Medroxyprogesterone & Meningioma Risks Identified

A major U.S. study published in JAMA Neurology in late 2025 examined whether certain hormonal contraceptives are associated with an increased risk of meningioma, a typically slow-growing brain tumor. Using real-world data from millions of women, the researchers identified a specific pattern worth understanding—particularly for women over age 30 considering long-term hormone use.

Learn more about the results of this study and how bioidentical hormone replacement therapy offers a safe, natural alternative.

What Is Depot Medroxyprogesterone Acetate (DMPA)?

Depot medroxyprogesterone acetate (DMPA) is a synthetic form of the hormone progesterone. It is most commonly known by the brand name Depo-Provera, an injectable contraceptive given once every three months.

DMPA works by:

• Suppressing ovulation
• Thickening cervical mucus to prevent sperm from reaching the egg
• Thinning the uterine lining

Beyond contraception, DMPA is sometimes prescribed to help manage heavy menstrual bleeding, endometriosis-related pain, or other gynecologic conditions.

What Is a Meningioma?

A meningioma is a tumor that develops from the meninges—the protective membranes that surround the brain and spinal cord. Key points about meningiomas include:

• Most are benign (non-cancerous)
• They often grow slowly and may take years to cause symptoms
• Many are discovered incidentally on imaging
• When treatment is needed, options include monitoring, surgery, and/or radiation

Meningiomas are known to be hormone-sensitive, particularly to progesterone, which has long raised scientific interest in possible links between progestin exposure and tumor growth.

Why Women Take Medroxyprogesterone

Medroxyprogesterone is prescribed for a variety of medical reasons because it mimics the effects of progesterone. It is used to help treat a variety of health concerns, including:

• Preventing Pregnancy (most commonly as the injectable contraceptive)
• Regulating Irregular Menstrual Cycles
• Treating Heavy or Abnormal Uterine Bleeding by stabilizing the uterine lining
• Managing endometriosis and amenorrhea (absence of periods)
• Correcting Hormonal Imbalances (where estrogen is unopposed) 
• Protecting Uterine Lining from Overgrowth (for postmenopausal individuals)

Its widespread use reflects its effectiveness, convenience, and versatility across both contraceptive and therapeutic hormone care.

Key Findings from the Study

The study, titled “Depot Medroxyprogesterone Acetate and Risk of Meningioma in the US,” was led by investigators from Cleveland Clinic and Case Western Reserve University and published in JAMA Neurology (November 2025).

• DMPA use was associated with a 2.43-fold increase in relative risk of being diagnosed with a meningioma compared with matched controls
• The increased risk was not uniform across all users. It was primarily seen in women who used DMPA for more than 4 years or started DMPA after age 31
• Other hormonal contraceptives—including combined oral contraceptives, progestin-only pills, hormonal IUDs, and implants—did not show an increased risk\
• Oral medroxyprogesterone acetate (the pill form) showed a much smaller increase in risk (about 1.18 times), substantially lower than the injectable form
• About one additional meningioma diagnosis would be expected for every 1,152 women using DMPA compared with non-users

Importantly, this indicates that while the relative risk increase is notable, the absolute risk remains low.

What This Means for Women Over 30

Meningiomas are uncommon overall, and most are treatable when detected early. This study does not suggest that Depo-Provera causes meningiomas in most users. Instead, it identifies a measurable association—particularly for women who begin DMPA after age 30 or use it continuously for many years.

For women considering hormone-based contraception or hormonal therapy:

• Duration of use matters
• Age at initiation may influence risk
• Alternatives exist that did not show this association in the data

Talking With Your Healthcare Provider

If you are currently using or considering DMPA, this study is a good reason to have a thoughtful discussion with your healthcare provider. Topics to review may include:

• Your age and long-term reproductive plans
• How long you expect to use a particular therapy
• Personal or family history of hormone-sensitive conditions
• Whether other contraceptive or hormone options may be a better fit

Clinical decisions should always balance benefits, risks, and individual health goals—and for many women, DMPA may still be an appropriate and effective choice.

How Bioidentical Hormone Replacement Therapy Can Correct Imbalances

Bioidentical hormone therapy can offer an alternative to medroxyprogesterone for some women who are managing symptoms related to hormone imbalances. It is particularly effective when progesterone support is needed.

Bioidentical progesterone is chemically identical to the progesterone naturally produced by the body and is often prescribed to help address issues such as: 

• Irregular Menstrual Cycles
• Heavy or Prolonged Bleeding
• PMS Symptoms
• Sleep Disturbances
• Mood Changes 

In certain clinical situations, it may also be used alongside estrogen therapy to help protect the uterine lining while aiming for a hormone profile that more closely mirrors natural physiology. At Premier Integrative, treatment is always individualized to each patient’s unique needs.

Dosing and delivery methods are based on a patient’s symptoms, lab results, age, and overall health. As with any hormone therapy, decisions about using bioidentical hormones are always made following a thorough consultation with one of our qualified naturopathic doctors who can help you navigate the benefits and risks, while providing appropriate monitoring.