Oral contraceptives with progestogens desogestrel or levonorgestrel and risk of intracranial meningioma: national case-control study
Abstract
OBJECTIVE: To assess the risk of intracranial meningioma associated with oral contraceptives containing desogestrel, levonorgestrel, or levonorgestrel combined with oestrogen. DESIGN: Case-control study. SETTING: French national health data system (Système National des Données de Santé). PARTICIPANTS: 8391 women living in France who required surgery for intracranial meningioma in 2020-23. Each patient was matched to 10 women without intracranial meningioma (controls) on year of birth and area of residence. MAIN OUTCOME MEASURE: Risk of intracranial meningioma associated with oral contraceptives containing desogestrel 75µg, levonorgestrel 30µg, or levonorgestrel 50-150 µg combined with oestrogen, and duration of use: short term use was defined by one or more dispensations within the year before the index date only, and prolonged use was defined by continuous use of one year or more (up to seven or more years of continuous use). Conditional logistic regression was used to calculate odds ratios. RESULTS: 1933 (2.3%)). In analyses of desogestrel according to duration of use, the odds ratio for risk of intracranial meningioma for short term use was 1.02 (95% confidence interval 0.77 to 1.34) and for prolonged use was 1.32 (1.14 to 1.53). Risk was driven by more than five continuous years of use: odds ratio 1.51 (1.17 to 1.94) for five to seven years and 2.09 (1.51 to 2.90) for ≥7 years. Excess risk was greater in women with meningiomas located in the middle or anterior part of the skull base (1.90 (1.47 to 2.46) and 1.50 (1.17 to 1.93), respectively) and in those who had previously used a progestogen of known associated increased risk (3.30 (2.64 to 4.11)). Results showed no excess risk of intracranial meningioma for levonorgestrel (alone or combined with oestrogen) regardless of duration of use. The estimated number needed to harm with desogestrel was 67 300 women for one intracranial meningioma requiring surgery. Risk was no longer observed one year after discontinuation of desogestrel. CONCLUSIONS: The results showed a small increased risk of intracranial meningioma in women who had used desogestrel 75 µg for more than five continuous years, but no risk in users of levonorgestrel (alone or combined with oestrogen).
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BibTeX
@article{roland2026oral,
title = {{Oral contraceptives with progestogens desogestrel or levonorgestrel and risk of intracranial meningioma: national case-control study}},
author = {Noémie Roland and Epiphane Kolla and Bérangère Baricault and Pauline Dayani and Lise Duranteau and Sébastien Froelich and Mahmoud Zureik and Alain Weill},
journal = {BMJ - British Medical Journal},
year = {2026},
month = nov,
doi = {10.1136/bmj-2024-083981},
url = {https://hal.science/hal-05851901v1},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Oral contraceptives with progestogens desogestrel or levonorgestrel and risk of intracranial meningioma: national case-control study
AU - Noémie Roland
AU - Epiphane Kolla
AU - Bérangère Baricault
AU - Pauline Dayani
AU - Lise Duranteau
AU - Sébastien Froelich
AU - Mahmoud Zureik
AU - Alain Weill
PY - 2026
DA - 2026/11/04
JO - BMJ - British Medical Journal
DO - 10.1136/bmj-2024-083981
UR - https://hal.science/hal-05851901v1
AB - OBJECTIVE: To assess the risk of intracranial meningioma associated with oral contraceptives containing desogestrel, levonorgestrel, or levonorgestrel combined with oestrogen. DESIGN: Case-control study. SETTING: French national health data system (Système National des Données de Santé). PARTICIPANTS: 8391 women living in France who required surgery for intracranial meningioma in 2020-23. Each patient was matched to 10 women without intracranial meningioma (controls) on year of birth and area of residence. MAIN OUTCOME MEASURE: Risk of intracranial meningioma associated with oral contraceptives containing desogestrel 75µg, levonorgestrel 30µg, or levonorgestrel 50-150 µg combined with oestrogen, and duration of use: short term use was defined by one or more dispensations within the year before the index date only, and prolonged use was defined by continuous use of one year or more (up to seven or more years of continuous use). Conditional logistic regression was used to calculate odds ratios. RESULTS: 1933 (2.3%)). In analyses of desogestrel according to duration of use, the odds ratio for risk of intracranial meningioma for short term use was 1.02 (95% confidence interval 0.77 to 1.34) and for prolonged use was 1.32 (1.14 to 1.53). Risk was driven by more than five continuous years of use: odds ratio 1.51 (1.17 to 1.94) for five to seven years and 2.09 (1.51 to 2.90) for ≥7 years. Excess risk was greater in women with meningiomas located in the middle or anterior part of the skull base (1.90 (1.47 to 2.46) and 1.50 (1.17 to 1.93), respectively) and in those who had previously used a progestogen of known associated increased risk (3.30 (2.64 to 4.11)). Results showed no excess risk of intracranial meningioma for levonorgestrel (alone or combined with oestrogen) regardless of duration of use. The estimated number needed to harm with desogestrel was 67 300 women for one intracranial meningioma requiring surgery. Risk was no longer observed one year after discontinuation of desogestrel. CONCLUSIONS: The results showed a small increased risk of intracranial meningioma in women who had used desogestrel 75 µg for more than five continuous years, but no risk in users of levonorgestrel (alone or combined with oestrogen).
SN - 1756-1833
ER -