Do progestogens in contraceptives increase the risk of developing meningioma?

Meningioma is the most common intracranial tumour in adults, representing 38%–42% of all primary central nervous system tumours. It is benign in about 90% of cases, but can cause seizures, cognitive impairment and focal neurological deficits, and often requires surgery and/or radiotherapy with risks of complications and recurrence. The incidence of meningioma is consistently higher in women, supporting a hormonal role in meningioma development. Tumour growth has been described during pregnancy and with progestogen therapy, followed by tumour regression after delivery or after withdrawal of progestogen treatment.An increased risk of meningioma has been established for several high-dose progestogens. However, evidence is conflicting for progestogens used as hormonal contraceptives, with only some studies reporting an association. Due to the potentially serious consequences of meningioma, it is important to investigate whether progestogens used for contraception also carry this risk. To examine this issue, researchers conducted a study to determine whether different progestogens used as hormonal contraception are associated with increased risk of meningiomas. The nested case-control study was conducted over a 25-year period (2000–2024) using a Danish nationwide population-based register, which included 3,078,410 females aged 15–59 years. Meningioma cases were identified, and for each case, 10 controls were matched based on age, birthplace and marital status. Progestogen use was identified by date of dispensing or procedural records, and grouped by route of administration and active substance. Exposure time was determined by daily doses dispensed or duration of use. If a female switched to a different product or became pregnant, her exposure time was changed to the new exposure. Females included in the study were allocated to their most recent use, defined as the exposure closest to the matching date. The main outcome was incident (first-time) meningioma. Key results:The nested cohort included a total of 1,473 cases and 14,717 controls (median age 48 years).For combined oral contraceptives, the estimated odds ratios (ORs) for the association between use of progestogens and meningioma were:1.66 (95%CI, 1.31–2.10) with desogestrel1.61 (95%CI, 1.00–2.59) with cyproterone1.58 (95%CI, 1.05–2.37) with drospirenone1.44 (95%CI, 1.17–1.77) with gestodene (not marketed in Canada)1.40 (95%CI, 1.12–1.76) with levonorgestrel1.38 (95%CI, 0.77–2.47) with norethisterone (norethindrone), and 1.04 (95%CI, 0.70–1.54) with norgestimate. For injectable medroxyprogesterone, the OR was 4.55 (95%CI, 2.19–9.45). For intrauterine devices (IUDs) with high-dose levonorgestrel (52 mg), the OR was 1.58 (95%CI, 1.28–1.94), and for IUDs with low-dose levonorgestrel (13.5 or 19.5 mg), the OR was 1.14 (95%CI, 0.59–2.22). Exposure within the past year was associated with the highest risk. Generally, five years after discontinuation, the increased risk was no longer present.The authors conclude that in this case-control study using data from the entire Danish population of females, recent use of the following contraceptive progestogens was associated with increased risk of meningioma: cyproterone, desogestrel, drospirenone, gestodene (not marketed in Canada), levonorgestrel, injectable medroxyprogesterone, and high-dose levonorgestrel IUD. The risk estimates were highest for medroxyprogesterone injections. The researchers consider their findings to be relevant information that should be conveyed to prescribing healthcare professionals and women seeking contraception.Reference:Lundstrøm NH, Knudgaard MH, Pedersen MS, et al. Contraceptive progestogens and incident meningioma. JAMA Network Open 2026;9(7):e2622603. (accessed July 7, 2026).

Do progestogens in contraceptives increase the risk of developing meningioma?

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