American researchers have found that women who use the injectable contraceptive depot medroxyprogesterone acetate, as well as its oral form, have an increased risk of developing meningioma—one of the most common types of brain tumors. In contrast, the use of combined oral contraceptives and intrauterine systems is associated with a reduced likelihood of such pathologies.

What is depot medroxyprogesterone acetate?

Depot medroxyprogesterone acetate, known by the brand name “Depo-Provera,” is used not only for contraception but also as part of hormone therapy during menopause, for the treatment of endometriosis, abnormal uterine bleeding, and certain types of cancer.

Previously identified cases and prevalence of meningiomas

There have already been reports in France and the USA of cases where meningiomas were detected and surgically removed in patients who had received such injections. Meningiomas are among the most common brain tumors. Most often, they are benign and can be surgically removed, but malignant forms also occur.

Study design

A group of American physicians analyzed data from the national TriNetX medical database to assess the frequency of meningiomas in women who used depot medroxyprogesterone acetate. The retrospective analysis also included patients who used other forms of hormonal contraception: combined oral contraceptives, intrauterine devices, subcutaneous implants, and others. The control group consisted of women who did not use hormonal contraceptives. In total, more than 61 million cases were reviewed over a 20-year period—from December 2004 to December 2024.

Main findings

The study results, published in JAMA Neurology, showed that the risk of developing meningioma in women who received injectable contraceptives was nearly 2.5 times higher than in women from the control group. The incidence rate was 7.39 cases per 100,000 patient-years compared to 3.05 cases in the control group. The duration of hormonal therapy had a significant impact: using the drug for four to six years increased the risk by 200%, and with longer use, by 290%.

Age at the start of therapy also influenced the likelihood of developing a tumor. If injections began between ages 31–40, the risk increased by 277%; between 41–50 years, by 175%; and for women over 50, by 220%.

Taking the oral form of medroxyprogesterone acetate increased the risk of meningioma by 18% compared to the control group.

Impact of other contraceptive methods

None of the other hormonal contraceptive methods studied showed a similar effect. Moreover, the use of combined oral contraceptives was associated with a 26% reduction in the risk of meningioma. The use of intrauterine systems reduced the likelihood of brain tumors by 13%, and for women with IUDs containing 52 mg of levonorgestrel, the risk reduction reached 26%.

Additional risks

However, scientific literature also contains concerning data about combined oral contraceptives: recent studies have shown that such drugs can triple the risk of cryptogenic ischemic stroke.