JAMA Neurol

Injectable contraceptive linked to higher meningioma risk

September 4, 2025

Study details: A retrospective, population-based cohort study utilized the TriNetX US national database (2004–2024) to assess the incidence of meningioma among women exposed to depot medroxyprogesterone acetate (DMPA), oral medroxyprogesterone acetate, combined oral contraceptives, IUDs, progestin-only pills, or subdermal implants, compared with unexposed controls. Propensity-score matching was applied to minimize confounding. The final cohort included 10,425,438 women (mean age, 33.4 years), with 88,667 in the DMPA group (mean age, 26.2 years).

Results: DMPA use was associated with a significantly increased relative risk (RR, 2.43; 95% confidence interval [CI], 1.77–3.33) of meningioma diagnosis vs. controls. The elevated risk was confined to women with >4 years of DMPA exposure or those initiating DMPA after age 31. Oral medroxyprogesterone acetate also showed a modestly increased risk (RR, 1.18; 95% CI, 1.10–1.27). No increased risk was observed with other contraceptives. The number needed to harm was 1,152 for DMPA and 3,020 for oral medroxyprogesterone acetate.

Clinical impact: While DMPA confers a higher relative risk of meningioma, especially with prolonged use or later initiation, the absolute risk remains low given the high number needed to harm. These findings support continued vigilance in long-term DMPA users, particularly those starting at older ages.

Source:

Xiao T, et al. (2025, September 2). JAMA Neurol. Depot Medroxyprogesterone Acetate and Risk of Meningioma in the US. https://pubmed.ncbi.nlm.nih.gov/40892397/