June 11, 2025

expert reaction to study looking at the association between prolonged use of progestogen contraceptive pill (desogestrel) and risk of brain tumour

A study published in The BMJ looks at the use of the progesterone contraceptive pill and brain tumour risk. 

Dr Karen Noble, Director of Research, Policy and Innovation at Brain Tumour Research, said:

“This study adds to the growing body of evidence around hormone-related risk factors for brain tumours. While it identifies a small increased risk of intracranial meningioma associated with long-term use of desogestrel oral contraceptives, it’s vital to stress that this is a correlation, not proof of causation. Most women taking desogestrel will not develop a brain tumour, and the overall risk remains low. However, the findings do reinforce the critical importance of sustained investment in research into brain tumours, which historically has received just 1% of the national spend on cancer research since records began in 2002.”

Dr Mangesh Thorat, Honorary Reader in Wolfson Institute of Population Health, Queen Mary University of London and Consultant Breast Surgeon, Homerton University Hospital, said:

“This large study using French national database is second in the series of studies by the same group, addressing some of the limitations of their previous study published last year. It shows association between taking a certain progestogen (desogestrel) continuously for more than five years and meningioma risk, however, the magnitude of increase in the risk is small, and short-term use is not associated with increased risk and that the excess risk ceases to exist once the use is stopped for more than a year. These results however do not give any reasons for women using progestogens to panic.”

What are progestogens?

“Progestogens are medicinal analogues of naturally produced female hormone progesterone. These are a common component of contraceptive agents, hormone replacement therapy and other hormonal treatments. Two important things to know about these are: first, effects of different formulations vary sometimes substantially and second, the effect of individual drug varies on different organs within our body. Therefore, it is important to consider which specific drug is being used by an individual.”

What is meningioma?

“Meningioma is a tumour of coverings of our brain and more than 90% of these are not cancerous. This is a rare tumour, for example, breast cancer is 10-times more common and it is even rarer in young individuals. A proportion of these need to be treated surgically as they increase pressure on the brain and / or nerves. The most common symptoms are persistent headache, and feeling sick all the time often with drowsiness.”

How much of the risk is attributable to these drugs?

“Recent studies and a similar study by the same group last year showed that 6 out of more than a dozen progestogen formulations to be associated with significant increase in the risk of developing meningioma. However, these 6 drugs put together account for just over 10% of all meningiomas in women. This study shows that 1 additional drug to be associated with meningioma risk, but the magnitude of increase in the risk is much smaller. In other words, a vast majority of meningioma would occur without use of such drugs.

“Importantly, this study also shows that many progestogens, for example commonly used tablets like Microgynon or the morning after pill to be completely safe, without any increase in the risk of meningioma.”

What should individuals using progestogens do?

“Talk to your healthcare provider regarding the drug you are using. If it is associated with an increased risk of meningioma, this can be changed to a safer alternative. There is no reason to panic as the risk is very small and even in those who developed meningioma, stopping the specific drug has shown to cause regression in the size of meningioma.”

More research is needed:

“Although this is a large study, all studies have limitations. This study could not investigate the over-the-counter use of contraceptives. Furthermore, the study cannot provide information on the formulations not commonly used in France but used in other countries. This therefore underscores the need for further research using similar databases in other nations.”

‘Oral contraceptives with progestogens desogestrel or levonorgestrel and risk of intracranial meningioma: national case-control study’ by Noémie Roland et al. was published in The BMJ at 23:30 hours UK time Wednesday 11 June 2025.

DOI: 10.1136/bmj-2024-083981

Declared interests

Dr Mangesh Thorat: No conflicts.

For all other experts, no reply to our request for DOIs was received.