Short answer: The Depo-Provera label added a warning in December 2025: meningiomas, usually benign brain tumors, have been reported after repeated shots of medroxyprogesterone acetate, mostly with long-term use. The label says to watch for signs and stop the shot if one is found. A large French study found higher odds of meningioma surgery with the injection, driven by use of a year or more, though the numbers of people affected were small.
Section 5.4, added under recent major changes in December 2025, reads: "Cases of meningiomas have been reported following repeated administration of medroxyprogesterone acetate, primarily with long term use." It asks prescribers to watch for signs and symptoms of meningioma and to stop Depo-Provera CI if one is diagnosed.
The patient leaflet lists a "possible increased risk for growth of a meningioma (a usually benign brain tumor), primarily when the product is used for a long time." It asks people to tell their provider if they have ever had a meningioma, and the label asks prescribers to counsel them about possible worsening. MedlinePlus also lists meningioma among the risks of the injection.
The National Cancer Institute describes meningiomas as tumors that form along the dura mater, the outer layer covering the brain and spinal cord. They are the most common type of primary brain tumor. Most are grade 1, slow-growing tumors, and grade 1 meningiomas are more common in females.
Symptoms depend on where the tumor sits. The NCI lists vision changes, loss of hearing or smell, confusion, seizures and headaches that are worse in the morning.
Roland and colleagues (BMJ 2024) used France's national health data to compare 18,061 women who had surgery for an intracranial meningioma between 2009 and 2018 with 90,305 matched women who did not.
| Progestogen | Used by cases | Used by controls | Odds ratio (95% CI) |
|---|---|---|---|
| Injectable medroxyprogesterone acetate | 9 of 18,061 (0.05%) | 11 of 90,305 (0.01%) | 5.55 (2.27 to 13.56) |
| Progesterone | No excess risk found | ||
| Levonorgestrel IUDs | No excess risk found |
The authors say the excess risk was driven by prolonged use, meaning a year or more. The study counts only tumors that led to surgery, the number of exposed women was small, and the confidence interval is wide, so it shows a link rather than an exact size of risk.
Points worth raising: any past meningioma, new headaches or vision, hearing or smell changes, and how long the shot has been used. Dose Track logs each shot date, so the total time on Depo-Provera is easy to show. The label's other long-term warning is about bone: see Depo-Provera and bone loss.
Read more on Dose Track: Depo-Provera side effects · Late Depo-Provera shot · Progestin · Progesterone