Depot medroxyprogesterone acetate and the risk for developing an intracranial meningioma

Several investigations have reported on the increased risk of meningioma following depot medroxyprogesterone acetate (DMPA) treatment. An extensive PubMed search was conducted evaluate systematic reviews, propensity-matched studies and case-control studies on the topics of DMPA use and meningioma risk from 2018-2026. Primarily, the studies have reported that the risk of a meningioma is exacerbated by prolonged use of DMPA, which confers sustained and higher systemic exposure to progestin. Despite the documented risk of meningioma from case-control studies, the actual number of meningioma cases associated with DMPA is extremely low. While patients should be aware of the risks associated with enduring use of DMPA, one should also consider the therapeutic benefits, namely the drug's use as a treatment for endometriosis, dysmenorrhea and the secondary effects of reducing the risk for endometrial and ovarian cancers. Additional research that evaluates the clinical risk-benefit ratio associated with DMPA use is warranted.