Very good info! I'm considering injections to make traveling for work easier, and I'm glad you mentioned the preference for older people to go that route (I'm still a few years away from that group but it's good info to have when I go in for my consultation).
A tip, if you ever need to travel with your injection stuff: make sure to bring it all with you onto the plane (including needles!). The TSA sees this stuff all the time, and it won't faze them a bit.
Also, if that becomes a thing, a little dopp kit for injections is a good idea, and Stealth Bros & Co makes great ones and is trans-owned! https://www.stealthbrosco.com/
A few notes from someone who does subcutaneous injections. These came from an instructional video from my local hospital, and my own experience confirms them.
I generally use *four* alcohol swabs per injection: two on the vial and two at the injection site. The video recommended using *six* swabs, but my doctor agreed that was excessive. It's a little wasteful, maybe, but given the risks it seems prudent.
Before drawing liquid from the vial, pull the needle back to draw in air equivalent to your dose. This keeps the pressure inside the vial equalized with the outside world and makes drawing a little easier.
When switching needles, it's a good idea to pull the plunger back so that there's some air in the syringe before removing the draw needle. You get more accurate dosing that way because you're not leaving any liquid in the draw needle. You're going to have to empty some air out of the new needle anyway, so a little more can't hurt.
Some very minor swelling and itching at the injection site for a few days afterward seems to be pretty normal with subcutaneous injections of estradiol valerate. But if it's ANYTHING more than very minor, that indicates possible infection, and you should probably contact your doctor.
And just to emphasize Doc Impossible's point, if you screw anything up, dispose of your supplies and start fresh. Period. If you do enough injections, you're going to screw something up at some point, no matter how careful you are. You'll drop a needle on the counter, or you'll forget to push all the air out, or whatever. That's okay. Just start over. Make sure you always have the supplies on hand to do that, even when traveling - two vials, three or four extra needles/syringes, and a ton of alcohol wipes.
Great tips! I have another question. Zoe emphasizes inserting the needle into your injection site quickly to minimize pain, but if you're not put off by pain, and you don't have a mental block about injecting yourself, is it still important to insert quickly? Does that vary between intramuscular and subcutaneous injections?
It's not necessarily important, per se, but it's a best practice. If you go slow, it's more likely you'll wiggle the needle, for lack of a better term, and cause more damage to your injection site than you really need to. It wouldn't be bad--just a sore spot and a bruise to show for it, maybe some bleeding--but it's better to have no pain and no bruise. Obviously, this would be more important for intramuscular than subcutaneous, just because of how far you have to go, but best to just do it right.
I don't really focus on injecting quickly, but I do make sure to do it in a single, smooth motion. Even with subcutaneous injections, if you're hesitant or jittery, you raise the risk of a bruise or bleeding. That going to happen anyway sometimes, unfortunately, but you can reduce incidence and severity with proper technique.
Great; that's what I figured. (Responding to both.) I haven't had any need to inject myself yet, but I've gotten to the point where, when I go for a shot or blood work, I watch the nurse or phlebotomist's technique to better understand what's happening.
I had one recent experience where the phlebotomist may have inserted the needle a little too quickly. She found the vein inside my elbow, lined up her aim, and shoved it in. I'm used to blood collection needles going in more slowly, and in that case I had a bruise for two weeks.
Of course, blood collection is a completely different procedure from injection.
Thank you very much for your tips.
As DIY, the vial should last around a year and I don't have the access to a pharmacy to change the vial. What should I do?
buying another one is sadly the only method for that.
Due to the laws where I live, I can't offer any advice on DIY. I'm sorry. 😢
You are a very effective science communicator. I learn a lot from you. Thanks! 🙏
Estradiol enantate probably isn't prescribed because there are no formulations that have FDA approval.
https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm?panel=0&drugname=estradiol
I know it's legal in other countries, and I didn't want to make a guide that only worked in the US.
Very good info! I'm considering injections to make traveling for work easier, and I'm glad you mentioned the preference for older people to go that route (I'm still a few years away from that group but it's good info to have when I go in for my consultation).
A tip, if you ever need to travel with your injection stuff: make sure to bring it all with you onto the plane (including needles!). The TSA sees this stuff all the time, and it won't faze them a bit.
Also, if that becomes a thing, a little dopp kit for injections is a good idea, and Stealth Bros & Co makes great ones and is trans-owned! https://www.stealthbrosco.com/
This was a really nice guide.
A few notes from someone who does subcutaneous injections. These came from an instructional video from my local hospital, and my own experience confirms them.
I generally use *four* alcohol swabs per injection: two on the vial and two at the injection site. The video recommended using *six* swabs, but my doctor agreed that was excessive. It's a little wasteful, maybe, but given the risks it seems prudent.
Before drawing liquid from the vial, pull the needle back to draw in air equivalent to your dose. This keeps the pressure inside the vial equalized with the outside world and makes drawing a little easier.
When switching needles, it's a good idea to pull the plunger back so that there's some air in the syringe before removing the draw needle. You get more accurate dosing that way because you're not leaving any liquid in the draw needle. You're going to have to empty some air out of the new needle anyway, so a little more can't hurt.
Some very minor swelling and itching at the injection site for a few days afterward seems to be pretty normal with subcutaneous injections of estradiol valerate. But if it's ANYTHING more than very minor, that indicates possible infection, and you should probably contact your doctor.
And just to emphasize Doc Impossible's point, if you screw anything up, dispose of your supplies and start fresh. Period. If you do enough injections, you're going to screw something up at some point, no matter how careful you are. You'll drop a needle on the counter, or you'll forget to push all the air out, or whatever. That's okay. Just start over. Make sure you always have the supplies on hand to do that, even when traveling - two vials, three or four extra needles/syringes, and a ton of alcohol wipes.
Great tips! I have another question. Zoe emphasizes inserting the needle into your injection site quickly to minimize pain, but if you're not put off by pain, and you don't have a mental block about injecting yourself, is it still important to insert quickly? Does that vary between intramuscular and subcutaneous injections?
It's not necessarily important, per se, but it's a best practice. If you go slow, it's more likely you'll wiggle the needle, for lack of a better term, and cause more damage to your injection site than you really need to. It wouldn't be bad--just a sore spot and a bruise to show for it, maybe some bleeding--but it's better to have no pain and no bruise. Obviously, this would be more important for intramuscular than subcutaneous, just because of how far you have to go, but best to just do it right.
I don't really focus on injecting quickly, but I do make sure to do it in a single, smooth motion. Even with subcutaneous injections, if you're hesitant or jittery, you raise the risk of a bruise or bleeding. That going to happen anyway sometimes, unfortunately, but you can reduce incidence and severity with proper technique.
Great; that's what I figured. (Responding to both.) I haven't had any need to inject myself yet, but I've gotten to the point where, when I go for a shot or blood work, I watch the nurse or phlebotomist's technique to better understand what's happening.
I had one recent experience where the phlebotomist may have inserted the needle a little too quickly. She found the vein inside my elbow, lined up her aim, and shoved it in. I'm used to blood collection needles going in more slowly, and in that case I had a bruise for two weeks.
Of course, blood collection is a completely different procedure from injection.