This March 8 was published an article entitled "I had a meningioma", "I want to take up the luteran": what care after the stop of the progestins? Including some claims of the gynecologist interviewed, Dr. Odile Bagot, are incomplete and erroneous.
Complete article here: https://www.20minute.fr/sante/4080376-20240308-meningiome-veux-reprendre-luteran-prise-apres-arret-progestifatives
With the help of Pr Johan Pallud, member of the association's scientific council, neurosurgeon, head of service at GHU Paris, we allow ourselves to complete and /or correct the following sentences:
"It is true that in most cases, these specific meningiomas are asymptomatic and regress to stop treatment," confirms Dr. Odile Bagot, gynecologist, author of the Mam Gyneco blog and the work vagina and Cie, we tell you everything! (ed. Mango). For these patients, the situation is evaluated on a case -by -case basis, in consultation between the various specialists (gynecologist, neurologist, etc.).
The assertion of Dr. Odile Bagot is incomplete and partly wrong:
- on the fact that they are asymptomatic: we do not have reliable statistics to date, but having "something in the head" is a minimum source of a symptom of anxiety.
- For regression when you stop treatment: studying the real life screening program carried out by Pr Johan Pallud, neurosurgeon, published in 2022, shows that after stopping progestogen, the tumor load has decreased over time in 79% of patients. This means that meningiomas have remained stable or increased in 21% of cases. An update of this study is planned, which will further refine this figure.
- For consultation between specialist, a neurosurgeon is more useful than a neurologist because it is the daily life of the neurosurgeon than to inform about the conduct to be held in the face of a meningioma (this is not the profession of the neurologist).
“Once you have stopped treatment, we will not develop specific meningioma later, reassures Dr. Bagot. So those who have taken progestin, who take it no longer and who have no neurological symptoms do not have to go from MRI. On the alternative side, some can benefit from a progesterone IUD, with which no meningioma ride is associated, and which is a very good indication in particular for hemorrhagic rules. And for endometriosis, there are other pills , ”reassures Dr. Bagot.
- This paragraph, also erroneous, is falsely reassuring. The situation is more complex than what Dr. Bagot says. First of all, any gynecologist should above all know and seek the neurological symptoms that can sign the presence of meningioma (headache, dizziness, absence, loss of memory, loss of vision, smell, weakness of a member, intense fatigue often taken for depression, etc.). Then, if one of the 6 progestins identified to date as being at risk of meningioma is replaced by another progestin and that a meningioma is present, this meningioma could continue to grow.
In addition, when the progestin is stopped when discovering a meningioma, it is not certain that it stops its growth. A continuation of the evolution of meningioma is sometimes observed, requiring long -term systematic monitoring and, sometimes, an intervention on meningioma.
It is also necessary to keep in mind that any progestin can be at risk of meningioma, it is the dose and the duration which induce the risk. 3 other molecules are being studied to study their possible link with the occurrence of meningioma.
The association recalls that the ANSM communicated for the first time in 2023 on a possible class effect, in view of the large number (we recall: 6 to date) of progestins identified at risk.
