WARNING: DepoP and Meningiomas

Depo-Provera was approved in 1992 by U.S. regulators. About 1 in 4 sexually active women in the United States have used the shot at some point, according to the U.S. Centers for Disease Control and Prevention (CDC). Meningiomas are common intracranial tumors with a female predominance. In fact, they are the most common primary brain tumor in women, with an incidence of approximately 12.76 per 100,000 in the general female population. The vast majority of these tumors are benign (World Health Organization [WHO] grade 1) while 15% to 20% of these tumors can behave atypically (WHO grade 2) and rarely, in 1% to 2% of cases, these tumors can be malignant (WHO grade 3). We covered the relationship between Depo-Provera, as a contraceptive agent, and brain meningiomas back in March 2024. With the increase in data, the ACOG released a patient centered counseling tool titled, “Counseling Patients on Birth Control Injection and Meningioma”. The most recent update on this story comes from the FDA, which has granted a medication label change to Depo-Provera (Pfizer) warning of this association. Even though association does not prove causation, the association between depo and meningiomas seems strong (with new data from the US). Does this warning extend to other progestins? Listen in for details. 1. https://podcasts.apple.com/us/podcast/dr-chapas-obgyn-clinical-pearls/id1412385746?i=10006508795722. ACOG’s “Counseling Patients on Birth Control Injection and Meningioma” 3. https://www.statnews.com/pharmalot/2025/12/17/fda-pfizer-contraception-cancer-preemption-depoprovera/4. Xiao T, Kumar P, Lobbous M, et al. Depot Medroxyprogesterone Acetate and Risk of Meningioma in the US. JAMA Neurology. 2025;82(11):1094-1102. doi:10.1001/jamaneurol.2025.3011.5. de Dios E, Näslund O, Choudhry M, et al.Prevalence and Symptoms of Incidental Meningiomas: A Population-Based Study.Acta Neurochirurgica. 2025;167(1):98. doi:10.1007/s00701-025-06506-7.6. Schaff LR, Mellinghoff IK.Glioblastoma and Other Primary Brain Malignancies in Adults: A Review. JAMA. 2023;329(7):574-587. doi:10.1001/jama.2023.0023.7. BMJ 2024; 384 doi: https://doi.org/10.1136/bmj-2023-078078 (Published 27 March 2024) Cite this as: BMJ 2024;384:e078078