Disproportionality analysis of progestogens and estrogens demonstrates increased meningioma risk

This study aims to clarify the relationship between the use of various progestogens and estrogens and the risk of developing meningiomas, given the widespread prescription of hormonal contraceptives and their potential implications in tumour proliferation.

Data from the FDA Adverse Event Reporting System (FAERS) was analyzed using disproportionality analysis to assess the association between specific progestogens and estrogens and meningioma risk. Reporting odds ratios (RORs) and 95% confidence intervals (CIs) were calculated to quantify these associations.

Among progestogens, promegestone showed the highest risk with an ROR of 2620.651 (95% CI: 982.032, 6993.474), followed by medrogestone with an ROR of 871.475 (95% CI: 256.382, 2962.253) and dydrogesterone with moderate risk (ROR 113.802; 95% CI: 60.676, 213.444). For estrogens, estradiol exhibited the highest risk (ROR 17.786; 95% CI: 14.875, 21.266), followed by ethinyl estradiol (ROR 7.441; 95% CI: 6.099, 9.080), while conjugated estrogens showed a lower risk (ROR 1.736; 95% CI: 1.043, 2.889). No cases were reported for estriol, estrone, or mestranol, indicating a potentially lower risk profile for these estrogens.

The study reveals significant variations in meningioma risk associated with different hormonal therapies. Certain progestogens and estrogens present notably higher risks, emphasizing the need for personalized risk assessments in hormonal therapy prescriptions. These findings advocate for further research to better understand meningioma risk linked to hormone-based contraceptives, supporting safer clinical decision-making.