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Pain in left leg after injection (self.mtf)
submitted 3 months ago* (last edited 3 months ago) by will_steal_your_username to c/mtf
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Hi! I've been using gel for several months, but a few weeks ago I made the change to injections. Each injection has resulted in some pains in random areas in my left leg, but mostly concentrated in the muscles below the knee. I also started waking up with muscle spasms in the same leg, which is something I used to have before puberty. The pain mostly subsides after a day or two.

I suspect the issue is vasodilation which I understand is more common in women than men because estrogen dilates the blood vessels, but I wanted to hear other peoples thoughts.

Wearing overknee socks (to compress) helps, as does ice and exercise/movement, which I think is in favour of this being vasodilation.

I will be bringing this up with a doctor in a couple of weeks, but I'm afraid he won't be able to help much or have someone to refer me to as competence regarding trans stuff is pretty low here in Norway (also I'm diy).

I would like to know as much as possible about what this could be so I have something to present to him.

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[-] mjsaber 10 points 3 months ago

Estrogen does not dilate blood vessels, and vasodilation won't cause pain. It's very unlikely that the hormone is causing the pain.

I have a few questions, if you don't mind? You said you are doing the injections subcutaneous. Where are you injecting? What length of needle are you using? Subcutaneous injections are relatively painless and shouldn't be causing any of the issues you are describing, but if you're using a needle that is too big or injecting in a bad spot the pain could be related to injection site soreness.

Pain in the legs and below the knee could be a sign of deep vein thrombosis. It's very unlikely, but estrogen can make you more susceptible to blood clots. You are at higher risk for this if you smoke cigarettes (especially if you're over 35), if you have a more sedentary lifestyle, or if your serum estrogen level is too high. Subcutaneous injections tend to lead to higher serum estrogen levels, which can put you at a higher risk for blood clots.

You said you are DIY, is anyone checking your estrogen levels? What dose of estrogen are you taking, and how often?

It's pretty unlikely the pain is from a DVT, but that is a very serious complication you need to rule out (a dislodged clot from a DVT that travels to your lungs can cause a pulmonary embolism, which can potentially be fatal).

I hope this doesn't come across as condescending, but these are the questions I would ask if you were a patient.

[-] will_steal_your_username 3 points 3 months ago

I hope this doesn’t come across as condescending

Not at all! I posted this to hopefully figure out more stuff. I'm not a doctor and I expected to get some things wrong, and I very much appreciate your input <3

What length of needle are you using? Where are you injecting? [...] the pain could be related to injection site soreness.

0.33 mm (29 G) x 12.7 mm insulin needles. In my thigh at 45 degrees per the video on the diywiki. I'm not an english speaker so I had to search around, the area that hurts is my calves, so I doubt it's injection soreness.

deep vein thrombosis

I hope not! As I'm on monotherapy my levels are certainly higher than the levels of cis women, but I figured the risks of clood clots were long term, and I've only been on E for like half a year. No smoking or drugs. I've been very sedentary up until recently. I started doing a lot of walks and doing some semi-regular exercise, mostly focused on my legs. On average I take a walk a day (less during winter), and I've been doing this for a year. I'm unsure when I started exercising? One or two months ago? I suppose the exercise kinda lines up as well.

is anyone checking your estrogen levels? What dose of estrogen are you taking, and how often?

I did my first blood test for hormone levels last wednesday, but I haven't received the results yet. I was gonna talk to my doctor about all this during the same appointment were I asked for the blood test, but he was away on holidays so I had some other random doctor as a substitute. I was not comfortable coming out to the substitute. I take 4mg every wednesday. I've taken 4-5 doses at this point. I took gel before this, but it was a bit of a mess in terms of how much I took and how often which isn't good, so I figured injections were more my thing.

Estrogen does not dilate blood vessels

I might have been hasty. Found some mentions of weakened veins and leg pains being more common in women, and a reddit thread from a lady experiencing something similar after 4 months of hrt. I'm not sure where I got vasodilation from to be honest, but it got stuck in my brain.

[-] mjsaber 5 points 3 months ago

Thank you for the thought-out response.

It doesn't sound like site soreness, and if you're using insulin needles, those are too small to get into the muscle anyway.

Your dose might be a little high, but I doubt it's so high that it's putting you at a risk for blood clots.

It honestly sounds like it could just be soreness from exercising more if you started doing that around the same time as injections, and your body isn't used to it. It could also be an electrolyte imbalance, as some others mentioned, but if you're young and relatively healthy that's fairly unlikely.

I usually start with the most likely scenario and move from there. It's pretty unlikely to be a DVT, injection site soreness, or electrolyte imbalance, so it's likely just soreness. If you aren't already, try adding some light stretching before or after you exercise. Applying heat should help, too, if it's just muscle soreness. I would bring all this up with your doctor so they are able to rule out the more serious stuff, but I would not be overly concerned about it.

On a somewhat related note, when looking up medical information I would stick with Mayo Clinic or Cleveland Clinic for general medical stuff. For trans specific info, Fenway Health is the gold standard (imo), someone linked to them in a different response. You can also check WPATH standards of care 8, but that's meant as more of a reference for medical professionals and it might be a bit dense.

Please let us know how it goes, and keep asking questions! It's best to get from medical professionals, but sadly folks like us don't always have that luxury.

[-] dandelion 3 points 3 months ago

Yeah, I suspect it's just dehydration and electrolyte imbalance from the increased exercise - I had a similar thing happen when I went from sedentary to regular exercise.

[-] will_steal_your_username 2 points 3 months ago* (last edited 3 months ago)

I'm sure that explains the cramps, but the pain/discomfort happens within an hour or two after injection and lasts for a couple of days, which is the part that I'm worried about. But they might be connected in some way so taking the advice I've been given here seems like the way to go. I've bought magnesium, bought some banana smoothies, had some fried creamed spinach with broccoli, and made sure to drink lots. Hopefully there won't be any issues (or at least milder symptoms) with the next injection. Also gonna go grab some of those electrolyte sports drinks.

Thanks again <3

Edit: Also chocolate contains lots of potassium as well ! Treating myself as we speak

[-] dandelion 2 points 3 months ago

Awesome - I really hope the cramps go away. I was happy to hear you were starting to exercise more too, and to see now that you are really taking care of yourself is just so heart-warming!! ❤️ ❤️ ❤️

this post was submitted on 03 Aug 2024
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