Using the progestogen-only contractive pill “desogestrel” for more than five years may increase the risk of developing a type of brain tumor known as an “intracranial meningioma,” a new study has warned.
The researchers noted that the risk is low—and is eliminated one year after desogestrel treatment is suspended—but that doctors’ awareness of the possibility could eliminate the need for surgery in some cases.
Meningiomas are a rare, non-cancerous form of tumor that arise from the membranes surrounding the brain. While slow-growing and benign in and of themselves, they can develop to a size that compresses other structures in the brain.
They usually only require surgery when they cause symptoms such as persistent headaches or neurological issues.
The study, based on data from France’s national health system, compared over 8,000 women who underwent surgery for meningioma between 2020 and 2023 with more than 83,000 matched controls.
Researchers found that women who had taken desogestrel continuously for more than five years had a slightly elevated risk of developing the brain tumors.
Reassuringly, no increased risk was found for short-term use or for other commonly used progestogens like levonorgestrel, either alone or combined with estrogen.
“This large study using French national database… shows [an] 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,” said paper author Dr. Mangesh Thorat of Queen Mary University of London in a statement.
Short-term use does not increase risk and the risk ceases after stopping use, he added.
The authors estimate that one woman in every 67,000 using desogestrel would need surgery for meningioma and this drops to 1 in 17,000 with continuous use beyond five years.
By comparison, breast cancer is about 10 times more common than meningioma.
To understand progestogens, Thorat said it’s crucial to note that the effects of different drug formulations can vary significantly and individual drugs can affect various organs differently.
“Therefore, it is important to consider which specific drug is being used by an individual,” he said.
The study also showed that Microgynon and the morning-after pill—both containing levonorgestrel—were not linked to increased risk.
Still, the findings have clinical relevance, especially for women over 45 or those with a prior history of using other high-risk progestogens.
In such cases, the study suggests discontinuing desogestrel if a meningioma is identified, rather than jumping straight to surgery.
“Stopping desogestrel may also avoid unnecessary potentially harmful treatments,” said neurosurgeon Gilles Reuter of the University Hospital Liegein an accompanying editorial.
Reuter emphasized that similar results have already been seen with other high-risk progestogens.
While the study is observational and cannot prove cause and effect, its large sample size adds weight to the findings. However, experts say the takeaway should be caution, not alarm.
For those affected by the findings, Thorat advises speaking with a healthcare provider regarding which drug is being used.
“If it is associated with an increased risk of meningioma, this can be changed to a safer alternative,” he said.
“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.”
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References
Roland, N., Kolla, E., Baricault, B., Dayani, P., Duranteau, L., Froelich, S., Zureik, M., & Weill, A. (2025). Oral contraceptives with progestogens desogestrel or levonorgestrel and risk of intracranial meningioma: National case-control study. BMJ, 389. https://doi.org/10.1136/bmj-2024-083981
Reuter, G. (2025). Progestogens and meningioma: New evidence on levonorgestrel and desogestrel. BMJ, 389. https://doi.org/10.1136/bmj.r1095
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