Hormonal factors predisposing to the development of meningiomas in men: a case-control study.

PURPOSE: The characterization of meningiomas within the male population, particularly regarding the potential over-representation of hormonal factors, currently lacks precision, emphasizing the need for a comprehensive understanding of risk factors influencing their development or growth. This study aims to delineate the hormonal profiles in males diagnosed with meningiomas and seeks to identify whether specific factors are more prevalent in this population compared to a control group. METHODS: A case-control study was conducted, involving eligible individuals (n = 288) diagnosed with intracranial meningiomas between January 1st, 2003, and January 1st, 2021, at ‘Hôpital de l’Enfant-Jésus CHU-de-Québec – Université Laval’. Hormonal exposure, including 5α-reductase inhibitors, gonadotropin-releasing hormone (GnRH), testosterone, anti-androgens, medication for alopecia and hair loss, spironolactone, and other hormonal comorbidities, was assessed. RESULTS: A statistically significant association was identified between the use of 5α-reductase inhibitors and an increased risk of meningioma in men (OR 5.99 [1.99–18.06], p = 0.0015). Vasectomy (OR 0.35 [0.18–0.68], p = 0.0021) and alopecia (OR 0.24 [0.12–0.45], p = < 0.0001) were associated with a decreased risk of meningioma, while other endogenous and exogenous hormonal factors showed no significant associations with meningioma development. CONCLUSION: The study highlights a potential link between 5α-reductase inhibitor use and meningioma development, suggesting a role for progesterone in the pathophysiology. While the findings related to vasectomy and alopecia warrant further investigation, they are likely limited by study design biases. These results emphasize the need for more robust, prospective studies to better understand the hormonal factors influencing meningioma risk.