Everything you need to know about the Depo-Provera® brain tumor risk and your options

Key takeaways:

• Risk is low: Current research does not show a clear cause-and-effect link between Depo-Provera® and brain tumors, though prolonged use of certain progestins may lead to a slightly increased risk of developing meningioma.
• Know the warning signs: Persistent headaches, vision changes, new seizures, weakness, or balance issues are symptoms to discuss with a healthcare provider promptly.
• Personal health matters: Factors like duration of use, family history, age, and other health conditions can influence your risk—talking with a clinician helps you make an informed choice.
• You have options: Pills, patches, rings, and nonhormonal IUDs offer safe, effective alternatives if you’re considering switching from the Depo-Provera® shot.
• Support is easy to access: Nurx connects you with licensed providers who can review your history, discuss risks, and help you find the birth control method that fits your lifestyle.

You may have seen concerns about whether Depo-Provera® is linked to brain tumors. 

At this time, research doesn’t show a clear cause-and-effect relationship. Some studies have explored whether long-term use of certain high-dose progestins is associated with rare, usually benign brain tumors called meningiomas. For Depo-Provera® (medroxyprogesterone acetate), the overall risk of meningioma appears to be low, but the science is still evolving, which is why it’s important to look at the full picture of your health rather than relying on headlines alone.

But choosing birth control is a personal decision, and your medical history matters. A clinician can review factors like how long you’ve used Depo-Provera®, your migraine history, any vision changes, and other health considerations to help you weigh benefits and potential risks. 

What is the Depo-Provera® shot?

The Depo-Provera® birth control shot is a form of birth control you get as an injection once every three months.

It contains medroxyprogesterone acetate, a progestin hormone that helps prevent pregnancy in a few reliable ways. It stops ovulation, thickens cervical mucus to make it harder for sperm to reach an egg, and thins the uterine lining. When you stay on schedule with your shots, it’s more than 99% effective.

Many people choose Depo-Provera® because it’s low maintenance. There’s no daily pill to remember and no weekly or monthly method to manage. You simply check in every 12 weeks for your next dose. The shot has been used for decades and is well studied, which can feel reassuring if you want a long-standing option.

Beyond pregnancy prevention, some people use the shot to help with heavy or painful periods or symptoms related to endometriosis. Nurx providers can guide you through other birth control options such as pills, patches, and rings. 

FDA warnings on brain tumor risk

In 2025, the FDA updated the prescribing information for Depo-Provera® to include new safety details about a possible link to meningioma, a rare type of brain tumor. This update doesn’t mean Depo-Provera® is unsafe for everyone, but it does highlight an important conversation to have with your healthcare provider when choosing or continuing this method.

The warning is based on research suggesting that long-term use of certain high-dose progestins may be associated with meningioma development. Meningiomas are tumors that form in the membranes surrounding the brain and spinal cord and are often slow-growing.

Here’s what’s helpful to know:

• Meningiomas are usually benign, but they can cause symptoms depending on their size and location
• The research focuses on prolonged exposure to certain progestins, not short-term use
• Risk increases after one year of consistent use 
• The FDA update is meant to support informed decision-making, not to discourage birth control use altogether

It’s also important to keep perspective. The overall risk of intracranial meningioma appears to be very low, and most people who use Depo-Provera® will not develop a meningioma.

If you’re using the shot or thinking about it, a provider can review your health history, how long you’ve used progestin-based birth control, and any symptoms that matter. Together, you can decide what feels like the right next step for you.

Warning signs of a meningioma brain tumor

Knowing what to watch for can help you get care quickly if something feels off. Meningiomas often grow slowly, and many people don’t notice symptoms at first. When they do appear, it’s usually because the tumor is pressing on nearby brain tissue or nerves.

Some key signs to be aware of include:

• Persistent or worsening headaches: These are different from typical tension headaches. They may get worse over time, feel stronger in the morning, and not respond well to over-the-counter pain relief.
• Vision changes: Blurry vision, double vision, or partial loss of sight can indicate pressure on the optic nerves.
• New seizures: Any sudden onset of seizures warrants prompt evaluation.
• Weakness or numbness: Feeling weakness or numbness on one side of your body can be a warning sign.
• Balance, speech, or memory changes: Difficulty walking steadily, speaking clearly, or recalling information may point to neurological effects.

If you notice any of these symptoms, reach out to a healthcare provider in person right away. Early evaluation and monitoring can make a big difference.

Who’s at risk?

Knowing your personal risk factors can help you have a more informed conversation with your provider about whether the Depo-Provera® shot is the right choice for you. While the overall risk of developing a meningioma remains low, a few factors can influence individual risk.

• Duration of use: Longer exposure of more than one consecutive year to progestins may be linked to a slightly higher risk.
• Personal or family history: If you or a family member have had meningiomas, be sure to mention it during your appointment.
• Age and sex: Meningiomas are more common in adults over 40 and occur more often in women.

If you’re a little concerned about Depo-Provera®, it’s understandable. But there are plenty of other well-studied birth control options to consider. Pills like Slynd®, Opill®, or Norethindrone are effective alternatives, and Nurx has over 50 different options with free delivery right to your door. 

Your provider can help you weigh the benefits, risks, and convenience to find a method that works for your lifestyle and health.

Alternative birth control choices

Finding a birth control method that works for you doesn’t have to be complicated. Nurx makes it easy to explore options and get prescriptions delivered right to your door. If you’re considering switching from the shot, several effective alternatives are available.

Combined birth control pills

These pills contain both estrogen and progestin and are among the most well-studied options.

Evidence-based choices to discuss with your provider include Lo Loestrin Fe® (ultra low dose), Tri-Sprintec® (generic for Ortho Tri-Cyclen®), and Microgestin® (generic Loestrin® Fe 1/20) or Junel Fe®. 

Many people like that pills give them a greater sense of control: you can start or stop anytime with guidance from your provider.

Progesterone-only options

Progesterone-only birth control may be a good option if you can’t take estrogen or prefer a hormone option with fewer estrogen-related side effects. 

Options include progestin-only pills like Heather®, which are taken daily and work primarily by thickening cervical mucus and preventing sperm from reaching an egg.

Patch and ring options

Non-injectable alternatives include NuvaRing® or Annovera® (the ring) and Twirla® (the patch).

The patch is changed weekly, so you don’t have to think about it daily, while the ring provides monthly protection.

Nonhormonal IUD

If you prefer hormone-free birth control, the copper IUD offers highly effective pregnancy prevention without hormonal side effects.

Taking control of your birth control choices

Making informed decisions about birth control means understanding both the benefits and any potential risks. The recent FDA update about Depo-Provera® and meningioma may feel concerning, but the absolute risk is still very low. It’s completely reasonable to review your options and talk with a clinician if you have questions or worries.

You have choices that fit your lifestyle and health needs. Whether you continue with your current method, switch to a pill, try a patch or ring, or explore a nonhormonal IUD, the right option is the one that works best for you.

With Nurx, you can compare birth control options, get expert guidance, and have prescriptions delivered directly to your door—making it simple to take control of your reproductive health with confidence.

Frequently Asked Questions

How do I know if I have a brain tumor from Depo?

You can’t know without a medical evaluation. Brain tumors are very rare, and most people who use Depo-Provera® will never develop one. Watch for concerning symptoms like new or worsening headaches, vision changes, seizures, or weakness on one side of the body. If any of these occur, see a clinician promptly for evaluation.

What are the first signs of a brain tumor?

Early signs can include persistent headaches (sometimes with morning nausea), new seizures, loss of ability to see things on the side while looking straight ahead, weakness or numbness, and balance difficulties. Many meningiomas grow slowly, so they can be present without obvious symptoms for some time.

How long on Depo Provera to develop a meningioma?

There’s no established timeline. Research on a link is limited and mixed. If you’ve used progestin contraception for years and have concerns, a clinician can review your personal risk and discuss alternative methods.

What is the controversy with Depo Provera?

Discussion focuses on weighing side effects (like temporary bone density changes, irregular bleeding, or possible weight and mood shifts) against its high effectiveness. Some research also explores a possible association with meningioma after long-term use. A clinician can help you understand the benefits and risks for your individual situation.

The information provided is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon this content for medical advice. If you have any questions or concerns, please talk to a medical professional. 

Services not offered in every state. Medications prescribed only if clinically appropriate, based on completion of the required consultation. Individual results may vary.

Not all options discussed in the blog are available through Nurx. Please see Nurx.com for details. 

Annovera® (segesterone acetate and ethinyl estradiol vaginal system, 0.15mg/0.013mg), Rx only, is used as contraception to prevent pregnancy. This drug may cause side effects, including headache, nausea/vomiting, yeast infection, and abdominal pain. If you would like to learn more, see full prescribing information, here.

Aviane® (levonorgestrel and ethinyl estradiol tablets, USP), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including irregular and/or heavy uterine bleeding, headache, breast tenderness, nausea, and dizziness. If you would like to learn more, please see the full prescription information here.

Depo-SubQ Provera 104® (medroxyprogesterone acetate injectable suspension, 104mg/0.65mL for subcutaneous use), Rx only, is used as contraception to prevent pregnancy. This drug may cause side effects, including dysfunctional uterine bleeding (irregular, increase, decrease, spotting), headache, and weight gain. Meningiomas have been reported after repeated administration of medroxyprogesterone acetate, primarily with long-term use. Patients using this form of birth control should be monitored for signs and symptoms of meningioma, and treatment should be discontinued if a meningioma is diagnosed. If you would like to learn more, see full prescribing information, here. Depo-SubQ Provera 104® may be prescribed by a Nurx affiliated provider but is not fulfilled through a Nurx pharmacy.

Heather® (norethindrone), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including headaches, irregular and/or heavy uterine bleeding, dysmenorrhea, nausea and/or vomiting and back pain. If you would like to learn more, please see the full prescription information here. 

Junel Fe 1.5/30® (norethindrone acetate and ethinyl estradiol, and ferrous fumarate), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including headaches, irregular and/or heavy uterine bleeding, dysmenorrhea, nausea and/or vomiting and back pain. If you would like to learn more, please see the full prescription information here.

Lo Loestrin Fe® (norethindrone acetate and ethinyl estradiol tablets, ethinyl estradiol tablets and ferrous fumarate tablets), Rx only, is used as contraception to prevent pregnancy. This drug may cause side effects, including irregular uterine bleeding, nausea, breast tenderness, and headache. If you would like to learn more, see full prescribing information, here. 

Levonorgestrel (generic Plan B®) tablet 1.5 mg, intended to reduce the chance of pregnancy after unprotected sex, may cause side effects, including dizziness, abdominal pain, diarrhea, headache, fatigue, irregular menstruation, breast tenderness, nausea or spotting. If you would like to learn more about Levonorgestrel tablet 1.5 mg, please see product information here.

Microgestin FE® 1/20 (norethindrone acetate/ethinyl estradiol and ferrous fumarate), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including headaches, irregular and/or heavy uterine bleeding, dysmenorrhea, nausea and/or vomiting and back pain. If you would like to learn more, please see the full prescription information here. 

Nikki® (drospirenone and ethinyl estradiol), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including headaches, irregular and/or heavy uterine bleeding, dysmenorrhea, nausea and/or vomiting and back pain. If you would like to learn more, please see the full prescription information here. 

NuvaRing® (etonogestrel 0.12mg/ethinyl estradiol 0.015mg vaginal ring), Rx only, is used as contraception to prevent pregnancy. This drug may cause side effects, including irregular uterine bleeding, nausea, breast tenderness, headache, and increased or unusual vaginal discharge. If you would like to learn more, see full prescribing information here.

Tri-Sprintec® (norgestimate and ethinyl estradiol), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including headaches, irregular and/or heavy uterine bleeding, dysmenorrhea, nausea and/or vomiting and back pain. If you would like to learn more, please see the full prescription information here.

Twirla® (levonorgestrel/ethinyl estradiol patch), Rx only, is an oral contraceptive used to prevent pregnancy. This drug may cause side effects, including headaches, irregular and/or heavy uterine bleeding, dysmenorrhea, nausea and/or vomiting and back pain. If you would like to learn more, please see the full prescription information here.

You are encouraged to report negative side effects to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.