As with any medication, there are possible side effects or risks involved. Common risks from steroid injections include pain at the injection site, bruising due to broken blood vessels, skin discolouration and aggravation of inflammation. Rarer risks include allergic reactions, infection, tendon rupture and serious injury to bones called necrosis. Long term side effects (depending on frequency and dose) include thinning of skin, easy bruising, weight gain, puffiness in the face, higher blood pressure, cataract formation, and osteoporosis (reduced bone density). Steroid injections may be given every 3-4 months but frequent injections may lead to tissue weakening at the injection site and is not recommended. Side effects do not happen in everyone and vary from person to person.
We have also noted that 24-hour urinary estrogens can be a sensitive monitor of liver detoxification capability. Elevated urinary estrogens in normally-cycling women may indicate a history of exposure to liver stresses such as excessive environmental organic chemicals. Interventions intended to improve liver function result in a gradual normalization of the abnormal estrogen levels. Thus, measurement of urinary estrogens can give insight into other aspects of physiology. This phenomenon is also noted in peri- or post-menopausal women who have previously taken Premarin, and have switched to triple-estrogen replacement with less-than-optimal symptom relief.