Taking the progestogen-only contraceptive tablet desogestrel repeatedly for greater than 5 years is related to a small elevated danger of creating a kind of mind tumor referred to as an intracranial meningioma, finds a research from France revealed by The BMJ.
Nonetheless, the researchers stress that the chance is low in contrast with another progestogens (for each 67,000 ladies taking desogestrel, one would possibly want surgical procedure for meningioma) and disappears one 12 months after stopping therapy.
Intracranial meningiomas are usually non-cancerous mind tumors that often require surgical procedure. They’re extra widespread in older ladies, however many research lack info on the precise sort of progestogen used, and danger has not been measured for steady, present, and long-term use.
To deal with this information hole, researchers got down to assess the real-life danger of intracranial meningioma related to short-term (lower than one 12 months) and extended (one to seven or extra years) use of oral contraceptives containing desogestrel 75µg, levonorgestrel 30µg, or levonorgestrel 50–150 µg mixed with estrogen.
Their findings are primarily based on information from the French nationwide well being information system (SNDS) for 8,391 ladies (common age 60; 75% older than 45) who had undergone surgical procedure for intracranial meningioma in 2020–2023. Every case was matched to 10 management ladies with out meningioma (complete 83,910) of the identical age and space of residence.
Probably influential elements, together with using a identified high-risk progestogen within the six years earlier than the research, have been taken into consideration.
The outcomes present a small elevated danger related to use of desogestrel for greater than 5 steady years.
An elevated danger was not discovered for shorter durations or when desogestrel had been discontinued for multiple 12 months, but it surely was if different progestogens of identified related elevated danger of meningioma had been used within the six years earlier than desogestrel.
This extra danger was better in ladies older than 45 years, these with a meningioma situated within the entrance or center of the cranium, and after extended use of one of many identified excessive danger progestogens earlier than desogestrel.
The authors estimate that 67,000 ladies would want to make use of desogestrel for one lady to want surgical procedure for intracranial meningioma, and 17,000 ladies if present use was for greater than 5 years.
Reassuringly, no elevated danger of meningioma was discovered for levonorgestrel, alone or mixed with estrogen, no matter period of use.
That is an observational research so cannot set up trigger and impact, and the authors acknowledge that some info could also be lacking from the SNDS database. Nor have been they capable of account for genetic predisposition and publicity to high-dose radiation—elements that will have affected the outcomes.
Nonetheless, by utilizing complete, real-life information, together with historical past of utilizing different identified high-risk progestogens, they have been capable of enhance reliability and reduce bias.
As such, they recommend that desogestrel needs to be discontinued if an intracranial meningioma is recognized and sufferers monitored somewhat than present process quick surgical procedure.
Though direct proof continues to be missing, stopping therapy when desogestrel-related meningioma is identified might preclude the necessity for surgical procedure, says neurosurgeon Gilles Reuter in a linked editorial.
“It’s already widespread information that stopping cyproterone, nomegestrol, chlormadinone, promegestone, medroxyprogesterone, or medrogestone precludes the necessity for surgical procedure,” he explains. “Now we all know that stopping desogestrel can also keep away from pointless probably dangerous remedies.”
Extra info:
Oral contraceptives with progestogens desogestrel or levonorgestrel and danger of intracranial meningioma: nationwide case-control research, The BMJ (2025). DOI: 10.1136/bmj-2024-083981
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Extended use of desogestrel tablet linked to small elevated mind tumor danger (2025, June 11)
retrieved 11 June 2025
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