In 2024, the FDA finally added meningioma warnings to Depo-Provera's label—more than three decades after the drug hit the market. For thousands of women who developed brain tumors after years of injections, that warning came far too late.
The scientific trail connecting Depo-Provera to meningiomas didn't emerge overnight. Researchers have understood for years that meningiomas are hormone-sensitive tumors, with approximately 70% expressing progesterone receptors. What makes Depo-Provera particularly concerning is the sheer amount of synthetic progestin it delivers—and how long that progestin stays in the body.
The Progestin Problem
Unlike daily birth control pills, which deliver small hormone doses that clear quickly, Depo-Provera works by flooding the body with depot medroxyprogesterone acetate every three months. This creates sustained high progestin levels that persist between injections, exposing hormone-sensitive tissues to continuous stimulation.
French researchers sounded early alarms. Studies of similar high-dose progestin drugs in France revealed a five to seven-fold increase in meningioma risk among long-term users—findings serious enough that French regulators restricted those medications. Yet Depo-Provera continued without similar scrutiny in the United States, and American women kept receiving injections without any warning about brain tumor risk.
The 2024 BMJ Study
A landmark British Medical Journal study analyzing over 100,000 women finally provided the large-scale data the scientific community needed. The findings were stark: long-term Depo-Provera use significantly increased meningioma rates, with risk climbing the longer women used the drug. Perhaps most troubling, elevated risk persisted even after women stopped the injections, suggesting the hormonal exposure had lasting effects on tumor development.
For women who'd used the drug for years—many starting as teenagers for birth control and continuing into their thirties or beyond—this study confirmed what they'd suspected after their diagnoses: the contraceptive they trusted may have caused their brain tumors.
What Meningiomas Mean for Patients
The word "benign" offers false comfort. While most meningiomas aren't cancerous, they're still brain tumors that can cause debilitating symptoms depending on size and location. Women describe crushing headaches that don't respond to medication, vision deteriorating without explanation, personality changes that strain relationships, seizures appearing without warning, and weakness spreading through their limbs.
Treatment typically means brain surgery—a craniotomy where surgeons cut through the skull to remove the tumor. Some women face multiple surgeries as tumors recur. Others receive radiation when complete removal isn't possible, trading one set of risks for another. None of this is minor, and none of it was disclosed as a potential consequence of choosing Depo-Provera for birth control.
The Warning That Wasn't
The central question in the litigation isn't whether the science existed—it's why the warnings didn't. Plaintiffs argue that the manufacturer had access to the same research linking progestins to meningiomas, knew that meningiomas expressed progesterone receptors, watched European regulators restrict similar drugs, and still chose not to warn American women.
For over thirty years, women made contraceptive decisions without knowing they might be increasing their brain tumor risk. Many would have chosen differently—opted for non-hormonal birth control, limited their duration of use, or at least monitored for symptoms—had they known what the manufacturer allegedly knew and didn't share.
Who Should Be Concerned
The research suggests particular concern for women who used Depo-Provera for more than a year, especially those who received many consecutive injections over multiple years. Women who started use at younger ages and continued long-term accumulated the highest progestin exposure and may face the greatest risk.
If you used Depo-Provera extensively and experience persistent headaches, vision changes, or other neurological symptoms, discuss meningioma screening with your doctor. An MRI can identify tumors that might otherwise go undetected until they cause serious problems. Early detection matters—and so does understanding whether you may have a legal claim against the company that failed to warn you.