Depo provera effectiveness

[55]

Hey,

I recently went for my fifth depo shot. Previously, a nurse had warned me not to massage the injection site as it can make the shot less effective.

Usually after injecting, the nurse dabs it lightly and sticks a bandaid on if it bleeds. I’m worried because this time when I got the shot, the nurse wiped the blood away in a swiping motion 3 times.

I know that isn’t really a ‘massage’. But I also read that you shouldn’t rub the injection site either, and what she did was sort of rubbing it. Now I’m worried my shot might not work and don’t know what to do? Thanks

[Sam W]

Hi 55,

When you're thinking about a massage, that's more about manipulating muscles, whereas what the nurse did is more a of a quick, surface motion that isn't doing much, if anything, to the muscles beneath the skin. As long as the injection site is not swollen, itching, or burning excessively, you should be fine.

[55]

I thought that, but then I read online you shouldn’t rub the injection site either or it can make it less effective. I’m not sure if rub means hard or at all

[Sofi]

That's more for a longer lasting rub than what the nurse did, also probably with more pressure applied. The quick "rubbing" she did, which was wiping the blood off, won't affect the effectiveness of the injection.

[55]

Thanks! Can I clarify by ‘injection site’ do you mean literally just the area where it was injected (in my case the glute muscle)?

I also happened to have sore leg muscles that day from a previous workout. So I remember rubbing my thigh muscle quite firmly to sooth the pain, but my injection was in the glute muscle so I assume rubbing my thigh muscle wouldn’t make a difference to my injection? Seeing as it’s a completely different muscle, just on the same side of my body. Probably overthinking it!

[Sam W]

Yes, injection site refers to the spot where the actual injection occurred. That would also be why rubbing a different section of your body wouldn't be an issue either.

[55]

Thanks Sam

[Sam W]

You're welcome!

[55]

Hi, I have another question about depo provera injection. I had my most recent shot last week. Because I have quite severe anxiety, after the injection (which was in my butt area) I kept twisting around in the mirror to try and look at where it had been injected (the injection leaves a little red mark). I was trying to look at where it had been injected because this reassured me that it had been injected in the right place. I know it sounds dumb.

However, when I was twisting around to look behind me in the mirror, I suddenly felt a weird sensation right near the injection site. Like a twinging or a tickle / trickling feeling . This has made me freak out that what I felt could have been the injection liquid moving around in my muscle.

I was told not to massage the injection site as this can push the medication up through the subcutaneous tissue and make it less effective. I did not massage the area. I just twisted around quite a few times on the day of the injection and the day after to look in the mirror. But this obviously will have twisted the muscle a bit, as I was twisting quite far around to try and look behind me.

Do you know is it possible that what I’ve done (twisting around too much) would have made my injection less effective?

It’s possible what I felt could have been the muscle twitching or something but because of my anxiety I find it really hard to see things in a rational way. Thanks

[Logan W]

Hi 55,

I also struggle with anxiety and can see where you're coming from. From what I understand, it is not recommended to massage the injection site right after injection but twisting around should not affect the injection. What they are referring to is hard rubbing of the muscles at the injection site, which twisting around does not do. I hope this is helpful!

[55]

Thanks! Are you able to please explain why massaging causes a problem but exerting / twisting the muscle by turning around too far wouldnt?

I didn’t think it was an issue myself until I felt this weird sensation when I did it.

This is the problem with anxiety. Makes you do things to reassure yourself that then cause bigger worries!

[Sam W]

Hi 55,

The basic answer is that massaging the site of an injection or otherwise applying serious pressure to it can mess with how the medication disperses in the body, which can in turn mess up the intended effects.

Have you been having any success with any kind of anxiety management or treatment lately? If you have tools that help you calm persistent fears, now might be a time to use a few of them.

[55]

Ah right. So doing what I’ve done shouldn’t have had the same negative effect?

Sort of but not really because with things like this I struggle to know if it’s a ‘real’ issue or not like if what I’ve done and what I’ve felt means my injection is now less effective. Thanks

[Sam W]

That's correct. Really, when you're thinking about that warning around massaging the site, they mean someone putting a lot of deliberate pressure on it, rather than someone moving around or bumping it in the course of going through their day (since if that decreased the effectiveness, the shot wouldn't work well at all).

Do you feel like once you have the information to tell if an issue is one you need to worry about or not, the anxiety tends to go away? Or does it keep coming back after that?

[55]

Getting information reassures a particular worry but then another one will probably just pop up. Or I may still in this example worry because in this instance I felt something when I twisted around so it’s the uncertainty of what that was. And also worrying whether I can rationalise a problem myself or whether to speak to a doctor etc.

[Sam W]

Have you been getting any help around that pattern of one worry popping up after you get another under control? I ask because that's an element of anxiety that can be extra exhausting, so if you're not already getting some mental health supports, those might help you manage it.

[55]

I’ve been having CBT but the problem is I struggle to know if a worry is ‘real’ or not. For instance I feel pretty convinced that my injection might not be working now because of the fact I kept twisting around the day of and day after I got my injection, which is reinforced by the weird sensation I felt. I could try and rationalise it but the risk feels too big. I’m just really mad at myself for doing something so dumb in the first place tbh!

[Sam W]

Hi 55,

So, I think in this instance it would help to remember what we mentioned previously in the thread; that the thing that could mess up the injection is deliberate massaging of the area, not moving the area in weird ways over the course of the day. Massage is about sustained pressure, which is what can cause the injection to move in ways it's not meant to.

Too, if you're sexually active right now and still can't shake this worry, you have the option to back up with condoms until your next injection.

[55]

Thanks! I should add I do use extra protection but even then I worry about it ripping or something .

[Sam W]

I'm glad you're doubling up on methods, just because that can be a big help with anxiety, and it gives you that security of having a second method protecting you in case the first one fails for some reason. Too, with condoms, as long as you're following the steps of correct use, like checking expiration dates and making sure there's lube, they're very unlikely to break.

[55]

Unfortunately because of the anxiety and intrusive thoughts, even having two methods still causes me major anxiety. Everything will seem fine and then an hour or two later I’ll suddenly have a doubtful thought like I’ll convince myself something might have leaked out the base of the condom or there was a tiny hole I didn’t see , etc. Hopefully counselling will start to help. Thanks

[Sam W]

I hope it helps as well! One more good piece of information to have is that when condoms break, they break in a super noticeable way (think a ripped balloon). So you can rely on seeing the intact condom as proof it worked when you need to.

[55]

Oh, so tiny holes aren’t really a thing? I normally look quite closely and inspect condom after but is this not necessary? Do I need to check in case anything leaked out the base or is this again not possible? Thanks

[Sam W]

Nope, tiny holes aren't really a thing that happens to condoms. When they break, it'll be noticeable when you look at it (and, in many cases, the person wearing the condom might actually feel the break happen). And since condoms are designed to keep fluids in, as long as the person is wearing a condom that fits them correctly, everything should stay inside it.

[55]

Hi, recently had another depo shot, 5-6 days ago. This time I’ve done really well at keeping my anxiety under control. However something has just happened that’s made me spiral again and I feel I could do with some help with please re-establishing the facts. I just was drying after a shower, wasn’t thinking and rubbed the area where I’d had my injection quite hard with the towel. Online it just says ‘don’t massage the area after the injection’. What would happen if the area gets rubbed or massaged five days later? Thanks