A LARGE Danish study has linked several contraceptive progestogens to a higher risk of meningioma, with the strongest association seen for injectable medroxyprogesterone and desogestrel-containing methods, prompting fresh questions about long-term surveillance for women using hormonal contraception.
Progesterone’s Long-Suspected Role in Tumour Growth
Meningioma was the most common intracranial tumour in adults, making up nearly 40% of primary central nervous system tumours, and occurred far more often in women than men. Progesterone receptors were found in up to 87% of these tumours, and case reports had long described growth during pregnancy or progestogen treatment, followed by regression after stopping, supporting a hormonal explanation.
Tracking Contraceptive Progestogens and Meningioma Cases Over 25 Years
Danish researchers ran a nested case-control study using nationwide registers covering the population from 2000 to 2024. Among 3 million women aged 15 to 59, 1,473 diagnosed with meningioma were matched with 14,717 controls, at a ratio of ten controls per case, on age, birthplace and marital status. Exposure to contraceptive progestogens, including combined pills, progestogen-only pills, injections and intrauterine devices, was tracked through prescription records. Women who had used hormone replacement therapy, antiandrogens or fertility treatment beforehand were excluded. The primary outcome was incident meningioma confirmed via the National Cancer Register.
Odds Ratios Varied by Drug and Duration of Use
Risk varied by progestogen and route of administration. Among combined oral contraceptives, odds ratios ranged from 1.04 (95% CI, 0.70 to 1.54) for norgestimate to 1.66 (95% CI, 1.31 to 2.10) for desogestrel, with similar increases for cyproterone, drospirenone, gestodene and levonorgestrel. Desogestrel taken as a progestogen-only pill carried an odds ratio of 1.73 (95% CI, 1.17 to 2.56). Injectable medroxyprogesterone showed the highest risk, with an odds ratio of 4.55 (95% CI, 2.19 to 9.45), while high-dose levonorgestrel intrauterine devices carried an odds ratio of 1.58 (95% CI, 1.28 to 1.94) after more than a year of use. Current use within the past year carried the highest risk of meningioma, and elevated risk generally disappeared five years after stopping.
What the Findings Mean for Contraceptive Counselling
The authors concluded that the risk extended beyond high-dose progestogens already flagged by regulators, though absolute risk remained very low. Risk fell after stopping treatment, and they advised clinicians to weigh individual risk when prescribing contraception.
Reference
Hasselblad Lundstrøm N et al. Contraceptive Progestogens and Incident Meningioma. JAMA Netw Open. 2026;9(7):e2622603.
Featured image: Karyna on Adobe Stock
- Author:
