Insider’s Guide to: Administering Progesterone in Oil

By: Elie Salomon

Progesterone in Oil, or PIO, is a seemingly scary medication to administer based on the needle size alone. The reason for the needle being MUCH larger than the other medications you may take during the fertility process, is because these are INTRAMUSCULAR and need to get into the muscle.

Please note that these injections are not the only method available for progesterone administration. Other methods are vaginal suppositories and vaginal gels.  Some women find progesterone injections to be quite painful (during the injection itself and/or as aftereffects on the body), thus if your doctor prescribes the injections, you should feel free to discuss with him or her if other methods are an option for you. Personally I had a better experience with injections, my body responded better to them in terms of maintaining appropriate hormone levels and I did not enjoy the messiness of suppositories (tip: be sure you wear a pad if using suppositories as they will leak during absorption).

Every woman is different- so don’t be afraid to speak up and talk to your doctor about what is right for you!  Bottom line, if your situation calls for progesterone injections, we hope that these suggestions will reduce the difficulty and give you more control and power over the process.


Here is the regimen I followed to take my shots, and it is based on tips from friends on forums as well as my nurses:

Once I got this system down, there was NO PAIN. In fact, I got so good at it that when my husband went on an overnight work trip, I was able to administer it myself. I hope this routine give you chizuk (encouragement)  to make it through these shots all the way through your first trimester.

Before you begin, even on the day or your transfer, ask your nurse to draw circles with a sharpie on your upper bum cheeks so that you, or your husband, know the areas where the injection should go.

Once you are home, and it is time to take your shot:

  1. Fill a small cup with hot water.
  2. Draw up the progesterone with the larger needle. (if your pharmacy gives you 2 needle sizes)
  3. Tap it to make sure there are no air bubbles inside, and push the plunger up so a tiny bit comes out and there are no air bubbles inside.
  4. Stick the syringe (with the top on it) into the hot water. PIO is VERY thick, so this will heat the oil and make it thinner and therefore easier to push the medication out of the syringe.
  5. Take an ice pack to numb the location where the needle will go on your backside.
  6. When ready, remove the syringe from the cup and replace the needle with the smaller one.
  7. Which “upper bum cheek” should you choose?
    • Rest all your weight on one leg, that leg’s muscle will be tight and will tighten the bum cheek as well.
    • The other leg’s muscle will be loose and the injection should go on the loose leg’s bum cheek to minimize pain.
    • (Reverse sides for the next night.)
  8. Pick a spot for injection and place two fingers on the site and then pulling the skin tight by separating those two fingers into the shape of a “V”
  9. Inject the needle into the spot between the two fingers where the skin is taught.
  10. You should pull back a little on the plunger to make sure you have not hit a vein, and should not see blood. If you do see blood, remove the needle, toss it and begin again in a new location.
  11. After the needle is out, massage the injection site with a hot towel to keep the medication heated and thin to get down into the muscle. This also prevents blistering.
  12. Some also say to walk around after to get the circulation moving.


Once you have this guide, you will be in total control of what you need to do, and will even be able to administer it yourself in front of a mirror. Good Luck!!

Contents Copyright © 2019 Yesh Tikva