Certain progestogens linked to higher brain tumor risk in women, study suggests

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In a caller study published successful nan diary BMJ, a squad of French researchers investigated nan relation betwixt progestogen usage and nan consequence of benign cardinal tense strategy tumors specified arsenic intracranial meningioma among women.

 vitahima / ShutterstockStudy: Use of progestogens and nan consequence of intracranial meningioma: nationalist case-control study. Image Credit: vitahima / Shutterstock

Background

Meningiomas hap each 9.5 per hundred-thousand-person years successful nan United States and relationship for 40% of nan cardinal tense system-associated superior tumors. Although histologically benign and slow-growing, they tin origin problems by exerting unit connected adjacent insubstantial successful nan brain, requiring surgical involution to decompress nan area. Age is 1 of nan factors that importantly increases nan consequence of meningiomas, particularly aft 65 years.

Female sex, neurofibromatosis type 2, and ionizing radiation vulnerability to nan intracranial region are different known consequence factors for meningiomas, isolated from age. Recent investigation has besides indicated that nan semipermanent usage of 3 progestogens — chlormadinone acetate, nomegestrol acetate, and cyproterone acetate — astatine precocious doses tin besides summation nan consequence of intracranial meningiomas. Studies person besides recovered meningioma volumes to summation during gestation and subsequently alteration successful nan postpartum phase.

Furthermore, nan important beingness of progesterone receptors successful meningiomas indicates a biologic nexus betwixt meningioma consequence and female intersexual hormones, highlighting nan request for robust studies connected progestogen usage and meningioma risk.

About nan study

In nan coming study, nan researchers investigated nan intracranial meningioma consequence associated pinch galore progestogens and various management routes of these progestogens. The progestogen exposures included intravaginal, percutaneous, and oral progesterone, dydrogesterone by itself aliases pinch estrogen, hydroxyprogesterone, promegestone, medrogestone, nan injectable contraceptive medroxyprogesterone acetate, dienogest by itself aliases pinch estrogen, and intrauterine systems of levonorgestrel.

The study besides aimed to qualify factors specified arsenic age, location of meningioma, and tumor people for nan women included successful nan lawsuit group and find really galore of nan meningiomas that were surgically treated could beryllium attributed to nan usage of 1 of nan progestogens. The information for this case-control study was obtained from France's nationalist wellness information system.

The study included women of each ages who lived successful France and had undergone surgical curen for intracranial meningioma betwixt 2009 and 2018. The power group included women who matched successful nan area of residence and commencement twelvemonth pinch nan lawsuit group participants. The World Health Organization's anatomical, therapeutic, and chemic classification was utilized to specify progestogen exposure.

The various management routes assessed successful nan study were percutaneous, oral, intramuscular, intravaginal, and intrauterine. For progestogens administered via nan intravaginal, oral, intramuscular, aliases percutaneous routes, 1 exception successful nan twelvemonth preceding nan scale day was considered arsenic an exposure, whereas for intrauterine progestogens and levonorgestrel intrauterine systems, an vulnerability was 1 exception successful 3 aliases 5 years preceding nan scale date, respectively.

The researchers analyzed 3 modes of vulnerability to progestogens. The first was vulnerability to nan progestogen of concern. The 2nd was vulnerability to a precocious dose of 1 of nan 3 progestogens already associated pinch accrued meningioma consequence (nomegestrol acetate, chlormadinone acetate, and cyproterone acetate) successful nan 3 years starring up to nan scale date. The 3rd mode was nan absence of vulnerability to immoderate of nan progestogens. The study besides included a wide scope of aesculapian and sociodemographic factors arsenic covariates.

Results

The results showed that semipermanent usage of promegestone, medrogestone, and nan injectable contraceptive medroxyprogesterone acetate was associated pinch a higher consequence of intracranial meningioma. However, short-term usage spanning little than a twelvemonth of immoderate of these progestogens was not recovered to summation nan meningioma risk.

Furthermore, nan usage of intravaginal, percutaneous, and oral progesterone, dydrogesterone by itself aliases pinch estrogen, short—or semipermanent usage of spironolactone, aliases levonorgestrel intrauterine systems was not associated pinch immoderate summation successful intracranial meningioma risk.

The usage of promegestone, medrogestone, and medroxyprogesterone acetate was not recovered to beryllium linked to nan incidence of malignant meningiomas, and nan number of cases of intracranial meningiomas that needed surgical curen that was associated pinch promegestone, medrogestone, and medroxyprogesterone acetate was importantly less than those associated pinch nomegestrol acetate, chlormadinone acetate, and cyproterone acetate.

Conclusions

To conclude, nan findings reported that semipermanent usage of 3 progestogens — promegestone, medrogestone, and nan injectable contraceptive medroxyprogesterone acetate — was recovered to summation nan intracranial meningioma consequence successful women. However, these progestogens did not summation nan consequence of malignant meningiomas, and nan usage of these progestogens for little than a twelvemonth was not recovered to summation nan intracranial meningioma risk. Additionally, different progestogens specified arsenic spironolactone, dydrogesterone, progesterone, aliases hormonal intrauterine systems were not linked to accrued consequence of meningiomas.

Journal reference:

  • Roland, N., Neumann, A., Léa Hoisnard, Duranteau, L., Froelich, S., Mahmoud Zureik, & Weill, A. (2024). Use of progestogens and nan consequence of intracranial meningioma: a nationalist case-control study. BMJ, 384. DOI: 10.1136/bmj2023078078, https://www.bmj.com/content/384/bmj-2023-078078