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Welcome to the Deep Dive, the show where we cut through the noise, helping you get truly wellinformed on some fascinating topics. Today, we’re diving into something pretty surprising and uh frankly quite unsettling. We’re talking about a very widely used, trusted contraceptive, you know, a real staple in women’s healthc care for decades, and it’s recently identified kind of unexpected link to a specific type of brain tumor. It’s like finding a hidden chapter in a medical story we thought we
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knew. you know, a scientific discovery that’s now raising some really big questions about trust and transparency. >> That’s absolutely right. Our mission today is to really unpack this complex issue for you. We’ve got a stack of medical studies, research papers, legal stuff, too. We’ll dig into the science behind this connection, look at these tumors, specifically how the contraceptive actually works, and maybe most importantly, the big implications for how medical risks get communicated
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to patients, or maybe how they don’t. >> Yeah, exactly. Yeah, this deep dive should give you a genuine shortcut to understanding what’s really going on here. We’ll bring up some surprising facts, some really important context. Get ready to have some assumptions challenged, maybe. >> Oh, >> okay. Let’s unpack this. >> Yeah. >> All right. So, the medication we’re focusing on today is PA. Many of you probably know it as the birth control shot. >> It’s an injectable contraceptive super
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widely used by women since what it was approved in the US back in uh ’92. >> That’s right. 1992. So, it’s been a go-to option for a long time. Convenient, effective for many. And uh its effectiveness comes down to the active ingredient, hydroxy progesterone acetate or MPA. Now, this is a synthetic hormone. It’s made to be very similar structurally to our natural progesterone. You get the injection usually every 3 months and it mainly works by stopping ovulation, so preventing the ovaries from releasing an
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egg. But it also does something else. It thins the lining of the uterus. >> Oh, okay. >> Yeah. which basically makes it a tough environment for sperm or for a fertilized egg to implant. >> Right. So contraception is its main job, the reason most people know it. But MPA itself, the hormone, it’s used for other things, too, isn’t it? >> Oh, absolutely. That’s a really good point. MPA isn’t just for birth control. It actually plays quite a diverse role in women’s health. Doctors prescribe it
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to regulate periods, for example, or to help with really heavy bleeding. Um, sometimes in adolescence, it can be used to delay or suppress puberty. And you even see it used in treating conditions like endometrial cancer and endometriosis. So yeah, it’s a significant tool in various medical contexts. >> Okay, so it’s definitely got wide application. Now let’s switch gears a bit to the other side of this story, the menioma tumors. >> For those of us hearing this term maybe
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for the first time, what exactly is a menioma? >> Right. So a meningioma is a very specific kind of tumor. It grows from the mening. >> The meninges remind us. Yeah, those are the protective layers, the membranes that surround your brain and your spinal cord. Think of them like the brain’s natural wrapping or casing. Uh the pronunciation just for clarity is met and edges. And what’s really key to understand about them is that they usually develop very slowly. >> Okay, slow developing. What does that
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mean in practical terms like for someone who might have one without knowing? >> Well, it means these tumors can literally grow for years, sometimes many years without causing any symptoms you’d notice. You could be living your life completely unaware. But over time, even a slow growing tumor just because of its size or location can start pressing on the brain tissue or nerves nearby. >> Ah, the pressure aspect. >> Exactly. And depending on where it is and how big it gets, that pressure can
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lead to well adverse effects, sometimes debilitating ones, and potentially even life-threatening complications down the line. Hm. The fact that it can just sit there unnoticed, growing slowly, that makes understanding potential causes even more critical, doesn’t it? >> It really does. >> And that brings us right to the heart of today’s deep dive. This is where things get well really interesting and maybe a bit alarming. Recent medical studies have found a significant link, a
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startling link really. >> Yes, indeed. Our sources, particularly a study in the British medical journal, the BMJ from 2024, present some pretty strong evidence. They found a clear link between using deep priva injections and developing these menioma intraanial tumors in women. >> And this wasn’t just a small study. >> No, not at all. This was substantial. They meticulously analyzed medical records from uh 108,000 women. That’s a huge data set giving the findings a lot of weight.
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>> Wow. Okay. 108,000 W. So what was the key takeaway? The big number. >> Well, here’s what’s truly fascinating and yeah, deeply concerning. The key statistic that jumped out. Women who use Dep Depota for birth control had a 5.6 times higher risk of developing meniomas compared to women who didn’t use it. >> 5.6 times >> 5.6 times higher. Yeah. And uh what’s more, the risk wasn’t flat. It actually increased the longer someone used pravera and potentially with higher
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cumulative doses over time. >> Okay, let’s pause on that. 5.6 6 times higher risk. That’s that’s not a small increase. That’s substantial. >> It’s very substantial. Statistically significant, >> especially for a product that, like we said, has been trusted and used by millions for decades. >> Exactly. >> But hang on. If Deepo Tr has been around since 1992, why are we only hearing about this major link now? Is it just that it takes that long for data to build up or does this
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point to maybe some, I don’t know, slowness in tracking drug safety long term? That’s a fantastic question and it it really gets to the core insight here. It’s not just about the risk itself, right? It’s about what this whole situation reveals. Meniomas as we discussed grow slowly. So spotting a pattern and increased incidence across a large population. Well, that takes years, decades even, >> right? You need long-term data. >> You need massive data sets. These complex epidemiological studies, they
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just take time to compile and analyze properly. So yes, part of it is definitely the challenge of long-term data collection, but it also, you know, forces us to ask some tough questions about how proactively we monitor medications, especially ones used by so many people for such long stretches. This new data really changes the whole risk benefit calculation, doesn’t it? >> It certainly seems to. So, okay, if these risks are now known, the studies are pointing this way. What does that mean for patients? How is this
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information getting to the women actually using the shot? Well, that brings us to a really fundamental concept in pharmaceuticals, the duty to inform. >> Duty to inform, meaning >> meaning drug companies have a basic responsibility, a legal and ethical obligation really to tell consumers about any potential risks tied to their products, especially risks that aren’t obvious. It’s crucial for patients safety. And frankly, it’s the only way someone can give truly informed consent
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for a medical treatment. You need all the facts. And based on what we’re seeing in the sources, there seems to be a pretty big difference in how this duty to inform is being handled depending on where you live. Right. >> Precisely. This is one of the most striking things we found. In European countries, the warning labels for PA have actually been updated. They now specifically mention the potential risk of mining tumors. >> Okay. So, in Europe, they warn about it. >> Yes. But, and this is the crucial point,
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Fizer, the manufacturer, hasn’t made the same update to the US labels. The information about this specific risk isn’t on the patient information leaflet here. >> Wait, really? The same drug, the same manufacturer, but different warnings in Europe versus the US. >> Exactly. And connecting that to the bigger picture, well, it raises some serious questions about global standards for patient safety information. Why the difference? >> That’s kind of astonishing. A woman in
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France gets a warning about menomas, but a woman in the US taking the identical medication doesn’t. That appears to be the situation based on our sources. >> Wow. What could possibly explain that kind of difference? Different regulations. >> That’s the million-dollar question, isn’t it? And it’s likely complex. You have different regulatory bodies. The FDA here, the EMA in Europe, they have different processes, different timelines, maybe different thresholds for what evidence triggers a label
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change. It could be how quickly new research gets reviewed and integrated. It might even involve different legal considerations in different markets influencing what a company chooses to disclose and when. >> But the bottom line for the patient is >> the bottom line is where you live could determine how much safety information you receive about the exact same drug. And this disparity strongly suggests particularly in the US context that by not including these known risks on the US label, the manufacturer’s duty to
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warn might not have been fully met. >> Okay. So that potential failure to warn >> Mhm. That leads us to the legal side of things, right? Yeah. What happens when people feel they weren’t properly informed? >> Yeah. When that feeling combines with a serious diagnosis like a menioma, it often leads to legal action. And that’s what’s happening now. Women who use Depot PA and were later diagnosed with men are filing federal product liability lawsuits across the United States.
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>> Product liability meaning they’re suing the company. >> Essentially, yes. The core claim in these lawsuits is that Fizer knew or should have known about the risk of these tumors but failed to adequately warn doctors and patients in the US by not updating the labels. They argue this failure to warn prevented them from making an informed choice about their contraception. And these cases are being grouped together now uh in what’s called multidist litigation or MDL. It’s a way
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to handle lots of similar cases efficiently in the federal court system. >> Okay. And the plaintiffs aren’t just saying you didn’t warn us. They’re also often alleging negligence that the company didn’t do enough testing on the long-term effects of Depot pervera, suggesting a lack of due diligence. >> Right. And for anyone listening who might be in this situation or knows someone who is, there’s also a practical legal point to remember, isn’t there? >> Yes, absolutely. The statute of
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limitations. >> Explain that quickly. >> It’s basically a legal deadline. There’s a limited amount of time after you’re diagnosed or sometimes after you reasonably should have known about the link between the drug and your injury to actually file a lawsuit. >> So time is a factor. >> Time is definitely a factor. It adds another layer of urgency for people needing to understand their options. >> Okay, let’s shift back to the medical side for a moment. If someone is
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diagnosed with a mining, what happens next? What are the treatment options? >> Well, the good news is that there are treatments available, but it’s very much an individualized approach. What treatment is best depends heavily on things like the tumor’s exact location in the brain or spine, how big it is, and crucially whether it’s benign, which most are, or less commonly malignant. >> So, what are the main categories of treatment? >> Broadly speaking, surgery is often the
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first and most effective option if possible. The goal is to remove the tumor. This can involve different surgical techniques. Sometimes a cranottomy is needed >> which involves >> removing a piece of the skull temporarily to get access to the tumor and carefully separate it from the brain tissue. But there are also less invasive options now like keyhole surgery that uses a smaller incision and an endoscope, a tiny tube with the light and camera to reach and remove the tumor. And sometimes depending on
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location, surgeons can even go through the nose or sinuses using an endoscope. That’s called endoscopic surgery. Very minimally invasive. What if surgery isn’t an option or doesn’t get everything? >> Then radiation therapy often comes into play. It uses high energy beams to target and shrink the tumor or kill any remaining cells after surgery. It’s also used sometimes if surgery is just too risky because of the tumor’s location or the patient’s health. >> Are there medications?
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>> Not usually to treat the tumor itself, though sometimes steroids are used to reduce swelling around the tumor, maybe in elderly patients who can’t have surgery. and anti-epileptic drugs might be needed if the tumor causes seizures. >> And then there’s one more approach, observation or watchful waiting >> is watching it >> essentially. Yes. For some patients, maybe older individuals, if the tumor is small, slow growing and isn’t causing symptoms or pressing on anything vital,
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the doctor might recommend just monitoring it closely with regular brain scans, maybe every 3 to 6 months. Okay, so a range of options, but clearly some are quite major interventions. Definitely the complexity and potential impact of these treatments really highlight why getting that upfront information about potential risks for medications is so incredibly important. Ideally, you want to avoid needing these treatments if possible. >> Absolutely. Okay, so let’s try to bring this all together. We’ve covered a lot
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in this deep dive. We started with this really surprising link between a very common birth control shot PA and a significantly higher risk 5.6 six times higher of developing these men menoma brain tumors. A link that’s now backed by major medical studies and is actually leading to legal action. >> That’s right. And the really stark contrast we discussed between the warning labels in Europe including this risk and the US labels not including it. That just throws into sharp relief this
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ongoing challenge. How do we make sure that patients that consumers get complete up-to-date information about their treatments? It’s not just about scientists finding a risk. It’s about getting that knowledge to the people who need it promptly and clearly >> so they can make genuinely informed choices about their own health. >> Exactly. >> So this whole situation with deep pa meniomas and this global difference in warnings, it leaves us and hopefully you with a really important question to
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think about. What does this tell us about how medical risk information travels or doesn’t travel around the world? And maybe more personally, how can you as an individual best advocate for getting all the facts about the treatments you rely on, especially when the information seems to change depending on where you look? That’s definitely something worth mulling over long after this deep dive ends.
