Can You Use Numbing Cream for Progesterone Shots? A Guide to Easing Injection Discomfort

Progesterone in oil (PIO) injections are often cited by patients undergoing fertility treatments as a source of significant discomfort and anxiety. For those wondering, yes, you can use numbing cream for progesterone shots, and it is a common and effective strategy recommended by healthcare providers to alleviate injection site pain.

Quick Summary

Many patients use lidocaine-based numbing cream to manage the pain from progesterone injections. Correct application involves cleaning the skin, applying the cream under an occlusive dressing for a set time, then wiping it off before injecting. This helps reduce the initial needle prick sensation.

Key Points

• Consultation is Key: Always consult your healthcare provider or fertility clinic before using numbing cream to ensure it is safe and appropriate for your treatment plan.

• Lidocaine is Effective: Creams containing lidocaine, such as prescription EMLA or OTC options, are commonly used to numb the skin's surface and reduce injection pain.

• Follow Proper Application: To achieve maximum numbing, apply a thick layer of cream to the injection site, cover it with a sterile occlusive dressing, and allow the recommended time to pass before wiping it off completely.

• Manage Expectations: Numbing cream is highly effective for the surface needle prick but won't eliminate deep muscle soreness caused by the oil. Combine with other strategies for best results.

• Combine with Other Techniques: For comprehensive pain management, pair numbing cream with methods like warming the progesterone oil before injection and using a warm compress and massage afterward.

How Topical Anesthetics Work for Progesterone Injections

Topical anesthetic creams, most often containing lidocaine, work by blocking nerve signals in the skin. When applied to the injection site, the active ingredient penetrates the outer layers of the skin and temporarily numbs the area. This effectively dulls the sensation, helping to minimize the initial prick of the needle, which is often a major source of pain and anxiety for patients.

Numbing cream vs. deep muscle pain

It is important to understand that numbing cream primarily affects the surface of the skin. While it can be highly effective for reducing the pain associated with the needle's entry, it may not completely eliminate the deep muscular soreness that can follow a progesterone in oil (PIO) injection. This soreness is caused by the thick, oil-based medication being injected deep into the muscle tissue. However, by removing the discomfort of the needle prick, the overall experience can be significantly less stressful and more manageable.

Step-by-Step Guide for Using Numbing Cream

If your healthcare provider approves the use of a numbing cream, follow these steps for safe and effective application:

1. Consult Your Provider: Always discuss the use of any numbing cream with your doctor or fertility nurse. They can recommend a specific product and provide guidance on the correct application and timing.
2. Clean the Area: Wash your hands thoroughly. Use an alcohol wipe to clean the designated injection site (e.g., the upper outer quadrant of the buttock). Let the area dry completely before proceeding.
3. Apply the Cream: Squeeze a generous amount of numbing cream onto the injection site. Do not rub it in. The goal is to create a thick layer on top of the skin for maximum absorption.
4. Cover the Site: Place an occlusive dressing over the cream to keep air out. A simple plastic wrap or a waterproof bandage (like Tegaderm) works well for this purpose.
5. Wait for Numbing: Allow the cream to work for the amount of time recommended by your provider, typically ranging from 30 minutes up to 2 hours, depending on the specific product and individual needs.
6. Remove and Re-Clean: Before the injection, remove the dressing and thoroughly wipe away all the excess numbing cream. Use a fresh alcohol swab to clean the injection site one more time. This is a critical step to ensure a sterile injection.
7. Proceed with Injection: Follow your clinic's instructions for administering the PIO shot. The site should now feel significantly numb.

Types of Numbing Creams

Several types of topical anesthetics are available, and their availability and strength vary:

• EMLA Cream (Lidocaine and Prilocaine): This is a prescription-strength cream that is commonly recommended by fertility clinics. It typically needs to be applied under an occlusive dressing for about an hour to achieve a deep numbing effect.
• Over-the-Counter (OTC) Lidocaine Cream: Maximum-strength lidocaine creams are available without a prescription. These are often used for hemorrhoids but can be effective for skin numbing when used as directed and with a doctor's approval. Popular options include Zensa and Curist.
• Benzocaine-based Gels: While products like Anbesol are designed for oral pain, some have reported using a small amount for topical numbing. However, these are generally less effective and not specifically formulated for injection site relief. Always consult your provider before using any off-label medication.

Comparison of Pain Management Strategies

| Method | Primary Effect | Best For | Application Timing | Cautions | Numbing Cream | Numbs surface skin and superficial nerves. | Reducing initial needle prick pain and anxiety. | As directed by your provider, typically 30-60+ minutes before injection. | Use only with provider approval; wipe off completely; potential for allergic reaction. | Ice Pack | Numbs surface skin and constricts blood vessels. | Reducing needle pain, swelling, and bruising immediately after the shot. | Briefly (5-7 minutes) before injection for numbing; immediately after for swelling. | Avoid prolonged pre-injection icing, as it can tense muscles and make the shot more painful. | Warm Compress | Relaxes muscle tissue and increases blood flow. | Promoting absorption of the oil and reducing knots and soreness after the shot. | After the injection for 15-20 minutes. | Do not apply heat before the shot, as it can cause irritation. | Massage | Helps disperse the oil and prevents knots. | Reducing muscle soreness and lump formation after the shot. | Vigorously massaging the injection site for several minutes immediately after the shot. | Avoid massaging too hard if the area is very sensitive or bruised. | Warming the PIO Vial | Thins the thick oil, making it easier to inject. | Reducing injection time and effort. | Rolling the vial between your hands or using a heating pad on the loaded syringe before injection. | Never microwave the vial, as this can damage the medication.

Important Safety Considerations

• Allergies and Skin Reactions: Always perform a patch test on a small area of skin 24 hours before your first application to check for any allergic reactions or irritation. If redness, itching, or swelling occurs, discontinue use immediately.
• Provider Guidance: Never apply numbing cream without first consulting your healthcare provider. They can ensure the cream and its usage are appropriate for your specific treatment plan and medical history.
• Proper Technique: Applying the cream correctly, covering it with an occlusive dressing, and fully wiping it off afterward is essential for safety and effectiveness. Skipping these steps can lead to suboptimal results or skin issues.
• Avoid Overuse: Excessive use of numbing cream, especially higher concentrations, can potentially lead to systemic absorption of the anesthetic. Always use the minimum effective amount and do not exceed the recommended duration.

Conclusion: Taking Control of Injection Discomfort

While progesterone in oil (PIO) injections are notoriously uncomfortable, they do not have to be a source of overwhelming pain or anxiety. By consulting your healthcare provider, you can safely explore using numbing cream as an effective tool to manage the initial needle prick. Combining this strategy with other techniques like warming the oil, using a warm compress after injection, and regular massage can provide comprehensive relief from both the initial sting and the subsequent muscle soreness. Taking control of your injection routine can help you focus on the bigger picture of your fertility journey.

For more detailed patient instructions on preparing for PIO injections, you can visit the University Hospitals patient resources page.

Frequently Asked Questions

What type of numbing cream is safe for progesterone injections?

Lidocaine-based numbing creams are generally considered safe when used under a doctor's supervision. Prescription-strength EMLA (lidocaine and prilocaine) is often recommended, and over-the-counter creams are also used, provided they are approved by your healthcare provider.

How long should I leave numbing cream on before a PIO shot?

For effective numbing, most healthcare providers recommend leaving the cream on the injection site for a specific duration, which can range from 30 minutes up to 2 hours, and covering the area with an occlusive dressing (like plastic wrap or a Tegaderm bandage) during this time.

Can I use an ice pack instead of numbing cream?

You can use an ice pack to numb the skin before an injection, but it has a different effect. While cold can numb the nerves, it can also cause the muscle to tense up, potentially increasing pain from the intramuscular injection. Many patients find numbing cream preferable for this reason.

Will numbing cream help with the muscle soreness after the shot?

Numbing cream primarily affects the skin's surface and will not significantly impact the deep muscle soreness that can occur after a PIO injection. For post-injection soreness and lumps, strategies like applying a warm compress and massaging the area are more effective.

Is it important to wipe the cream off completely?

Yes, it is extremely important to wipe all traces of the numbing cream off the injection site with a sterile alcohol swab before the shot. This ensures a clean injection and prevents any topical medication from being carried into the muscle with the needle.

Can numbing cream cause an allergic reaction?

Yes, numbing creams can cause allergic reactions in some individuals. It is always recommended to perform a patch test on a small, less sensitive area of skin first. If you experience any redness, itching, or swelling, you should not use the product.

What if numbing cream doesn't seem to work for me?

If numbing cream doesn't provide enough relief, consider combining it with other pain management techniques. Ensure you are using the product with proper application time and technique. Always discuss persistent injection pain with your healthcare provider, who can offer additional guidance.