Depo Provera Use Linked to Brain Tumors

Recent scientific studies including a major national case control study have raised serious concerns about the link between long-term Depo Provera use and increased risk of brain tumors, particularly meningiomas.

This research has prompted legal action and heightened scrutiny of the medication’s safety profile for women who have used it for extended periods.

Landmark Studies Linking Depo Provera to Brain Tumors

The most important findings came from a March 2024 study published in the BMJ (British Medical Journal), which examined 18,061 women who underwent surgery for intracranial meningiomas between 2009 and 2018, matched with 90,305 controls.

This research found that women who used Depo-Provera for over a year were more than 5 times more likely to develop meningioma brain tumors compared to the general population.

A September 2024 cohort study published in the journal Cancers further reinforced these findings, analyzing over 117,000 meningioma cases and more than one million matched controls using data spanning 2006–2022.

This large-scale case-control study found that injection exposure to medroxyprogesterone acetate was associated with a 53% increase in the risk of developing meningiomas, with the risk becoming stronger with prolonged use.

The research methodology included:

• Conditional logistic regression analysis showing a staggering 555% increased risk of intracranial meningioma among long-term Depo Provera users
• Case-control studies used to estimate odds ratios comparing women who developed brain tumors with matched controls
• A clear correlation observed between the duration of Depo-Provera use and increased odds of developing meningiomas compared to non-users
• Focus on women who used the injection for more than one year, with results considered statistically significant

How Synthetic Progestin Affects Brain Tissue

Meningiomas express more progestin receptors than estrogen receptors, with 88% versus 40% in immunohistochemical analysis, meaning progestin use can directly influence meningioma development, similar to how three potent progestogens including cyproterone acetate, nomegestrol acetate, and chlormadinone acetate have been studied.

The biological mechanisms leading to tumor growth include, but are not limited to:

• Direct binding to progesterone receptors in meningioma tissue, as the majority of meningiomas contain these receptors
• Progestin stimulation of cell growth in the meninges, the protective layers surrounding the brain and spinal cord
• Meningiomas often express progesterone receptors, suggesting a biological pathway for tumor growth in response to synthetic progesterone like MPA
• Cumulative hormone exposure effects with repeated injections over extended periods, with exposure relative to duration of use

Progestin-associated meningiomas show higher levels of progesterone receptor expression and are more frequently located at the skull base than other meningiomas.

Risk Factors That Increase Brain Tumor Development

Risks were highest among women who had used the injectable form for extended periods, underscoring existing medical guidelines advising against prolonged use unless alternative options are unsuitable.

Several factors compound the risk of meningiomas:

• Primary Risk Factor: Duration of Use – Risk increases significantly for women using Depo shots for over a year, with prolonged use showing a dose-dependent association with meningioma development. Long-term users face substantially higher risk compared to short-term users, with studies estimating that odds ratios increase with each additional year of use.
• Additional Risk Factors: Several factors compound meningioma risk including cumulative hormone exposure from repeated quarterly injections, age factors (with younger premenopausal women potentially at higher risk), genetic predisposition (as progestin-related meningiomas show specific mutations affecting cellular pathways), individual hormone sensitivity variations, and previous hormone replacement therapy exposure.

Researchers noted that approximately 74 million women globally use injectable medroxyprogesterone acetate, meaning “the number of attributable meningiomas may be potentially high” due to this extensive usage, prompting pharmaceutical companies to review safety data.

While meningiomas represent the most common brain tumors linked to Depo Provera use, research indicates that prolonged exposure to synthetic progestin may contribute to various types of intracranial tumors.

Each type presents unique challenges and requires specific medical attention, though most are benign tumors.

Meningiomas: The Primary Concern

Meningiomas are the most common type of primary brain tumor, accounting for 37.6% of all primary central nervous system tumors and originating from arachnoid cap cells within the protective layers surrounding the brain and spinal cord.

These tumors form in the protective layers of tissue surrounding the brain and spinal cord, and while usually slow-growing and often noncancerous, benign brain tumor types, they can cause important health issues depending on their size and location.

Meningiomas are classified using the World Health Organization (WHO) grading system:

Grade I (Benign) – Most Common Type:

• Approximately 78-81% of meningiomas are benign, representing slow-growing tumors with distinct borders
• Account for 70-80% of all meningiomas and are found most often in people between the ages of 50 and 80
• Typically require surgical removal if they cause symptoms or grow in size
• May still require radiation treatment in certain cases

Grade II (Atypical) – Mid-Grade Tumors:

• Approximately 15-20% of meningiomas are atypical, meaning tumor cells do not appear normal
• Exhibit increased tissue and cell abnormalities, grow at a faster rate than benign meningiomas, and are often characterized by brain invasion
• Have a higher likelihood of recurrence and may become malignant at some point

Grade III (Malignant/Anaplastic) – Aggressive Type:

• Fast-growing cancerous tumors that tend to invade the parts of the brain closest to the tumor
• Show increased cellular abnormalities and are most likely to invade the brain and recur more frequently than other subtypes
• According to tumor registries, only 1.7% of meningiomas are confirmed to be malignant

Other Brain Tumor Types Under Investigation

Research indicates that a progestogen tied to Depo-Provera has been linked to an increased risk of developing brain tumors including both glioblastoma and meningioma, with synthetic hormones potentially affecting cell growth and proliferation in various brain tissues.

Current research areas include:

• Glioma Investigation: Studies suggest elevated risk estimates for progestin-only use and glioma risk, as receptors for both estrogen and progestin are present in gliomas, potentially allowing exogenous hormone exposure to impact tumor growth
• Multiple Tumor Types: Research continues into whether synthetic progestins affect other brain tumor classifications beyond meningiomas
• Spinal vs. Cerebral Distinctions: Studies show an increased risk specific to cerebral meningiomas, with no significant association observed for spinal meningiomas

Location and Size Considerations

Meningiomas are found near the top and outer curve of the brain, or at the base of the skull pushing on the brain tissue, with location determining both symptoms and potential treatment approaches.

Common Locations and Their Importance:

• Skull Base Meningiomas: Skull base meningiomas have significantly higher progesterone receptor expression than non-skull base meningiomas and are more frequently associated with progestin-related tumors
• Convexity and Parasagittal Areas: These locations are associated with greater amounts of vasogenic edema in adjacent brain tissue
• Multiple Sites: Meningiomas can grow along the external surface of the brain, spinal cord, or rarely within the ventricular system

Size Thresholds and Medical Intervention:

Many small meningiomas are found incidentally and are entirely asymptomatic, but larger tumors may impinge on vital nerves or compress the brain, causing disability and potentially becoming life-threatening.

Size considerations include:

• Small asymptomatic tumors may be monitored with regular MRI scans
• Tumors causing symptoms, showing growth, or reaching an important size usually require surgical intervention
• More than half of meningiomas demonstrate variable amounts of vasogenic edema in adjacent brain tissue, with severe edema being more compatible with aggressive tumors

Monitoring Protocols:

• Regular MRI surveillance for diagnosed tumors
• Assessment based on molecular signatures associated with aggressive meningiomas rather than WHO grade alone
• Evaluation of growth patterns and symptom development over time

Brain tumor symptoms often develop gradually and may be mistaken for other conditions, making early detection challenging.

Women who have used Depo Provera for extended periods should be aware of these warning signs and seek medical evaluation if they experience persistent symptoms.

Early Warning Signs to Monitor

Because meningiomas are typically slow-growing tumors, they may not cause noticeable symptoms until they grow large enough to push on important structures around them.

The most commonly reported early meningioma symptoms include headaches, fatigue, vision trouble, and cognitive impairment, with these symptoms taking years to appear since tumors grow slowly.

Persistent Headaches with Changing Patterns:

• Headaches that may be more severe in the morning or wake you up at night, though a severe headache on its own is seldom a symptom of meningioma or brain tumor
• Persistent neurological symptoms such as headaches warrant medical evaluation, especially if they are worsening
• Headaches that become gradually more frequent and severe over time

Vision Changes and Problems:

• Changes in vision such as double vision, blurriness, or loss of vision, particularly if pressing on or near the optic nerve
• Vision loss or other focal neurological deficits associated with convexity meningiomas
• Loss of peripheral vision or visual field defects
• Vision problems caused by tumors near the pituitary gland and the optic nerve

Hearing Problems and Related Issues:

• Hearing loss and hearing problems that can indicate the presence of a brain tumor
• Hearing problems caused by posterior fossa tumors pressing on cranial nerves
• Ringing in ears (tinnitus) that persists or worsens over time

Balance and Coordination Difficulties:

• Problems with balance, dizziness, and difficulty with walking or coordination, particularly from tumors in or near the cerebellum
• Unsteadiness or dizziness from tumors in the back of the brain due to the tight space
• Gradual loss of coordination in fine motor tasks

Progressive Symptoms Requiring Immediate Attention

A healthcare professional should assess symptoms that gradually worsen over time, as progressive symptoms are particularly concerning for brain tumor development.

Seizures and Convulsions:

• Seizures occur due to abnormal electrical activity in the brain, with brain tumors responsible for 30% of new-onset seizures in adults
• Seizures associated with convexity meningiomas and other brain tumor locations
• Seizures that vary from brief lapses in awareness to full convulsions

Personality and Behavioral Changes:

• Behavioral or personality changes, including increased aggression, confusion, or memory loss caused by brain tumors
• Personality changes and difficulty thinking, speaking, or understanding language
• Mood changes that are uncharacteristic for the individual

Memory Problems and Cognitive Issues:

• Memory issues and cognitive problems that can indicate brain tumor presence
• Problems with thinking, speaking, or finding the right words that can indicate a tumor affecting specific brain areas
• Memory problems from larger meningiomas that block cerebrospinal fluid flow

Speech and Communication Difficulties:

• Changes in voice and swallowing difficulties from tumors in the back of the brain
• Problems finding words or expressing thoughts clearly
• Difficulty thinking, speaking, or understanding language

Physical Weakness and Numbness:

• Weakness, numbness, and paralysis that can affect one part or one side of the body
• Leg weakness from large parasagittal meningiomas affecting major blood vessels
• Gradual loss of sensation or movement in arms or legs

Diagnostic Tests and Medical Evaluation

Many tumors are slow growing, so without a sudden onset of symptoms, meningioma isn’t often the first consideration when symptoms do start to appear.

Women with a history of Depo Provera use should specifically request brain imaging evaluation.

MRI Scans – Preferred Method:

• MRIs are the preferred scan for looking at brain tumors, offering superior image quality with exceptional detail for better visualization of soft tissues and blood vessels
• MRI offers clearer views of soft tissues, making it easier to differentiate between healthy and affected regions, with high-resolution images that can show much smaller details
• Different types of MRIs can be used for brain tumor diagnosis, including gadolinium-enhanced MRI, diffusion-weighted imaging, and perfusion imaging

CT Scans – Faster Alternative:

• CT scans are much faster than MRI, taking only a minute or less, and are often the first imaging test received
• CT scans can provide more detailed images of bone structures near brain tumors and may be used when patients cannot have MRI due to pacemakers
• CT scans provide clear images of brain anatomy, aiding in detecting abnormalities, tumors, and bleeding

When to Request Brain Imaging:

• If you used Depo shots for over a year or received at least two injections, it may be worth making an appointment with your primary care doctor, especially if you’ve begun experiencing symptoms
• Women who used Depo Provera for extended periods should mention this history to healthcare providers
• Request evaluation even for mild or seemingly unrelated neurological symptoms

Importance of Disclosing Medication History:

• Duration and frequency of Depo Provera use
• Medical history including past surgeries, allergies, or conditions that might influence scan procedures
• Current medications that might interfere with imaging results
• Any family history of brain tumors or neurological conditions

It is important to consult with a medical provider if you or someone you know is having any of these symptoms, particularly if they are persistent and worsening, as detecting and diagnosing early can greatly enhance the effectiveness of treatment.

Women who developed brain tumors after using Depo Provera for more than one year may have legal options for seeking compensation.

Product liability laws protect consumers when medications cause serious health complications that weren’t adequately warned about.

Grounds for Legal Action

Depo-Provera cases are primarily product liability lawsuits against Pfizer based on the company’s failure to warn about meningioma risks, with the legal case built on Pfizer’s inadequate disclosure of serious side effects.

These lawsuits aim to hold Pfizer accountable for their negligence and seek compensation for women who developed meningiomas after using Depo-Provera, alleging the company knew or should have known for decades about the increased risk but failed to warn users.

Failure to Warn:

• Claims that Pfizer did not sufficiently warn patients and healthcare providers about potential brain tumor risks associated with long-term use, failing to update product labels or provide adequate safety information
• Pfizer’s failure to adequately warn consumers about the risk of developing meningioma brain tumors, despite growing evidence linking long-term use to this serious condition
• Years ago, Canada and the European Union added warnings about the potential link between Depo-Provera and meningiomas to the drug’s label, however, users in the U.S. were left unaware of this risk

Product Liability Claims:

• Claims that the drug is inherently dangerous and unsafe for use because of its design, with manufacturers held liable even if they were careful in producing the drug
• Arguments that Pfizer had a safer alternative (Depo-SubQ Provera 104 with lower progestin dose) yet continued to produce and promote the higher-risk version

Negligence and Design Defect:

• Allegations of negligence in research and testing, negligent design defect, negligent failure to warn, and negligent and fraudulent misrepresentation
• Breach of warranty and violations of state Products Liability Acts and Consumer Sales Acts

Types of Compensation Available

Women are seeking financial compensation for medical expenses, lost wages, and pain and suffering, with the amount varying based on several factors including the severity of the condition, impact on quality of life, and strength of evidence linking meningioma to Depo-Provera use.

Medical Expenses (Past and Future):

• Costs related to diagnosing brain tumors, including imaging tests like MRIs or CT scans, treatment such as surgery or radiation therapy, and ongoing long-term medical care
• Diagnostic medical tests, emergency medical care, surgery to remove brain tumors, hospital fees, follow-up appointments, in-home medical care, and follow-up surgery when necessary
• Regular monitoring for tumor regrowth and neurological evaluations

Lost Wages and Earning Capacity:

• Replacement income for time off work during treatment and recovery, lost future income if unable to return to work due to brain tumor complications
• Impairment of future earnings and damages for the permanency of injury
• Economic losses from reduced work capacity due to ongoing neurological issues

Pain and Suffering Damages:

• Physical pain associated with surgery, recovery, and ongoing health problems, emotional distress including anxiety and depression from brain tumor diagnosis
• Diminished quality of life due to long-term neurological complications, chronic headaches, or cognitive difficulties
• Loss of enjoyment of life and emotional distress damages

Potential Punitive Damages:

• Damages intended to punish defendants and discourage future similar behavior, awarded when courts determine companies prioritized profits over patient safety
• Awards based on arguments that Pfizer knew or should have known about meningioma risks but failed to warn consumers

Additional Damages:

• Loss of consortium claims for spouses whose relationships were impacted by health issues, and wrongful death damages for families who lost loved ones due to brain tumor complications

Statute of Limitations Considerations

The statute of limitations for Depo-Provera lawsuits typically ranges from two to three years from diagnosis, though some states may have deadlines as short as one year or as long as six years for product liability cases.

State-Specific Filing Deadlines:

• Indiana has a two-year statute of limitations for personal injury or product liability claims arising from pharmaceutical injuries, with rare exceptions
• Alabama has a two-year statute of limitations deadline for most product liability cases
• Deadlines vary by state, typically ranging from one to six years from the date of injury or diagnosis

Discovery Rule Applications:

• The discovery rule may apply in some states, extending the deadline to file by starting the countdown when you could reasonably connect the tumor to Depo-Provera use rather than from diagnosis date
• Lawyers may argue that clients couldn’t reasonably connect Depo to their tumor without proper warnings on the drug’s label
• Many Depo-Provera claims may benefit from the discovery rule, allowing the statute of limitations to begin when plaintiffs learn about the link between their injury and drug use

Importance of Acting Promptly:

• Product liability cases have strict deadlines, and missing the deadline means losing the chance to pursue compensation
• Legal experts advise women who developed brain tumors after using Depo-Provera to act quickly, as the statute of limitations may limit their ability to file claims
• Due to Pfizer’s alleged intentional concealment of risks, plaintiffs may argue that Pfizer cannot use statute of limitations as a defense, as the company’s conduct invalidates attempts to dismiss claims based on statutory deadlines

Current Litigation Status:

• Lawsuits have been centralized into a multidistrict litigation (MDL) in Florida federal courts under Judge M. Casey Rodgers, with cases consolidated as MDL 3140
• The litigation doubled in size in April 2025 as new cases were filed, growing from 130 to 289 active cases
• Settlement predictions range from $300,000 to $1,000,000 (or more) for cases involving important complications, though exact amounts will vary based on individual circumstances

If you or a loved one used Depo Provera for extended periods and developed a brain tumor, consulting with an attorney experienced in pharmaceutical product liability cases can help you understand your legal options and ensure you meet all necessary deadlines to protect your rights.

If you’ve used Depo Provera for over a year and have concerns about brain tumor risk or have received a diagnosis, taking organized steps can protect both your health and legal rights.

Documentation and timely action are key to building a strong case while managing your medical care.

Gathering Medical Documentation

Providing evidence of Depo Provera use is central to litigation, with plaintiffs required to complete a “Plaintiff Proof of Use/Injury Questionnaire” and gather medical records, pharmacy receipts, or prescription history showing they received the injection at least two injections.

Injection Records and Dates:

• Prescription records for Depo-Provera, Depo-SubQ Provera, or authorized generics, including doctor’s notes detailing prescription and administration
• Records from prescribing doctors, insurance billing records, and third-party verification from pharmacies, clinics, hospitals, insurance companies, and military medical providers
• Documentation showing the plaintiff received Depo-Provera at least twice, with detailed pharmacy records showing dispensing dates and dosages

Medical Imaging and Diagnosis Records:

• Imaging results including MRIs and CT scans confirming the presence of brain tumors or meningiomas, along with pathology reports providing details on tumor type and characteristics
• Hospital records, treatment documentation, lab results, and physicians’ notes that support the diagnosis and convey the severity of medical issues
• Medical records and billings that detail Depo-Provera use and associated costs for documenting injuries

Treatment and Financial Documentation:

• Hospital bills related to brain tumor treatment, treatment records including surgery and radiation therapy details, and pharmacy receipts for medications
• Financial records documenting losses due to medical bills, lost wages, and other expenses related to the tumor

Creating a Comprehensive Medical Timeline:

• A clear timeline linking the start of Depo-Provera use, the diagnosis of the tumor, and the progression of the condition, with testimony from medical professionals helping build the timeline
• Documentation of Depo-Provera injections and medical history, including diagnosis, symptoms, and treatment for brain tumors

Finding the Right Medical Specialists

A patient diagnosed with meningioma should be evaluated by a multidisciplinary team that includes neurosurgeons, neurologists, neuro-oncologists, neuroradiologists, neuropathologists, radiation oncologists, and other specialists with advanced training and extensive experience in brain tumors.

Neurologists and Neurosurgeons:

• Patients should find neurosurgeons who specialize in brain tumors, operate on their tumor type frequently, and have teams of specialists including tumor boards to confer on cases
• Key questions to ask include: “Do you treat tumors like mine?” and “How many patients with my tumor type do you treat in a year?”
• Specialists should have expertise in meningiomas, with neurosurgeons having performed thousands of successful brain surgeries and research focusing on understanding meningioma biology

Oncologists Specializing in Brain Tumors:

• Neuro-oncologists who diagnose and treat patients with tumors affecting the brain, spinal cord, and nerves, working closely with multidisciplinary teams
• Specialists in molecular-targeted therapies for meningiomas
• Access to specialists skilled in stereotactic radiosurgery with advanced equipment like Brainlab iX, Gamma Knife, and CyberKnife

Second Opinion Importance:

• Getting a second opinion really matters, with patients encouraged to look for leaders in the field rather than settling for the nearest hospital.
• Most healthcare professionals are open to allowing second opinions, recognizing the sensitive nature of brain tumor diagnosis, with patients having the right to ask without fear of reprisal.
• Specialized centers offer remote second opinion programs, with neurosurgeons providing written recommendations within 7-10 business days for around $100.

Coordinating Care Between Specialists:

• Patients can travel for surgery and then undergo treatment closer to home, as having surgery at a particular hospital doesn’t require post-surgery treatment at the same location
• Neurosurgeons should be able to provide referrals and know other specialists who can provide advice and second opinions

Protecting Your Legal Rights

It’s important to act quickly as there are statutes of limitations in each state that set deadlines for filing certain types of lawsuits, with some being as short as one year after diagnosis.

Preserving All Medical Records:

• Gathering all medical records including Depo-Provera prescriptions and meningioma diagnosis, consulting an attorney experienced in pharmaceutical litigation to evaluate the case
• Attorneys take charge of collecting and organizing medical records, reviewing evidence, and ensuring all relevant documentation is in place
• Maintaining copies of all diagnostic imaging, pathology reports, and treatment records

Documenting Symptoms and Impacts:

• Recording the plaintiff’s account of Depo-Provera use, onset of symptoms, and impact on life including pain, suffering, and loss of income
• Evidence showing how the diagnosis affected quality of life, including work incapacity, loss of enjoyment, and psychological trauma
• Witness testimony from family, friends, or coworkers corroborating the impact on the plaintiff’s life

Avoiding Social Media Discussions:

• Refraining from posting about medical conditions or treatments on social platforms
• Avoiding discussions about legal cases or potential litigation online
• Being cautious about sharing personal health information that could impact legal proceedings

Speaking with an Experienced Attorney:

• Consulting with attorneys who are well-versed in pharmaceutical litigation or product liability, particularly those with experience in Depo-Provera or hormone-related cases
• The first step involves a confidential consultation with an attorney who focuses on pharmaceutical injury cases and represents Depo-Provera victims
• Most law firms offer free consultations to determine case strength and discuss potential legal strategies, with attorneys working on contingency fee basis

Timeline for Legal Action:

• Current MDL proceedings have established pilot cases with fact discovery beginning and cases expected to be ready for trial by late 2026 or early 2027
• The legal process can take several months to a year or more to complete, with accepting settlement offers helping to shorten the time to receive compensation

If you or a loved one used Depo Provera for extended periods and developed a brain tumor, contact TruLaw using the chat on this page to receive an instant case evaluation and determine whether you qualify to join others in filing a Depo Provera lawsuit today.

Our Depo Provera attorney at TruLaw is dedicated to supporting clients through the process of filing a Depo Provera lawsuit.

With extensive experience in dangerous drugs cases, Jessica Paluch-Hoerman and our partner law firms work with litigation leaders and medical experts to prove how Depo Provera injections caused you harm.

TruLaw focuses on securing compensation for medical expenses, meningioma treatment costs, pain and suffering, and other damages resulting from your Depo Provera-related meningioma.

We understand the physical and emotional toll that Depo Provera complications have on your life and provide the personalized guidance you need when seeking justice.

Meet the Lead Depo Provera Attorney at TruLaw

Meet our lead Depo Provera attorney:

• Jessica Paluch-Hoerman: As founder and managing attorney of TruLaw, Jessica brings her experience in product liability and personal injury to her client-centered approach by prioritizing open communication and personalized attention with her clients. Through TruLaw and partner law firms, Jessica has helped collect over $3 billion on behalf of injured individuals across all 50 states through verdicts and negotiated settlements.

How much does hiring a Depo Provera lawyer from TruLaw cost?

At TruLaw, we believe financial concerns should never stand in the way of justice.

That’s why we operate on a contingency fee basis—with this approach, you only pay legal fees after you’ve been awarded compensation for your injuries.

If you or a loved one developed meningioma after receiving Depo Provera injections, you may be eligible to seek compensation.

Contact TruLaw using the chat on this page to receive an instant case evaluation and determine whether you qualify to join others in filing a Depo Provera lawsuit today.

Depo Provera lawsuits are being filed by individuals across the country who developed meningioma and other significant health complications after receiving the contraceptive injection.

TruLaw is currently accepting clients for the Depo Provera lawsuit.

A few reasons to choose Depo Provera lawsuit lawyers at TruLaw for your case include:

• If We Don’t Win, You Don’t Pay: The attorneys handling Depo Provera lawsuits at TruLaw and our partner firms operate on a contingency fee basis, meaning we only get paid if you win.
• Expertise: We have decades of experience handling dangerous drugs cases similar to the Depo Provera lawsuits.
• Successful Track Record: TruLaw and our partner law firms have helped our clients recover billions of dollars in compensation through verdicts and negotiated settlements.

If you or a loved one has experienced health problems after receiving Depo Provera injections, you may be eligible to seek compensation.

Contact TruLaw using the chat on this page to receive an instant case evaluation that can determine if you qualify to join others in filing a Depo Provera lawsuit today.