Meningiomas are typically slow-growing tumors that arise from the meninges, the protective membranes surrounding the brain and spinal cord. While most meningiomas are benign (non-cancerous), their growth can compress surrounding brain tissue, nerves, or blood vessels, leading to a range of symptoms and potential neurological deficits. These symptoms can include headaches, vision changes (e.g., blurred vision, double vision), seizures, hearing loss, memory loss, and weakness in limbs. Surgical removal is often the primary treatment, but radiation therapy may also be used.
Risk Factors for Meningiomas:
Several factors are associated with an increased risk of developing meningiomas:
- Female Sex: Meningiomas are more common in women, suggesting a role for female hormones.
- Age: The risk generally increases with age.
- Radiation Exposure: Prior radiation therapy to the head is a known environmental risk factor.
- Genetic Conditions: Certain inherited nervous system conditions, such as neurofibromatosis type 2 (NF2), significantly increase the risk.
- Obesity: A higher body mass index (BMI) has been linked to an increased risk.
- Hormonal Factors: The presence of progesterone, estrogen, and androgen receptors on meningioma cells, and observations of tumor growth during pregnancy, suggest a role for hormones.
Depo-Provera (Medroxyproprogesterone Acetate) and Meningioma Risk:
Recent research, particularly a significant case-control study published in the British Medical Journal in March 2024, has highlighted a notable association between the prolonged use of certain progestins, including medroxyprogesterone acetate (MPA), the active ingredient in Depo-Provera, and an increased risk of intracranial meningiomas.
Here’s an overview of the findings and implications:
- Increased Risk with Prolonged Use: The study indicated that prolonged use (one year or more) of injectable MPA (Depo-Provera) was associated with a significantly higher risk of meningioma, with some reports suggesting a more than fivefold increase compared to non-users. The risk appears to increase with the duration of use and cumulative dosage.
- Absolute Risk Remains Low: While the relative risk is significantly increased, the absolute risk of developing a meningioma remains low given the rarity of these tumors. However, due to the widespread use of Depo-Provera globally, this finding is considered crucial.
- Benign Nature but Potential for Complications: Most meningiomas linked to Depo-Provera are benign. However, even benign tumors can cause serious health issues if they grow large enough to press on critical brain structures, often requiring surgical intervention.
- Hormonal Influence: The connection is thought to be related to the synthetic progesterone in Depo-Provera stimulating the growth of meningiomas, which often have progesterone receptors.
- Discontinuation of Treatment: If a meningioma is diagnosed, discontinuation of medroxyprogesterone acetate is generally recommended, as studies have shown that tumor volume may stabilize or even regress after stopping the progestin.
- Lack of US Label Warnings (as of early 2025): While some international regulatory bodies and manufacturers have updated product labels to include warnings about meningioma risk, there have been concerns that similar warnings have not been consistently added to U.S. labels, potentially leaving users unaware of this risk.
- Legal Action: This emerging evidence has led to lawsuits being filed against the manufacturer of Depo-Provera, alleging a failure to adequately warn users about the potential risk of meningiomas.
Important Considerations for Patients:
- If you are currently using Depo-Provera or have used it long-term and have concerns, it’s crucial to discuss these with your healthcare provider.
- Be aware of potential symptoms of meningioma, such as persistent headaches, changes in vision, seizures, or other neurological symptoms, and report them to your doctor.
- The decision to use any contraceptive should involve a thorough discussion with a healthcare professional, weighing the benefits against potential risks based on individual health history and circumstances.
In summary, while meningiomas are generally rare, recent studies suggest a significantly increased risk with prolonged use of Depo-Provera, a risk attributed to the progestin component. This information is important for both healthcare providers and individuals considering or using Depo-Provera for contraception.
Ochs Law Firm is currently reviewing potential meningioma cases involving Depo-Provera exposure. Consults are always free. Text us directly on our website, confidentially.
