Susten Injection
✅ Maintains a healthy uterine lining
✅ Supports the progress of pregnancy
✅ Helps regulate the menstrual cycle
✅ Restores hormonal balance
contains Progesterone
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
💡 Quick Answer
Susten Injection is natural progesterone 100 mg/mL in oil, administered as an intramuscular injection. Primary use: luteal phase support in IVF cycles and selected cases of threatened miscarriage. Intramuscular progesterone has the highest uterine bioavailability of any route. Administered daily or alternate days by a clinician or trained patient. This product is not indicated for menopausal HRT — oral or transdermal progesterone is standard for that use.
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What Is Susten Injection?
Susten Injection is a branded generic of natural progesterone 100 mg/mL formulated in oil (typically sesame or castor oil) for intramuscular injection. It is a bioidentical form of the progesterone hormone naturally produced by the corpus luteum and placenta. Manufactured by Sun Pharma.
Category note: while this product appears in the HRT category, IM progesterone is primarily used for fertility and early pregnancy support — not typical menopausal HRT. For menopause, oral (endogest, susten-capsule) or micronized progesterone is more convenient.
Clinical Uses
- Luteal phase support in IVF — 50–100 mg IM daily starting on day of egg retrieval, continued through early pregnancy (up to week 10–12).
- Frozen embryo transfer (FET) — programmed cycle with IM progesterone for endometrial preparation.
- Selected cases of threatened miscarriage — typically in women with ≥3 prior miscarriages and current bleeding (PRISM trial criteria).
- Progesterone challenge test — to evaluate secondary amenorrhoea.
- Secondary amenorrhoea and functional uterine bleeding — less common; oral progesterone is usually preferred.
How to Use Susten Injection
- Warm the vial in your hands to reduce pain and improve flow through the needle.
- Use a 21–22 gauge needle for injection (larger than standard insulin needle because of the oil vehicle).
- Inject into the upper outer quadrant of the buttock (gluteal region) or outer thigh. Alternate sides daily.
- Inject slowly to minimise pain; expect the site to be sore or lumpy for several days.
- Apply warmth after injection (warm pack) to aid absorption and reduce lumps.
- Rotate sites consistently — daily injections in the same spot produce painful nodules.
- Follow fertility clinician’s timing: typically daily in IVF cycles, continuing through week 10–12 of confirmed pregnancy.
Side Effects
Injection-site effects (very common): pain, soreness, bruising, redness, nodule formation, rarely sterile abscess.
Systemic (common): fatigue, drowsiness, breast tenderness, mood changes, bloating, breakthrough bleeding.
Rare serious: allergic reaction to oil vehicle (sesame-allergic patients must use castor-oil variant), acute pancreatitis, cholestasis, jaundice, thrombosis.
Who Should Not Use Susten Injection
- Known allergy to sesame oil or castor oil (depending on vehicle)
- Active severe liver disease
- Known or suspected breast cancer
- Active VTE or history of thrombophilia
- Undiagnosed vaginal bleeding
- Ectopic pregnancy (do not continue once confirmed)
Oral vs IM vs Vaginal Progesterone
| Route | Advantages | Drawbacks |
|---|---|---|
| Oral (endogest, susten-capsule) | Convenient, sleep benefit | First-pass metabolism, drowsiness |
| Vaginal (off-label oral, gels, pessaries) | High uterine delivery, less drowsiness | Messy, daily dosing |
| IM (Susten Injection) | Highest uterine levels, most reliable absorption | Painful, lumpy sites, requires training |
Storage
Store at room temperature (15–25 °C / 59–77 °F). Do not refrigerate (oil hardens). Protect from light. Discard any unused portion after withdrawal if single-use ampoule.
Frequently Asked Questions
Why is IM progesterone so painful?
The oil vehicle requires a large-bore needle. The oil takes time to absorb, producing a palpable nodule for days. Rotating injection sites, warming the vial before injection, and applying warmth afterwards all help.
Can I take oral Susten Injection instead?
For IVF/fertility use, IM is often preferred for bioavailability and reliability. Some clinics use vaginal suppositories as a less painful alternative. For menopausal HRT, oral is the standard. Discuss with your fertility specialist or gynaecologist.
Is IM progesterone for menopausal HRT?
Typically no — oral or vaginal is used. IM is too painful and impractical for long-term HRT. This product in the HRT category is more commonly used for fertility / early pregnancy support.
Can I inject this myself?
With training, yes. Many women undergoing IVF self-inject IM progesterone daily at home. Alternatively, a nurse or partner can administer. Request training from your fertility clinic.
How long do I continue Susten Injection in IVF?
Typically from egg retrieval through confirmed pregnancy at ~week 10–12, when the placenta takes over progesterone production. Exact duration per fertility clinic protocol.
What if I miss a dose?
Take it as soon as you remember, unless it is close to the next scheduled dose. Contact your fertility clinic — luteal phase consistency matters.
Are there side effects that warrant stopping?
Sterile abscess at injection site, severe allergic reaction, signs of thrombosis (leg pain/swelling, chest pain, shortness of breath), jaundice, severe mood changes. Seek urgent care.
Can I travel with Susten Injection?
Yes — carry in original packaging with a clinician letter for customs. Needles require clinician documentation in some jurisdictions. Room-temperature storage makes travel easier than refrigerated drugs.
Related Hormone & Women’s Health Products
- Premarin (Conjugated Estrogens)
- Premarin Cream (Vaginal Estrogen)
- Progynova (Estradiol Valerate)
- Endogest (Progesterone 100 mg)
- Gestoford (Progesterone 100 mg)
- Gestheal (Progesterone 200 mg)
- Susten Capsule (Progesterone)
⚕️ Medical Disclaimer: Information is educational and does not replace medical advice. Hormone therapies carry specific risks (breast cancer, VTE, stroke, endometrial cancer if unopposed estrogen) — consult a clinician before starting, stopping, or changing any hormone medication. Individual risk–benefit depends on personal and family medical history.
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| Strength | 100mg/ml * 1ml, 100mg/ml * 2ml |
|---|---|
| Quantity | 5 Injection/s, 10 Injection, 15 Injection |
| Pharma Form | Injection/s |
| Manufacturer | Sun Pharma |
| Treatment | Female infertility, Hormone replacement therapy |
Susten Injection
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