Used in the treatment of various gynecological pathologies in women (endometriosis, fibroids, heavy periods, menstrual cycle disorders) or as part of hormone replacement therapy in postmenopausal women, certain progestins are the subject of an alert, due to of the excess risk of meningioma associated with their more or less prolonged use.
Between 2019 and 2020, several epidemiological studies have indeed shown that the meningioma risk increased with three progestins : Androcur, Lutenyl, Lutéran and their generics. The ANSM effectively warned in 2021 that 50 to 100 meningiomas could be attributed to prolonged use of these treatments. Nevertheless, thee Dr Geoffroy Robin, gynecologist and president of the CNGOF Medical Gynecology Commission, wanted to be reassuring: “Women taking Luteran or Lutényl should not panic given the rarity of meningiomas“.
What is a meningioma? A benign tumor of the envelope of the brain, it accounts for more than one primary brain tumor in three, and every year 9 people out of 100,000 are likely to develop one. The risk factors identified are in particular age, female gender and exposure to ionizing radiation in childhood, via scanner or scintigraphy in particular.
Tumor regression when treatment is stopped
In January 2023, a temporary scientific committee (CST) made up of representatives of people treated and healthcare professionals met, in particular to issue initial recommendations in order to manage the risk of meningioma associated with taking progestin, other than those based on cyproterone acetate (ACP), nomegestrol (ANMG) and chlormadinone (ACM).
Which ones are affected?
- Medrogestone (Colprone);
- Progesterone 100mg and 200mg (Utrogestan and generics);
- Dydrogesterone (Duphaston);
- Dienogest (generics from Visanne).
What did the CST conclude? He believes that an effect “class“progestins on the risk of meningioma cannot be ruled out.”Among the cases of meningioma declared under progestogen treatment, those reported with medrogestone (Colprone) and progesterone at 100mg and 200mg (Utrogestan and generics) are particularly suggestive of a role for these drugs given the stabilization or tumor regression at discontinuation of treatment”indicates the ANSM in a communicated. This also suggests that the impact of these treatments is not irreversible.
⚠️#Progestins and risk of #meningioma
Consult the preliminary recommendations of the patient/healthcare professional committee to limit this risk pending the results of ongoing epidemiological studies.
↪️Recos and list of #medications concerned: https://t.co/14YSpbDpXwpic.twitter.com/CXTdvXAJgJ—ANSM (@ansm) March 2, 2023
What are the recommendations to limit the risks?
- Eavoid any progestogen treatment in the event of a history of meningioma or existing meningioma, except in the event of a multidisciplinary opinion (gynecologists, endocrinologists and/or neurosurgeons, etc.)
- Before any change in treatment or any new prescription, check all the progestins already used and their duration of use;
- Prescribe the minimum effective dose with the shortest possible duration of use of the treatment;
- Reassess the benefit of continuing treatment every year, especially around menopause (the risk of meningioma increases with age);
- Perform an MRI in case of neurological signs suggestive of a meningioma, i.e. headaches, visual, language, memory and hearing disorders, nausea, dizziness, seizures, loss of sense of smell, or weakness or paralysis.
Source :
- Risk of meningioma and progestins: general recommendations to limit this risk, ANSM, 2 March 2023
