Your Questions Answered! Do contraceptives cause brain tumours?

Recently there has been some press coverage given to a paper published in the BMJ about the use of progestogens and the risk of intracranial meningioma requiring surgery.

It highlighted the increased risk with the contraceptive injection, and a low risk with hormonal coils.

While new research is important, I feel we have to be careful not to have “knee jerk” reactions and suddenly stop contraception without fully discussing this with a specialist.

Unfortunately the press coverage seemed to blow this out of proportion, so here are the facts.

What is a meningioma?

Firstly, meningioma is generally a benign (non-cancerous) growth that occurs in the brain or spinal cord. The problem is, as they grow, they can cause neurological symptoms and this is clearly a concern.

The risk of developing a meningioma increases significantly with age, the median age at diagnosis being 66 years old. The actual numbers of people developing them though are thankfully rare.

The incidence in patients over 40 is 18.69/100,000 and in patients aged 0-19 is 0.16/100,000. It’s worth noting that generally contraception is not needed after the age of 55.

The main risk factors for developing a meningioma are advanced age and being female.

So what has this got to do with contraception?

As well as the contraceptive injection the article referred to, the progestogens in contraceptives such as zoely (a combined pill containing estradiol hemihydrate and nomegestrol) and dianette (containing ethinyl estradiol and cyproterone acetate) also have associations with increased risk of developing meningioma.

There is a cumulative risk that builds over long term use of these medications. That being said, the additional numbers of people this affects is very small because the condition itself is rare.

Final thoughts

Is it worth bearing this in mind – yes of course, but before panicking and coming off contraception, book to speak to a specialist first. The general advice is not to use these contraceptives if there is a personal or family history of meningioma, but there is no reason why these contraceptives can’t still be used otherwise.

Ideally we need contraceptives that don’t come with these side-effects, but until that comes about, we have what we have. It’s important to be aware of these things going inside your body though – being informed is the best place to be.

Until next time!

Dr Nikki


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