Long-Term Use of Desogestrel Contraceptive Associated with Slight Increase in Brain Tumor Risk

Recent research from France indicates that women who use the progestogen-only contraceptive pill desogestrel continuously for over five years may have a slightly elevated risk of developing intracranial meningiomas — a type of typically benign brain tumor. Published in The BMJ, the study emphasizes that while the observed risk is small, it warrants attention for long-term users.

Intracranial meningiomas are usually non-cancerous tumors that develop in the membranes surrounding the brain. They are more frequently diagnosed in older women. Historically, many studies have not differentiated between types of progestogens used, nor have they adequately measured the risk associated with ongoing, long-term use of specific contraceptives.

To explore this gap, researchers analyzed data from the French national health database, focusing on 8,391 women who underwent surgical removal of intracranial meningiomas between 2020 and 2023, with an average age of 60. Each case was compared to ten women without meningioma, matching for age and area of residence, totaling 83,910 controls. The study considered various factors, including prior use of high-risk progestogens.

Findings reveal that prolonged (more than five years) use of desogestrel correlates with a small increase in meningioma risk. This increased risk diminishes within a year after discontinuing the medication. Importantly, no such risk boost was observed with levonorgestrel, another progestogen, whether used alone or combined with estrogen.

The researchers estimate that among 67,000 women using desogestrel, one might require surgery due to meningioma, with this risk rising to one in 17,000 for women on long-term (over five-year) use. The study also notes that women over 45, or with tumors located in the front or middle of the brain, are at higher risk, especially if they have previously used other high-risk progestogens.

Although this is an observational study, which cannot prove causality, the use of comprehensive real-world data enhances its reliability. The authors suggest that women diagnosed with meningiomas should consider discontinuing desogestrel, potentially avoiding the need for surgery. Supporting this, neurosurgeon Gilles Reuter highlights that stopping certain progestogens can prevent invasive treatments.

In contrast, no increased risk was associated with levonorgestrel, indicating it may be a safer alternative for women concerned about tumor risks. However, further research is needed to fully understand the mechanisms and establish firm clinical guidelines.

For more details, refer to the original study published in The BMJ: DOI: 10.1136/bmj-2024-083981. Source: https://medicalxpress.com/news/2025-06-prolonged-desogestrel-pill-linked-small.html