We understand that every fertility treatment is unique, as are the needs of each patient. Whether you're new, a returning patient, or researching pharmacies to help you with your journey, our mission is to make ourselves available to answer your questions and ensure you feel informed throughout your experience.
Hannah Lind, our director of nursing services, has been offering invaluable assistance in this area for many years. With 25+ years of experience in fertility treatments, Hannah is an expert source of support. Whenever VFP patients have questions, they can reach out to Hannah and her team of nurses, who will respond with the answers they need. In addition to providing direct feedback to inquiries, we also had the chance to sit down with Hannah and hear her thoughts on some of the more common questions she receives.
Question: How can patients prevent the burning sensation that accompanies some injections?
Hannah: Patients can try to proactively prevent burning sensations from their injections in a few different ways. However, please note that a burning/stinging sensation is not a side effect of all medications, and the recommendations below are injection-site-specific.
- Always make sure that after you clean the area with an alcohol wipe, it is completely dry before the injection. If you pass a needle through the alcohol, it can push the alcohol into the tissue and cause a burning/stinging feeling.
- Some medications are known to cause burning, and letting them sit for five minutes (after reconstitution) before injecting it can decrease the burning feeling.
Icing the site before injecting can temporarily numb the site to reduce pain and/or stinging.
- Using a “numbing cream” containing lidocaine prior to injection will numb the area and decrease burning/pain at the injection site. However, you should make sure to thoroughly cleanse the injection site of the cream prior to injecting.
- If your meds are refrigerated, letting them come up to room temp before injecting can help.
- Applying gentle pressure to the injection site immediately after injection can help prevent burning and pain.
Question: How can patients address or prevent the pain that follows some injections?
Hannah: Again, pain is not a side effect of all medications, and can be specific to the injection site. The tips I share above (specifically letting alcohol dry, letting medications sit for five minutes after reconstitution, using numbing cream and ice) certainly apply here as well. Additionally patients can:
- Let cold medications come to room temperature. Some people will gently warm medications like progesterone in oil until it reaches body temperature to make for easier injecting and increased comfort.
- Use a “shot blocker.” These are pad-like devices with many pointy projections that press into the skin and saturate the sensory signals around the injection site, distracting from the sting of needle sticks.
- Some patients prefer to apply heat to the injection site, especially after intramuscular injections of progesterone in oil.
- For intramuscular injections, warming up or engaging the muscle with vigorous rubbing or movement before injection can help with absorption and reduce pain.
- If you inject the medication into your buttock (upper outer quadrant area), try to keep the muscle loose and don't tighten or squeeze the muscle. Distracting yourself can help prevent you from subconsciously tightening your muscles. Try standing "pigeon-toed" with your toes pointing together with your weight on the leg opposite your injection site. Or, you can concentrate on wiggling your toes during the injection.
- Gently massaging IM progesterone at the injection site, moving and applying a heating pad can help with absorption and decrease the discomfort, swelling, and knots that can develop.
Question: Are there medications more likely to lead to burning and/or pain that patients should be aware of?
Hannah: There are a few medications that have been known to cause a burning sensation for some, but not all, patients. Menopur has been known to cause stinging when injected for about half of the patients who use it; however, the other half doesn't experience any burning or pain. Progesterone in oil can also be painful to inject as it is quite a thick and viscous oil requiring a larger needle and deep intramuscular injection.
Question: Are there any other common (injection site) side effects of fertility medications that patients should keep an eye on as they go through their treatment?
Hannah: There are a couple of common side effects from fertility medications that patients can keep an eye on, including:
- Leuprolide. This can cause a small red, raised, itchy welt at the injection site, which can appear shortly after injection. It normally goes away in a few hours, but icing can help minimize the welt if it's causing discomfort.
- Cetrotide. This can cause a larger welt at the injection site which can be two to three inches wide. This welt should go away in a few hours, and ice can help to minimize it. However, patients should notify their clinician if the welt continues to grow in size and doesn’t subside.
- hCG (Pregnyl, Novarel, generic). Using hCG subcutaneously can, for some, cause a small injection site reaction or welt shortly after injection, which should disappear quickly.
- Progesterone in oil. This can be very uncomfortable for some (but not all) patients to inject and can cause a red, raised welt that is sometimes itchy. Some patients have also experienced continued pain, knots under the skin, and discomfort that makes sitting difficult. Please notify your clinician if this becomes serious or bothersome.
Want to Make Fertility Medication Simpler?
Nurse Hannah and the entire team at VFP Pharmacy Group work hard each day to make fertility simpler for our patients. That's why we offer VFP patients can live, virtual injection medication lessons. Learn more now.