Contraceptive Hormones Associated with Brain Tumors Medroxyprogesterone Acetate, Promegestone, Medrogestone

It is already known that high-dose exposure to certain progestogens increases the risk of this tumor, but these are rarely used in clinical practice. However, there are many more that have not been evaluated individually.

The study further analyzed eight types to assess the risk of tumors requiring surgery.

It found that three types of long-term use increased the risk of surgery. Promegestone he increased 2.7 times. In Medrogeston, it was 4.1 times higher. For medroxyprogesterone acetate (MPA), it was 5.6 times higher.

There appears to be no risk if used for less than a year.

Gino Pecoraro, associate professor of obstetrics and gynecology at the University of Queensland, said the first two were not available in Australia.

However, MPAs (Depo-Provera and Depo-Lalovera) were available and consisted of injections given intramuscularly every three months, he said.

An estimated 74 million women worldwide use MPA for contraception.

In Australia, Depo-Provera lists meningioma in the “Special Warnings and Precautions'' section of the product information.

It states that “meningiomas have been reported after long-term administration of progestins containing MPA.” If a meningioma is diagnosed, MPA should be discontinued. Caution should be used when recommending medroxyprogesterone to patients with a history of meningioma. ”

This study found no excess risk for progesterone, dydrogesterone, or intrauterine devices that release. Levonorgestrel Delivered into the uterus for contraception. The use of IUDs (Mirena) is increasing in Australia.

“Australian women should be reassured that the majority of contraceptives available and used in this country are not associated with an increased risk of developing meningioma,” Professor Pecoraro said.

The findings of this study should serve as a timely reminder to women: Regularly review the need for contraceptionHe said.

“The World Health Organization says Australia is an outlier among OECD countries in that it still relies heavily on the pill as a contraceptive method and does not use others such as implants or IUDs.”

No conclusions could be drawn about the remaining two hormones, hydroxyprogesterone and dienogest, because too few women were exposed to them.

Intrauterine device preferences

Researchers used French national health data and based their findings on 18,000 women with an average age of 58 who underwent surgery for meningiomas between 2009 and 2018.

Each case was matched with five tumor-free control women, resulting in a study population of approximately 108,000 people.

Associate Professor Susan Evans from the University of Adelaide told the Australian Science Media Center that the study's results were likely to accelerate a shift in preference from oral hormones to intrauterine devices.

Dr Evans, a gynecologist and pelvic pain specialist, said it was important that the use of IUDs, including Mirena, had not been found to increase the risk of meningiomas.

“This information will further accelerate the shift in preference from oral hormones to intrauterine devices.”

The study was observational, and although it was possible to identify an association, it was not possible to determine causation.

Paul Pharoah, a professor of cancer epidemiology at Cedars-Sinai Medical Center, said the association reported for medroxyprogesterone acetate is likely causal.

Although the risks seem great, “it's important to recognize that meningiomas are rare and will remain rare even with a five-fold increase in rare diseases,” he said. .

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