Study Links Some Progestogen Contraceptives to Low but Increased Brain Tumor Risk
A new Danish study published July 2 in JAMA Network Open reports an association between several progestogen-based contraceptives and a higher risk of meningioma, the most common tumor of the central nervous system. Meningiomas are usually benign, and researchers emphasized that the absolute risk remains low.
The study compared 1,473 females diagnosed with meningioma with 14,717 similar females without the tumor. Participants lived in Denmark and had an average age of 48. Researchers matched controls by age, birthplace, and marital status to reduce the influence of unrelated factors.
The strongest association was seen with injectable medroxyprogesterone, sold as Depo-Provera. Current or recent users were 4.6 times more likely to be diagnosed with meningioma than nonusers. High-dose levonorgestrel intrauterine devices were linked to a 1.58-fold higher risk, while lower-dose IUDs showed a slightly lower increase. Progesterone-only pills were associated with a 1.7-fold increase, and combined estrogen-progesterone pills with a 1.61-fold increase.
Researchers found that the elevated risk was most apparent among current users and those who had used the contraceptives within the past year. For most methods, the increase was no longer observed within five years after stopping use.
Regulators have already taken some action. In 2025, the U.S. Food and Drug Administration added meningioma warnings to Depo-Provera labeling, advising discontinuation if a tumor develops. European regulators have also recommended limiting high-dose synthetic progestins to necessary, short-term use and monitoring for symptoms such as vision changes, headaches, hearing problems, seizures, memory loss, or limb weakness.
Experts said the findings should inform, not replace, contraceptive decision-making. Clinicians are encouraged to discuss relative and absolute risks, use the lowest effective dose when appropriate, and consider each patient’s medical history, preferences, and risk tolerance before selecting or continuing a birth control method.