Where Do They Inject Progesterone Shots? A Guide to Injection Sites

October 7, 2025 •

4 min read

Over 7 million women in the United States face infertility, and many rely on progesterone shots for fertility treatments like IVF. Understanding where do they inject progesterone shots is crucial for proper administration and minimizing discomfort, as the correct site varies depending on the type of injection prescribed.

Quick Summary

Progesterone shots are administered via intramuscular injection, typically in the upper outer buttock, or subcutaneously into the abdomen or thigh. Choosing the correct site, rotating injection spots, and using proper technique can help reduce pain and bruising associated with the shots.

Key Points

Buttock is the primary IM site: Intramuscular (IM) progesterone shots are most commonly injected into the upper outer quadrant of the buttock.
Abdomen or thigh for SC shots: Subcutaneous (SC) progesterone injections are administered into the fatty tissue of the lower abdomen or the front of the upper thigh.
Always rotate injection sites: To prevent soreness, bruising, and lumps, alternate between injection sites (e.g., left and right buttock, different spots on the abdomen) with each dose.
Manage pain with heat and massage: Applying a warm compress before or after the injection and massaging the area can help reduce discomfort and promote absorption.
Follow professional instruction: Always have a healthcare provider or nurse demonstrate the correct technique for your specific injection type and body, as safety and effectiveness depend on proper administration.
Type determines site: The location of the injection depends on whether it is an intramuscular (deeper) or subcutaneous (shallower) shot, which in turn depends on the progesterone formulation prescribed.

The Two Main Types of Progesterone Injections

When a healthcare provider prescribes progesterone injections, they are typically referring to one of two methods: intramuscular (IM) or subcutaneous (SC). The injection site is determined by which type of injection is prescribed, as the depth and speed of absorption differ significantly.

Intramuscular (IM) Injections

Intramuscular injections deliver the medication deep into a large muscle, ensuring a slow, sustained release of the progesterone. This method is often used for progesterone in oil (PIO), a thicker, more viscous medication that requires a longer and thicker needle. The most common site for IM progesterone injections is the buttock.

Locating the Buttock Injection Site

To find the correct location for a buttock injection, a person or their partner can follow these steps:

Divide the buttock: Mentally or physically divide one side of the buttock into four equal quadrants by drawing an imaginary horizontal and vertical line across it.
Locate the upper outer quadrant: The injection site is in the upper outer quadrant, several inches below the hip bone and away from the central gluteal cleft.
Alternate sides: Always rotate between the left and right buttock for each daily injection to reduce soreness and prevent the build-up of knots or lumps.
Avoid previous knots: Before each injection, gently feel the muscle for existing hard knots from previous shots. Inject at least an inch away from any knots.

Alternative IM Injection Sites

In some cases, a healthcare provider might approve or demonstrate alternative intramuscular injection sites, such as:

Upper Thigh (Vastus Lateralis): The outer, mid-thigh area is another large muscle that can be used for IM injections. It may be easier for self-administration but can be more uncomfortable.
Back of Upper Arm (Deltoid): While an option, this site is generally less common for deep IM injections and more difficult for self-administration.

Subcutaneous (SC) Injections

Subcutaneous injections are administered into the fatty tissue just below the skin and use a shorter, thinner needle. This method is typically reserved for water-based progesterone formulas rather than the thick progesterone in oil used for IM injections. Many patients prefer SC injections due to less pain and easier self-administration.

Common SC Injection Sites

Abdomen: The most common SC site is the lower abdomen, at least one to two inches away from the navel. Patients should choose a spot with adequate fatty tissue.
Upper Thigh: The front of the upper thigh also provides suitable fatty tissue for subcutaneous injections, offering another option for site rotation.

Techniques for Easing Discomfort

Regardless of the injection type, managing discomfort is a key part of the treatment protocol. Here are some techniques to help make injections easier:

Apply heat or cold: A warm compress or heating pad applied to the injection site for 10-15 minutes before the injection can help relax the muscle. After the shot, applying heat and massaging the area can help with absorption and reduce lump formation. Alternatively, some find that icing the area for a few minutes prior helps to numb the skin.
Relax the muscle: When administering a buttock injection, put your weight on the leg opposite the injection site. This helps relax the muscle, making the injection less painful.
Warming the medication: For progesterone in oil, some patients find that gently warming the syringe under their armpit or by rolling it between their hands makes the thicker liquid easier to inject.
Massage the area: Massaging the injection site in a circular motion for a few minutes after the shot can help distribute the medication and prevent pooling, which can cause knots.
Stay active: Walking or light activity after the injection can promote circulation and absorption of the medication, easing soreness.

Comparison of Intramuscular and Subcutaneous Progesterone Injections


Feature	Intramuscular (IM) Injection	Subcutaneous (SC) Injection
Injection Site	Upper outer quadrant of the buttock is most common. Also upper thigh.	Lower abdomen or upper thigh.
Needle Size	Longer and thicker (e.g., 22-gauge, 1.5-inch) to reach deep muscle.	Shorter and thinner (e.g., 27- to 31-gauge) for subcutaneous tissue.
Medication Type	Often Progesterone in Oil (PIO), which is a thicker, viscous liquid.	Water-based or modified progesterone formulas.
Common Use	Often preferred for IVF and other fertility treatments to ensure slow, stable absorption.	Increasingly used for fertility treatments, with some studies showing similar efficacy to IM injections.
Pain Level	Can be more painful and cause more bruising and soreness due to deep muscle injection.	Generally less painful and easier to self-administer.
Lumps/Knots	More likely to cause lumps or knots (panniculitis) at the injection site.	Less likely to cause significant lumps at the injection site.

The Importance of Professional Guidance

While the general injection sites are consistent, every patient's treatment plan is unique. It is essential to receive personalized instruction from a healthcare provider or a fertility clinic nurse on the precise location and technique for your specific medication. They can also help with mapping out injection sites and provide tips tailored to your body type and comfort level. Always consult with your medical team before beginning any injection protocol and ask for a practical demonstration to ensure safety and effectiveness.

Conclusion

Progesterone injections are a vital component of many fertility treatments, but knowing where do they inject progesterone shots is only part of the process. Whether an intramuscular injection in the buttock or a subcutaneous injection in the abdomen is prescribed, proper site location, consistent rotation, and pain management techniques are all essential for a successful and more comfortable experience. By following your healthcare provider's instructions and practicing safe administration, you can confidently navigate this part of your treatment journey.

Frequently Asked Questions

Yes, it is possible for some people to self-administer the injection. Your healthcare provider or a trained nurse should show you exactly how to do it safely, including how to reach the proper upper outer buttock quadrant. For many, having a partner or family member administer the shot is easier and more reliable.

To locate the site, draw an imaginary vertical line down the middle of one buttock and a horizontal line across its center. The injection goes in the upper outer quadrant, which is away from major nerves and blood vessels. You should also ensure you are not injecting into a previously formed lump.

IM injections are given with a longer, thicker needle into a large muscle and are often used for thicker progesterone in oil (PIO). SC injections use a shorter, thinner needle into the fatty layer under the skin and are for water-based formulas. SC shots are generally easier and less painful to administer.

Methods to reduce pain include using a warm compress on the site before and after the injection, relaxing the muscle during the shot, and massaging the area afterwards. Some people also find numbing the area with an ice pack beforehand can help.

Small, hard lumps, known as panniculitis, can form when progesterone in oil accumulates in the muscle. This is a common side effect, especially with IM shots. Rotating injection sites daily and massaging the area after the shot can help prevent them.

You should rotate injection sites with each daily injection. For IM shots in the buttock, alternate sides (left one day, right the next). For SC injections in the abdomen, move to a different spot within the recommended area each time.

No, it is important to always rotate sites. Even if an area is not immediately sore, repeated injections in the same spot can lead to chronic inflammation, scarring, and improper absorption of the medication.