Last Saturday, I stopped taking estradiol tablets and started injecting estradiol valerate instead. “Why on earth would you replace something as easy as swallowing some pills every day with something so horribly intimidating and faintworthy?” I ask myself.

Because: my liver.

Your liver processes estradiol tablets before they go into your bloodstream to do their thing, something called first-pass metabolism, which has a couple of downsides. A) It prevents some of the estradiol from getting into your blood, and B) running random substances through your liver can cause problems; for estradiol, those problems include blood clotting risks and some kind of lipid factor hijinks.

So yeah, better liver health, less risk of blood clots, and more direct estrogen absorption are all good reasons to switch.

One good reason not to switch is intramuscular injection, and the railroad spike-sized needles needed to do it.

Am I exaggerating? Yes, it’s one of my many charms. You shouldn’t ever thrust a railroad spike into any part of your body. I advise against it (consider that an official legal disclaimer).

But lord have mercy, the needles are big. Like 21 gauge big. Look it up. The whole multiple-step intramuscular injection process is intimidating and (initially) complicated, so Ayin and I watched a bunch of helpful how-to videos. (Shoutout to Jessie Gender, who may or may not have fainted in the process of recording giving herself her very first injection. Girl, that was messy, but also oddly reassuring to watch.)

I wasn’t going to make Ayin give me those injections (in the gluteus medius, AKA the butt area). I gave them B12 shots for a while, years ago, and it’s nerve-racking sticking a needle into your loved one. So I did it myself in the outer thigh muscle.

I mean, I did it myself eventually.

I managed to load up the syringe (which I think is too large for my dose, but what do I know – you hit with the bat the coach gives you), rub an alcohol pad on the injection site, and sit on the couch. Then I hovered that comically oversized spike above the spot and…hesitated.

Yeah, I psyched myself out and hovered that thing above my thigh for what felt like ten minutes, but was probably only nine. I couldn’t do the jab, I’m telling you! Ayin and I laughed, and Ruby was like, “What the fuck is your problem?”

What the fuck was my problem, indeed. I don’t know. I couldn’t visualize sticking that big needle into myself. Purposely hurting myself like that. I stick skinny needles into myself every day for other medically sanctioned-type purposes, but something about that big needle just broke my brain.

Finally, I said to Ayin, “Count me down!” They gave me a three-count, and I stuck it in. Without fainting! Honestly, it wasn’t a big deal. I just had to get over that first time.

But isn’t that the way it goes with a lot of things? We just have to get over them the first time.

I won’t know how this injectable dose works in comparison to the pills until I get my blood work done again in October. I do bloodwork every three months, which sounds excessive because it is. I have a LabCorp punch card, and for every ten visits, I get a free sub.

I mean, not really, but LabCorp, are you listening?

WRITTEN BY A HUMAN