European regulators are sounding the alarm on a brain tumor risk tied to certain contraceptives. The EMA's safety committee has flagged a small but real increased risk of meningioma with long-term use of desogestrel and etonogestrel-containing contraceptives. The risk grows with duration of use and drops off within a year of stopping — and these drugs are now contraindicated in women with a history of meningioma.
European regulators are putting healthcare providers on notice about a brain tumor risk linked to two common progestogen-based contraceptives. The European Medicines Agency's (EMA) Pharmacovigilance Risk Assessment Committee (PRAC) has issued a direct communication to healthcare professionals warning of a small but increased risk of intracranial meningioma associated with desogestrel (oral tablets) and etonogestrel (implants and vaginal rings).
The warning is backed by a large French case-control study published in the BMJ, which analyzed over 8,300 women who underwent surgery for intracranial meningioma between 2020 and 2023. The study found no excess risk with levonorgestrel, but a clear dose-duration relationship with desogestrel — the longer the use, the higher the risk. Importantly, the elevated risk largely disappeared within one year of stopping the drug.
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Why it matters: Desogestrel and etonogestrel are widely used contraceptives. This new contraindication and updated safety labeling means clinicians must now screen for meningioma history before prescribing and monitor patients on long-term use for neurological symptoms like headaches, vision changes, or seizures.
