Medrogestone, medroxyprogesterone, and promegestone are progestins synthetically derived from progesterone. At the beginning of 2024, in France, medrogestone (Colprone°) is authorized for various gynecological disorders. Medroxyprogesterone is authorized as an injectable contraceptive (Dépo-Provera°), in certain breast or endometrial cancers (Dépo-Prodasone°) or combined with an estrogen in hormone replacement therapy for menopause (Divina°, Duova°) . Promegestone (formerly Surgestone°) has no longer been marketed in France since 2020.
An epidemiological study carried out using the French National Health Data System (SNDS), the results of which were made public in 2023, focused on surgical interventions for intracranial meningioma after exposure to one of these 3 progestins. In view of these results, the French Medicines Agency (ANSM) has recommended no longer using medrogestone for symptoms linked to menopause, menstrual cycle irregularities, dysmenorrhea and moderate breast pain. She decided to maintain the contraceptive indication of medroxyprogesterone (Dépo-Provera°), as a last resort.
In patients exposed to one of these 3 progestins, the ANSM particularly recommends monitoring by brain MRI. The alignment of the recommendations concerning medrogestone and medroxyprogesterone with those already in place for several progestins (chlormadinone, cyproterone, nomegestrol is a coherent measure. More broadly, it is prudent to take into account the risk of meningioma whatever the progestogen , including those used long-term as oral contraceptives.
The data available in mid-2024 do not show an increased risk of meningioma with intrauterine devices dosed with 52 mg of levonorgestrel (Mirena° or other).
Prepared by the Editorial Team
©Prescrire June 1, 2024
• Full text:
“Medrogestone, medroxyprogesterone, promegestone: monitoring by brain MRI due to the risk of meningioma” Rev Prescrire 2024; 44 (488): 423-424. Reserved for subscribers.
