Medical Q&As

Contraceptive injection - faulty technique?

I am on the 12-week injection contraceptive for 4½ years. My previous doctor administered the injection in my bottom, but my present doctor administers it in my hip. After the injection the area bleeds for about an hour, is painful and leaves a bruise, which lasts three to four days. I questioned her on this but she said the injection works better administered in my hip. Is this true as I am quite worried about my doctor’s administration skills?

It is recommended that the depot injection be given by deep intramuscular injection, which is the reason why it is given into the buttock. The area you refer to as your hip may in fact be part of your buttock. The gluteal muscles wrap around from the bottom to just behind the hip joint. The gluteal muscles consist of a thick layer of muscle and are therefore very suitable for a deep muscular injection. The shoulder would not be a suitable injection site because the amount of muscle is not sufficient for a deep injection. Whenever a deep intramuscular injection is being given it is important that the track of the sciatic nerve be avoided so that the needle does not injure the nerve. Therefore when a deep intramuscular injection is being administered it is important to avoid the sciatic nerve while at the same time passing the needle into a deep mass of muscle. Both your past and present doctors are likely to be following these considerations and yet be giving the injection in slightly different locations on your buttock. Finally it is unusual to bleed to the degree that you describe following an intramuscular injection therefore I would bring that particular matter to the attention of your doctor.