effects of progesterone oil injections include: Redness and minor soreness at the injection siteHeadachesBreast tendernessWeight changesHair lossAcneBlotchy skinTrouble sleepingSleepinessVaginal dischargeNauseaFeverDepressionRash Let your healthcare provider know right away if you experience more serious side effects, such as: Breakthrough bleedingAllergic reaction (swelling, itching, tingling in the mouth)FeverYellow skin or eyesSwelling in the hands, feet, or anklesPain in the calves or chest (may indicate blood clots) Progesterone is usually compounded in sesame oil. If you have allergies to peanuts or sesame, mention it to your doctor. They may prescribe progesterone in olive oil instead. Precautions You shouldn't take progesterone oil injections if you have any of the following conditions: Breast cancer or cancer of the genitalsLiver diseaseStrokeHistory of blood clotsUnusual vaginal bleeding that hasn't been evaluated by your healthcare provider If you experience sleepiness or dizziness while taking progesterone oil injections, don't drive or operate heavy machinery. Anaphylaxis, a severe allergic reaction, is a life-threatening emergency. Call 911 for any of the following signs or symptoms: Difficulty breathing Swelling of the tongue, face, or throat Change in pulse rate Feeling dizzy or faint Loss of consciousness Storing Progesterone Oil Keep the oil in a warm place, not in the refrigerator. Oil can become thicker when it's in a cold environment. This can make it more difficult to draw up or inject. Alternatives to Progesterone Oil Injections In addition to intramuscular injections, there are different methods of delivering progesterone for IVF. These include Endometrin (a vaginal insert), Crinone (vaginal gel), and Prometrium (oral capsules). Intramuscular progesterone appears to work as well for IVF as the other forms of progesterone. Each has its benefits and drawbacks. Speak with your healthcare provider about which form would be best for you. Summary Progesterone is a hormone that is important for maintaining a healthy pregnancy. For this reason, women who are undergoing IVF may have to give themselves progesterone injections. Self-administering shots can be difficult, but there are ways to make the process easier and less painful. If you are having a lot of difficulty tolerating giving yourself daily injections, or if you notice any side effects, ask your doctor about switching to a different type of progesterone. Progesterone also comes in gel, tablet, and suppository form. These are taken orally or placed in the vagina and don't require an injection. 11 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Society for Reproductive Medicine. Progesterone Supplementation During In Vitro Fertilization (IVF) Cycles. University of Rochester Medical Center. Progesterone. Washington University Physicians. Progesterone and IVF: So why do I need this? Massachusetts General Hospital. Fertility Center. In vitro fertilization. Hirsch LJ, Strauss KW. The injection technique factor: what you don’t know or teach can make a difference. Clinical Diabetes. 2019;37(3):227-233. doi:10.2337/cd18-0076 Xiao W, Huang X, Lin C, Liu Y, Chen S, Wu R. Panniculitis caused by progesterone injection can be treated by physical therapy. Dermatologic Therapy. 2021;34(1):e14501. doi: 10.2337/cd18-0076 University of North Carolina Reproductive Endocrinology Clinical Studies. Progesterone instructions. University Hospitals. Progesterone in oil (IM) patient instructions. Oregon Health & Science University. Progesterone (injection). Watson Pharma, Inc. Progesterone injection USP in sesame oil. Zaman AY, Coskun S, Alsanie AA, Awartan KA. Intramuscular progesterone (Gestone) versus vaginal progesterone suppository (Cyclogest) for luteal phase support of in vitro fertilization-embryo transfer: patient preference and drug efficacy. Fertil Res Pract. 2017;3:17. doi:10.1186/s40738-017-0044-y By Nicole Galan, RN Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book." See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit