Medroxyprogesterone Acetate and Meningioma: A Global Concern

What is Medroxyprogesterone Acetate (DMPA)?

Medroxyprogesterone acetate (DMPA) is a widely prescribed injectable progestogen contraceptive used by 74 million women worldwide each year. This contraceptive is particularly valued for its high effectiveness and ease of administration. DMPA is administered as an intramuscular injection (150 mg/ml) or a subcutaneous injection (104 mg/0.65 ml) every three months.

Its usage varies significantly between countries: 1.8% of women aged 15 to 49 in high-income countries use it, compared to 8.7% in low-income countries. Inexpensive, it is particularly widespread in countries with strong family planning policies, especially in Southeast Asia, where 13% of women use it, amounting to approximately 22 million users per year.

Global Distribution of DMPA Usage

• Indonesia: 25% of women (17 million users, the largest consumer worldwide)
• Myanmar: 20% of women (2.5 million)
• Thailand: 5 to 10% of women (1.5 to 2 million)
• Cambodia: 300,000 women
• Laos: 200,000 women
• Philippines: 3.3% of women (900,000)
• Malaysia: 1% of women (300,000)
• Africa:
  • Malawi: 33.6% of women (1.1 million)
  • Ethiopia: 21% of women (4.6 million)
  • South Africa: 23.4% of women (3.6 million)
• Australia: 1% of women (2015)
• United States: 25.4% of women aged 15 to 44 have used DMPA at least once in their lifetime, with 2.6% annual users (1.7 million women).
  

Side Effects and Risks of DMPA

While DMPA is an effective and widely used contraceptive, it presents notable side effects, some of which can be severe:

• Weight gain
• Menstrual irregularities
• Mood changes
• Osteoporosis
• Increased risk of arterio-venous thrombosis
  

The Risk of Meningioma Associated with DMPA

In addition to these well-documented side effects, the risk of meningioma has been highlighted by several international scientific publications. This risk had already been observed with other progesterone-derived medications. Now, DMPA is also under medical scrutiny due to this emerging concern.

Conclusion

Medroxyprogesterone acetate is a widely used contraceptive, particularly in Asia and Africa. However, its side effects, especially its potential link to meningioma, raise significant public health concerns. It is crucial to continue researchand inform both patients and healthcare professionals about these risks to ensure the safe use of DMPA.

Full article: https://www.frontiersin.org/journals/global-womens-health/articles/10.3389/fgwh.2025.1470539