Summary
The retrospective study assessed data from the French National Health Data System between 2009 and 2018 to assess the risk of meningioma when taking progestogens. Progestogens are the synthetic version of the natural hormone progesterone. For each women who had a surgical removal of the meningioma there were five matched controls (matched by age and area of residence). The researchers assessed eight commonly used progestogens.
Results: Three of eight tested progestogens had a greater risk of developing a meningioma if used for a prolonged period of time (more than 12 months). Two of the progestogens with an increased risk, medrogestone and promegestone, are not available in Australia. For medroxyprogesterone acetate (Depo-Provera) a 5-fold risk for developing a meningioma was identified. Exact statistics: There were 9 exposed cases of 18,061 cases (0.05%) versus 11 exposed cases of 90,305 controls (0.01%) resulting in an odds ratio of 5.55 (with a 95% confidence interval of 2.27 to 13.56).
No excess risk was identified for oral, intravaginal and percutaneous progesterone, or dydrogesterone, or levonorgestrel intrauterine systems (known as Mirena).
You can listen to a patient report and commentary from the French lead investigator, Dr Noemie Roland, and Prof Kate Drummond, Head of Neurosurgery at the Royal Melbourne Hospital, on the risk of Depo-Provera here (ABC listen):
Please note, do not stop taking contraceptives before talking to your health specialist. Depo-Provera can still be an important short-term treatment of heavy periods, endometrial cancer and endometriosis for a particular group of women.
Full text
The full text is attached below or can be accessed from the British Medical Journal.
Research publication:
Roland, N., Neumann, A., Hoisnard, L., Duranteau, L., Froelich, S., Zureik, M., & Weill, A. (2024). Use of progestogens and the risk of intracranial meningioma: national case-control study. BMJ, 384, e078078. https://doi.org/10.1136/bmj-2023-078078