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This bias is particularly problematic in endometriosis, where pain is the predominant symptom and psychological comorbidities are common secondary effects

Common injection sites: For Intramuscular (IM): Upper arm (deltoid) Outer thigh (vastus lateralis) often the easiest self-injection site Upper outer gluteal muscle usually requires assistance For Subcutaneous (SQ): Abdomen (at least 12 inches away from the navel) Outer thigh Back of the upper arm What are the side effects

At patient request, we can discuss the use of topical numbing cream prior to the injection

Redness and inflammation: the injection site may become red or inflamed

This step removes bacteria that have settled on the stoppers during storage and shipping

Intrinsic factor antibodies