{"id":17053,"date":"2025-09-09T14:39:33","date_gmt":"2025-09-09T12:39:33","guid":{"rendered":"https:\/\/www.neurochirurgie-lariboisiere.com\/?p=17053"},"modified":"2026-03-30T10:33:05","modified_gmt":"2026-03-30T08:33:05","slug":"oral-contraceptives-and-risk-of-intracranial-meningioma-insights-from-a-french-nationwide-study","status":"publish","type":"post","link":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/2025\/09\/09\/oral-contraceptives-and-risk-of-intracranial-meningioma-insights-from-a-french-nationwide-study\/","title":{"rendered":"Oral contraceptives and risk of intracranial meningioma: insights from a French nationwide study"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Introduction<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">A recent case-control study based on the <strong>French National Health Data System (SNDS)<\/strong> assessed the association between the use of progestin-only oral contraceptives and the risk of intracranial meningioma requiring surgery. This large-scale analysis, including more than 92,000 women in France, provides important insights for clinical practice.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Methods<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Study population<\/strong>: 8,391 women who underwent surgery for intracranial meningioma between 2020 and 2023, matched with 83,910 controls without meningioma (matched on age and place of residence).<\/li>\n\n\n\n<li><strong>Exposure<\/strong>: use of desogestrel 75 \u00b5g, levonorgestrel 30 \u00b5g, or levonorgestrel (50\u2013150 \u00b5g) combined with estrogen.<\/li>\n\n\n\n<li><strong>Duration of use<\/strong>:\n<ul class=\"wp-block-list\">\n<li>short-term (&lt;1 year);<\/li>\n\n\n\n<li>prolonged \u22651 year (up to >7 years).<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Statistical analysis<\/strong>: conditional logistic regression (odds ratios, 95% CI).<br><\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Main results<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Desogestrel 75 \u00b5g<\/strong>:\n<ul class=\"wp-block-list\">\n<li>No excess risk with short-term use (OR 1.02; 95% CI 0.77\u20131.34).<\/li>\n\n\n\n<li>Significant increased risk with prolonged use:\n<ul class=\"wp-block-list\">\n<li>5\u20137 years: OR 1.51 (95% CI 1.17\u20131.94).<\/li>\n\n\n\n<li>\u22657 years: OR 2.09 (95% CI 1.51\u20132.90).<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Higher risk for meningiomas located at the skull base (anterior and middle fossa).<\/li>\n\n\n\n<li>Risk amplified in women with prior exposure to other progestins previously associated with meningioma (OR 3.30).<\/li>\n\n\n\n<li>Risk disappeared one year after discontinuation of desogestrel.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Levonorgestrel (alone or combined with estrogen)<\/strong>: no excess risk identified regardless of duration of use.<br><\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Clinical impact<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The <strong>number needed to harm (NNH)<\/strong> was estimated at 67,300 women for one case of surgically treated meningioma after prolonged desogestrel exposure.<\/li>\n\n\n\n<li>These findings confirm that desogestrel should be prescribed with caution in cases of prolonged use, particularly in women with a history of exposure to other high-risk progestins.<\/li>\n\n\n\n<li>By contrast, levonorgestrel, a widely used progestin, was not associated with an increased risk.<br><\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Conclusion<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">This French nationwide study highlights a <strong>modest but significant increased risk of intracranial meningioma after more than 5 years of continuous use of desogestrel 75 \u00b5g<\/strong>, especially for skull base meningiomas. Conversely, no association was found for levonorgestrel, either alone or combined with estrogen. These findings should be taken into account when assessing the benefit-risk ratio in the prescription of progestin-based oral contraceptives.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><br>Team &amp; expertise<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">This article is part of the scientific dissemination mission of the <strong>Neurosurgery Department, Lariboisi\u00e8re Hospital \u2013 AP-HP<\/strong>, led by <strong>Prof. S\u00e9bastien Froelich, Universit\u00e9 Paris-Cit\u00e9<\/strong>. The team specializes in the management of intracranial tumors, particularly skull base meningiomas.<br><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\ud83d\udd17 <strong>Source<\/strong>: <a href=\"https:\/\/www.bmj.com\/content\/389\/bmj-2024-083981\" target=\"_blank\" rel=\"noopener\">BMJ 2024 \u2013 Intracranial meningioma and oral contraceptives<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Related internal link: <a href=\"..\/meningiome\">Intracranial meningioma<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Introduction A recent case-control study based on the French National Health Data System (SNDS) assessed the association between the use of progestin-only oral contraceptives and the risk of intracranial meningioma requiring surgery. This large-scale analysis, including more than 92,000 women&#8230;<\/p>\n","protected":false},"author":5,"featured_media":17015,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-17053","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts\/17053","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/comments?post=17053"}],"version-history":[{"count":1,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts\/17053\/revisions"}],"predecessor-version":[{"id":17057,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/posts\/17053\/revisions\/17057"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/media\/17015"}],"wp:attachment":[{"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/media?parent=17053"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/categories?post=17053"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.neurochirurgie-lariboisiere.com\/en\/wp-json\/wp\/v2\/tags?post=17053"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}