New WCRF Publication Examines DMPA Use and Meningioma Risk
Medications can provide important health benefits while also carrying risks that researchers continue to evaluate as new evidence becomes available. Understanding both sides of that equation is essential—particularly when a medication may be used over an extended period.
A new review article coauthored by Women’s Cancer Research Foundation Founder and Chairman John P. Micha, M.D., and President and Senior Clinical Fellow Bram H. Goldstein, Ph.D., examines the available research surrounding depot medroxyprogesterone acetate, commonly abbreviated as DMPA, and the risk of developing an intracranial meningioma.
The article, coauthored with Randy D. Bohart and Andrew S. Gorman and funded by the Women’s Cancer Research Foundation, was published September 21, 2026, in the International Journal of Gynecology & Obstetrics.
What Is Depot Medroxyprogesterone Acetate?
DMPA is a long-acting injectable form of progestin. It is widely used as a contraceptive and may also be used in the treatment of conditions including endometriosis and dysmenorrhea, or painful menstrual periods.
The medication produces sustained exposure to progestin, which is one reason researchers have been examining whether prolonged use may be associated with an increased risk of meningioma.
What Is a Meningioma?
A meningioma is a tumor that develops in the membranes surrounding the brain and spinal cord. Many meningiomas are noncancerous and grow slowly, but they can still cause serious health concerns depending on their size and location.
Several studies have reported an association between prolonged DMPA use and an increased risk of developing a meningioma. However, an increased relative risk does not necessarily mean the condition is common. As the authors emphasize, the actual number of meningioma cases associated with DMPA remains extremely low.
That distinction is important when considering both the potential risks and the therapeutic benefits of the medication.
Published Abstract
Micha JP, Bohart RD, Gorman AS, Goldstein BH. Depot medroxyprogesterone acetate and the risk for developing an intracranial meningioma. International Journal of Gynecology & Obstetrics. First published September 21, 2026. doi:10.1002/ijgo.71361.
Abstract
Several investigations have reported on the increased risk of meningioma following depot medroxyprogesterone acetate (DMPA) treatment. An extensive PubMed search was conducted evaluate systematic reviews, propensity-matched studies and case–control studies on the topics of DMPA use and meningioma risk from 2018–2026. Primarily, the studies have reported that the risk of a meningioma is exacerbated by prolonged use of DMPA, which confers sustained and higher systemic exposure to progestin. Despite the documented risk of meningioma from case–control studies, the actual number of meningioma cases associated with DMPA is extremely low. While patients should be aware of the risks associated with enduring use of DMPA, one should also consider the therapeutic benefits, namely the drug's use as a treatment for endometriosis, dysmenorrhea and the secondary effects of reducing the risk for endometrial and ovarian cancers. Additional research that evaluates the clinical risk–benefit ratio associated with DMPA use is warranted.
Understanding Risk in Context
The review highlights an important challenge in women’s health research: determining how a documented association should be weighed against the benefits a medication may provide.
The studies reviewed suggest that meningioma risk may increase with prolonged DMPA use and sustained exposure to progestin. At the same time, the number of documented cases remains very low, and DMPA continues to have recognized therapeutic uses.
The article does not suggest that every patient who has used DMPA will develop a meningioma, nor does it determine whether the medication is appropriate for any individual patient. Instead, it identifies the need for continued research into the clinical risk–benefit relationship, particularly when DMPA is used over an extended period.
Patients who currently use DMPA or have concerns about previous use should speak with their healthcare provider before making changes to their medication. Individual medical history, length of use, treatment benefits, and available alternatives should all be considered as part of that conversation.
Continuing to Examine Questions Affecting Women’s Health
This publication reflects the continued commitment of Dr. John P. Micha, Bram H. Goldstein, and their fellow authors to examining complex questions that affect women’s health and medical decision-making.
Research of this kind helps place potential risks into context, identify where evidence remains incomplete, and support more informed conversations between patients and their healthcare providers. As additional studies become available, researchers will be better able to understand which patients may face an increased risk and how that risk should be weighed against the benefits DMPA can provide.
About the Women’s Cancer Research Foundation
The Women’s Cancer Research Foundation (WCRF) is a 501(c)(3) nonprofit organization dedicated to improving cure rates and quality of life for women with breast and gynecologic cancers. Its physicians and researchers have contributed to clinical research since 1985, including clinical trials, collaborative studies, and peer-reviewed publications focused on breast, ovarian, uterine, and cervical cancers. WCRF also provides accessible educational information about women’s cancers and advances in treatment.
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