Contraception is often used to prevent pregnancies and manage menstrual cycles—which is exactly why Sandra Somarakis, now 61, and Nicole Ryan, 60, chose it for over a decade.
Both women opted for medroxyprogesterone (a type of birth control injection) called Depo-Provera, owned by Pfizer, valuing the convenience of no periods and a quick doctor’s visit every three months.
However, both Somarakis and Ryan later developed a type of benign brain tumor called meningioma and required surgery to remove it. While these tumors are not cancerous, both women have suffered long-term side effects.
In January, researchers from the University of British Columbia’s Faculty of Medicine reported that women who used Depo-Provera for more than a year were roughly 3.5 times more likely to develop meningiomas compared with women using other forms of hormonal birth control.
From Routine Exam to Life-Altering Diagnosis
According to the Centers for Disease Control and Prevention (CDC), 24.5 percent of sexually active women have used the injectable contraceptive. Sandy began using Depo-Provera in 1996, until 2010.
Somarakis, from Oregon, told Newsweek that, during a routine mammogram in July 2008, doctors urgently summoned her back when they noticed swelling in her left eye.
“I thought my eye was watering and sore because of hay fever,” Somarakis said. “They sent me for an MRI, and an ophthalmologist called almost immediately: they’d found a tumor in my left eye socket.
“Within days, I was diagnosed with a meningioma,” Somarakis added.
The following year, the tumor was removed, and Somarakis continued to use the contraception.
“I was never told that Depo-Provera might be linked to meningiomas,” Somarakis said. She added that, 16 months later, she started suffering from severe headaches, and another tumor was found. “The neurologist was shocked,” Somarakis said.
In January 2010, she underwent surgery to remove her second tumor, followed by six weeks of radiation. She stopped using the injection after being told that radiation would leave her infertile.
“Radiation was horrible,” Somarakis said. “It completely changed me. I had been a 911 operator and a project manager—sharp, fast, making good money.
“It felt like my mind was wiped. My hair started falling out; I couldn’t swallow; and, for a time, I lived on yogurt and crushed crackers with milk.
“Even now, I’m not the person I used to be. I’ve lost many cognitive skills, and I can no longer work in the kind of high-pressure jobs I once excelled at,” Somarakis said.
“I have tinnitus and have lost the hearing in my left ear—I’ll need a hearing aid for the rest of my life. I still get terrible headaches; it feels like my frontal lobe is about to explode. My left eye is still watery, swollen, and sometimes it pops out slightly.”
In 2024, both Somarakis and Ryan learned of an ongoing multidistrict litigation (MDL) involving lawsuits filed against Pfizer over Depo-Provera and its alleged link to an increased risk of meningioma brain tumors.
“When you go through something like this as a healthy person, you wonder what you did to cause it,” Somarakis told Newsweek. “I was crushed when I found out.”
Nicole Ryan’s Symptoms and Surgery
Ryan, who lives in California, was diagnosed in 2014 after suffering from constant lightheadedness, near fainting spells and hearing loss in her left ear.
“I wasn’t surprised, but I was relieved to finally have confirmation of what was causing all my symptoms,” Ryan said. “Although the surgery was successful, I was left with permanent side effects such as permanent ringing in my left ear, poor balance, and headaches where the tumor was taken out.”
Legal Action and Claims Against Pfizer
Newsweek also spoke to Ellen Relkin, an attorney who is currently representing hundreds of women who claim they developed meningioma from Depo-Provera. The plaintiffs are seeking financial compensation and litigation has been filed in the U.S. District Court for the Northern District of Florida, Pensacola Division.
Relkin said: “Meningioma, the majority are ‘benign’ only in the sense that they do not metastasize to other organs. But it is in the brain and can grow.
“The brain controls sight, cognitive abilities, hearing. Clients have lost vision, some have become blind, others lost hearing.”
Relkin is a partner at Weitz & Luxenberg and chair of the firm’s Drug & Medical Device Litigation group. She has decades of experience representing thousands of plaintiffs in pharmaceutical, medical-device, and toxic-tort cases and has served in numerous court-appointed leadership roles.
Relkin told Newsweek about the core legal arguments: “One is failure to warn. They never warned about this risk of meningioma or to be on the lookout for the symptoms. Many of our clients had excruciating headaches or dizziness for years, and no one connected it to the drug.
“The second is safer alternative design. Depo-Provera is extremely high dose—150 milligrams. Pfizer got approval in 2004 for a lower-dose version, Depo-SubQ Provera—104 milligrams, which is equally effective. If you can give a lower dose that’s equally effective, why give more? The dose makes the poison.”
In the plaintiffs’ latest filing on September 22, in response to Pfizer’s attempt to have the case dismissed on federal preemption grounds, they say that Pfizer “refused to study or warn” about the risk of meningiomas for decades despite growing scientific evidence.
They add that when the company finally requested approval for a label change it “omitted crucial information and peer-reviewed studies,” failing to give the FDA the full picture of the dangers to patients.
Lack of Warnings in the US
Relkin claims there aren’t warnings about meningioma. She said: “Gynaecologists and clinics don’t tell patients because it’s not in the label.
“When women get these symptoms, doctors assume it’s something common like migraine and don’t make the causal connection. Then they keep taking the drug as the tumor grows.”
At minimum, Relkin added that the most-serious type of warning the U.S. Food and Drug Administration (FDA) issues—known as a black-box warning—should be applied.
“A black box would be ideal because then everyone would know. They’ll say it’s rare, but it’s not so rare—thousands of women are impacted because the drug is so widely used,” Relkin said.
Pfizer’s Response and Listed Side Effects
The Pfizer label highlights the following possible serious side effects of the drug. However, Somarakis and Ryan said that they were only made aware of weight gain when they opted for the injection in the late 1990s and 2000s:
- Bone loss
- Breast cancer
- Blood clots and stroke
- Ectopic pregnancy
- Severe allergic reactions: including serious eye problems or loss of vision
- Other health effects: may trigger migraines, depression, seizures, or liver problems.
A Pfizer spokesperson told Newsweek: “The Company stands behind the safety and efficacy of Depo-Provera, which has been used by millions of women worldwide and remains an important treatment option for women seeking to manage their reproductive health.”
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