The contraceptive injection Depo-Provera and two drugs used for menopause relief could be linked to a heightened risk for brain tumors in some women, a new study warns.
Depo-Provera (medroxyprogesterone acetate) increased the risk of intracranial meningioma 5.6-fold if used for longer than a year, researchers report in the BMJ.
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“In countries for which the use of medroxyprogesterone acetate for birth control is frequent [74 million users worldwide], the number of attributable meningiomas may be potentially high,” concluded the research team led by Noémie Roland, a general practitioner and epidemiologist with French National Health Insurance in Saint-Denis, France.
Further, the menopausal hormone therapy drugs medrogestone and promegestone increased the risk of intracranial meningiomas by 4.1-fold and 2.7-fold, respectively, results show.
Intracranial meningiomas are mostly non-cancerous tumors that grow in the layers of tissue that cover the brain and spinal cord, researchers said. Meningiomas account for 40% of cancers in the central nervous system.
The three drugs all contained progestogens, which are similar to the natural hormone progesterone. This class of drugs also are used to treat conditions like endometriosis and ovarian cysts.
For the study, researchers analyzed French health system data for more than 18,000 women who underwent surgery for intracranial meningioma between 2009 and 2018.
Each case was matched to five other women who didn’t have an intracranial meningioma.
The research team tracked women’s use of the progestogen drugs progesterone, hydroxyprogesterone, dydrogesterone, medrogestone, medroxyprogesterone acetate, promegestone, dienogest and levonorgestrel.
Prolonged use was defined as a year or more, as there appeared to be no risk posed by using the drugs for less than one year, researchers said.
None of the other drugs showed an increased risk for meningioma, including levonorgestrel, a hormone used in IUD contraceptive devices and in emergency contraceptives like Plan B.
Researchers warned that because this was an observational study, it couldn’t draw a direct cause-and-effect link between the drugs and brain tumors.
More research is needed to understand why these specific drugs might increase tumor risk in some women.
“Future studies should further clarify the association between the duration of use and risk for the progestogens studied,” the team said.
Progesterone receptors are present in more than 60% of meningiomas, which could provide one potential explanation, researchers said.