After Androcur (cyproterone), Lutéran (chlormadinone), Lutényl (nomegestrol), Dépo-Provéra (medroxyprogesterone), Colprone (medrogestone) and Surgestone (promegestone), the examination of the risk of meningioma linked to taking progestins continues with contraceptives oral medications widely prescribed in France.
Levonorgestrel ruled out
The Epi-Phare case-control study included 8,391 French women operated on for an intracranial meningioma between 2020 and 2023. Good news, the use of levonorgestrel (30 µg) or levonorgestrel-ethinylestradiol (50 µg-150 µg) does not increase the risk of meningioma regardless of the duration of exposure.
A risk for desogestrel
It is not the same, however, for the desogestrel 75 µg. The study showed a very small increase in the risk of meningioma in women aged over 45 years during prolonged and ongoing use of desogestrel. This risk appears after five years of use and doubles after seven years of treatment, while remaining much lower than that linked to taking the progestins already studied mentioned above. This additional risk disappears after stopping for more than a year. For the record, the risk with cyproterone acetate is multiplied by 7 after six months of treatment and by 20 after five years.
On average, the authors of the study estimate that “one case of operated intracranial meningioma is observed for 67,000 women exposed to desogestrel regardless of the duration of exposure and one case for 17,000 women exposed for more than five years”. No risk of meningioma has been noted if desogestrel has been used for less than a year, unless the woman has previously taken other risky progestins.
The new recommendations
While awaiting risk reduction measures announced for early 2025, the National Medicines Safety Agency (ANSM) recommends that women taking Antigone, Optimizette, Cerazette, Elfasette or Desogestrel 75 mcg not stop their contraception without the advice of their doctor. a health professional. And, above all, consult a doctor, gynecologist or midwife if signs suggestive of meningioma appear: frequent headaches, vision, language, hearing, smell or memory problems, paralysis, dizziness. , convulsions…
The Agency also reminds that desogestrel is not a hormonal treatment for menopause. And that no progestin treatment should be prescribed to women with a history of meningioma or an existing meningioma.
