According to a study by the National Agency for the Safety of Medicines and Health Products (ANSM), taking certain contraceptive hormones ” general “, for a year or more, is associated with an increased risk of developing a brain tumor. The researchers published their work in British Medical Journal [1].
This study is the first to link long-term use of certain progestins to an increased risk of the brain tumor intracranial meningioma, which accounts for 40% of primary central nervous system tumors. Although benign, this tumor, which grows from the membranes surrounding the brain and spinal cord, may require surgical removal.
Increased risks after a year of use
ANSM researchers examined National Health Data System (SNDS) data on 108,366 women, 18,061 of whom had brain surgery to remove intracranial meningioma between 2009 and 2018 (see “Data health: CNIL offers access to private entities” ).
Thus, they were able to observe that long-term use, that is, for a year or more, injection of 150 mg medroxyprogesterone acetate (Depo-Provera) was associated with a 5.6-fold increased risk of intracranial meningioma requiring surgery. Long-term use of medrogestone orally at a dose of 5 mg (Kolpron) was associated with a risk multiplied by 4.1, as well as the risk with 0.125 mg/0.5 mg oral progestone (Surgical stone) with a risk multiplied by 2.7.
However, according to their work, there is no risk if these progestins are used for less than a year. The researchers also did not notice any ” observed increased risk » for progesterone (Prometrium, Utrozhestan, Endometrin), dydrogesterone (Femoston) or intrauterine devices (IUDs) that release levonorgestrel, regardless of the dose they contain.
Millions of women affected
Women taking chlormadinone acetate (Belara, Ginorel, Lutheran, Prostal), nomegestrol acetate (Lutenil, Naemis, Zoeli) and cyproterone acetate showed ” excessive risk “, ” which is not surprising given that these foods are known to increase the risk of meningioma. “, the researchers point out. They were unable to conclude the effects of taking dienogest (Lafamme, Natasia, Claira) or hydroxyprogesterone (Delalyutin, Proluton, Makena) ” due to the small number of women receiving these drugs “.
” This is an observational study, so it cannot establish cause and effect. » Researchers clarify. Based on the database, they were unable to explain possible genetic predisposition to meningioma or exposure to high doses of radiation.
However, given that medroxyprogesterone acetate is used by 74 million women worldwide as a contraceptive,” the number of meningiomas caused by this drug may be high “.
A Call for Caution
” This information will speed up the transition from oral hormonal drugs to intrauterine devices. ” Susan Evans estimates (see Contraception: The IUD will have an effect far beyond the uterus). In the USA for the period 1995-2017. IUD use rose from 2% to 14% of contraceptive methods used, and oral contraceptive use fell from 31% to 22% (see Contraception, Very Common Among American Women).
The researchers also clarify that this study only looked at doses of 150 mg of medroxyprogesterone acetate, a product rarely used in France. So, ” there is an urgent need to conduct further studies in other countries that use it more widely to assess the risk of developing concomitant meningioma and to better understand the dose-response relationship. “(See Contraception: impact on brain anatomy?).
[1] N. Roland et al., Progestogen use and risk of intracranial meningioma: a national case-control study, BMJ 2024;384:e078078, doi: https://doi.org/10.1136/bmj-2023-078078 (published March 27 2024)
Source: New Atlas, Paul McClure (03/27/2024).
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