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Introduction: A groundbreaking study from France published by The BMJ has shed light on the potential risks associated with prolonged use of progestogen hormone drugs, commonly prescribed for various gynaecological conditions. The research reveals a concerning association between certain progestogens and the development of intracranial meningiomas, a type of brain tumor. While the findings underscore the need for further investigation, they raise important questions about the safety of these widely used medications.
Understanding the Risk: Progestogens, synthetic hormones similar to progesterone, are prescribed globally for conditions such as endometriosis, polycystic ovary syndrome, and menopausal hormone therapy. Despite their widespread use, little is known about the specific risks associated with individual progestogens. Meningiomas, non-cancerous tumors of the brain’s protective layers, have been linked to certain high-dose progestogens, but the full extent of the risk remains unclear.
Study Methodology: Researchers analyzed data from over 18,000 women who underwent surgery for intracranial meningiomas between 2009 and 2018. Each case was compared to five control women without the tumor. The study evaluated the use of various progestogens, including medrogestone, medroxyprogesterone acetate, and promegestone, over prolonged periods. Results indicated a significant increase in meningioma risk associated with certain progestogens, particularly with extended use.
Key Findings: Prolonged use of medrogestone was linked to a 4.1-fold increased risk of intracranial meningioma, while medroxyprogesterone acetate injection showed a 5.6-fold increased risk. Similarly, promegestone use was associated with a 2.7-fold higher risk. Notably, no increased risk was observed for short-term use of these progestogens. The study also confirmed the known risk of meningioma associated with other progestogens, such as chlormadinone acetate and cyproterone acetate.
Implications and Limitations: While the study provides valuable insights, researchers caution that it is observational and cannot establish causation. Additionally, limitations in data availability prevented a comprehensive analysis of all clinical details and indications for progestogen use. Further research is needed to understand the potential genetic and environmental factors contributing to meningioma risk.
Conclusion: The findings underscore the importance of closely monitoring the use of progestogen hormone drugs, particularly over prolonged periods. With millions of women worldwide using these medications, the potential impact on meningioma risk cannot be overlooked. Moving forward, additional studies are urgently needed to inform clinical practice and ensure the safety of patients prescribed these medications.
