Most women using Depo-Provera were unaware of developments in Europe, where similar progestogens had already been restricted or withdrawn due to their association with brain tumors. In France, three high-dose progestogens were taken off the market even before the Roland study was published.

The decision by the European Medicines Agency and UK regulators to update Depo-Provera’s label with meningioma warnings, while Pfizer continues to exclude such warnings in the U.S., has understandably caused frustration among women involved in this litigation.