A recent case-control study published in JAMA Network Open found an association between several progestogen-containing contraceptives and an increased risk of meningioma, a usually benign brain tumor. The overall risk for any individual remains low, but specific products and patterns of use were linked to higher relative risks in the study population.
What the study examined
Researchers in Denmark compared 1,473 women diagnosed with meningioma to 14,717 matched controls without the tumor. Participants averaged about 48 years of age. For each case, investigators selected 10 controls with similar age, birthplace, and marital status to limit confounding factors.
Key findings
– Injectable medroxyprogesterone (Depo-Provera) showed the strongest association: current or recent users were about 4.6 times more likely to have a meningioma than nonusers.
– Intrauterine devices (IUDs) that release higher doses of levonorgestrel were associated with a roughly 1.58-fold increase in risk; lower-dose levonorgestrel IUDs had a smaller increase.
– Progesterone-only oral contraceptives were associated with about a 1.7-fold increased risk.
– Combined oral contraceptives (estrogen plus progestin) showed a slightly lower but still elevated association (about 1.6-fold).
Timing and duration
The study observed that the excess risk was strongest among women currently using progestogen products or who had used them within the past year. For most contraceptive types examined, the increased risk diminished over time after stopping use and was not apparent five years after discontinuation.
About meningioma
Meningiomas are the most common primary brain tumor affecting the central nervous system and are typically benign. They occur more often in females than males, and hormonally active medications have been hypothesized to influence their development. Symptoms can include new or worsening headaches, changes in vision, seizures, balance problems, or other neurological changes depending on tumor location.
Regulatory updates and clinical guidance
In 2025 the U.S. Food and Drug Administration updated Depo-Provera labeling to include a meningioma warning and recommends discontinuation of the medication if a meningioma is diagnosed. The European Medicines Agency has also revised recommendations for certain synthetic progestins (for example, nomegestrol and chlormadinone), advising that high doses be used only when necessary, for the shortest duration, and only if no suitable alternatives exist. Agencies recommend close monitoring of patients on these therapies for signs or symptoms suggestive of a meningioma.
What this means for contraceptive users
– Absolute risk: Although relative risks for some products were elevated, meningiomas remain uncommon overall. The majority are benign and many people using hormonal contraception will not develop a tumor.
– Shared decision-making: Health professionals should discuss relative versus absolute risk, benefits of contraception, individual preferences, and personal or family history of meningioma when advising patients. Using the lowest effective dose of progestogen for the shortest necessary time is a reasonable precaution when appropriate.
– Monitoring: People using high-dose progestogen products or those advised by their clinician to be at higher risk should be aware of symptoms such as persistent headaches, visual disturbances, new seizures, or focal neurological deficits and seek evaluation if these occur.
Bottom line
This study adds evidence that certain progestogen-containing contraceptives are associated with an increased risk of meningioma, particularly with current or recent use of specific formulations like injectable medroxyprogesterone and high-dose levonorgestrel IUDs. The increased risk tends to decline after stopping use. For most people, the benefits of contraception will outweigh the small absolute risk, but individuals and clinicians should discuss options, monitor symptoms, and choose the lowest effective dose and duration based on medical history and preferences.