How to Minimize Pain and Discomfort During PIO Injections

Elizabeth King
4 hours ago
3 min read

(Yes, even the dreaded butt shots can feel more doable.)

Person injecting insulin into abdomen. Wearing pink top and blue jeans. Close-up shot, focused on syringe and action.

If you’re on a fertility journey, you already know: progesterone-in-oil (PIO) injections aren’t just part of the process — they’re often the part we dread the most. These deep muscle injections are critical for early pregnancy support, especially in IVF and IUI cycles, but they can come with real soreness, tenderness, and the kind of bruising no heating pad seems to touch.

You might be wondering:

“Why are progesterone injections so painful?” Or “Is there a way to make this suck less?”

The answer: YES.

Let’s walk through body-and-soul-aligned ways to reduce pain, ease tension, and support your nervous system — so each PIO injection feels just a little more manageable.

Why PIO Injections Hurt (and Why That’s Normal)

PIO shots use a thick, oil-based medication (usually sesame or peanut oil) that needs to be injected deep into the gluteal muscle. Because of the viscosity of the oil and the depth of the injection, it’s common to feel:

A burning sensation during the injection
Soreness or bruising afterward
Lumps or knots from oil pooling in the tissue

But pain doesn’t have to be part of your daily routine. The right technique, prep, and aftercare can make a world of difference.

10 Ways to Make PIO Injections Less Painful

1. Warm the Oil First

Cold oil = thick oil. Hold the vial in your hands or place it in warm (not hot!) water for a few minutes. This thins the oil and makes the injection flow easier — less pressure, less sting.

2. Relax Your Muscles (Really, Fully Relax)

Tense muscles make for tougher injections. Stand on the opposite leg, let the glute go soft, and take a few grounding breaths before the needle goes in. You can even try gentle stretching beforehand.

3. Know Where to Inject PIO

The safest spot is the upper outer quadrant of the buttock — away from nerves and big blood vessels. Ask your nurse to mark it for you once. You can also use a mirror or have your partner help.

4. Use Heat Before + After

Apply a warm compress 5–10 minutes before and after your injection. It helps dilate blood vessels, relax tissue, and make the whole experience smoother.

5. Massage After Injection

Using small circular motions, gently massage the injection site for 2–5 minutes to disperse the oil and prevent lumps. You can also do a few light squats or take a short walk to help it absorb.

6. Rotate Injection Sites

Don’t inject into the same spot two nights in a row. Alternate sides to reduce irritation and give your muscles time to recover.

7. Check Your Needle Size + Technique

Ask your provider about the best needle gauge and length for your body. Sometimes switching to a slightly smaller needle or adjusting technique can reduce pain dramatically.

8. Move Afterward

A short walk post-injection helps the oil disperse and prevents soreness. Bonus: movement helps your nervous system process the stress response.

9. Use Ice for Lingering Pain

If you're still sore later, try 5–10 minutes of ice. Heat is ideal before/after the injection — but cold can help calm lingering inflammation.

10. Support the Whole You — Not Just the Injection Site

PIO pain isn’t just physical. These shots often carry emotional weight, too. You’re doing something brave, over and over again. So be gentle. Hydrate. Rest. Cry if you need to.

Celebrate the fact that you're showing up.

Every injection is a love letter to the life you're creating.

Common Questions About PIO Injections

How to make progesterone shots hurt less?

→ Warm the oil, use heat, massage after, and relax your body before injecting.

How do you get rid of oil injection pain?

→ Heat + movement + gentle massage = the magic trio for reducing pain.

Where should I inject PIO?

→ Upper outer quadrant of the glute — and rotate spots often.

Are injections painful for everyone?

→ Everyone’s experience is different. But pain can be minimized with the right prep and technique.

What should I avoid while on progesterone injections?

→ Avoid injecting into bruised or swollen tissue. Also avoid sitting too long right after, and always check with your provider before adding new meds or supplements.