Written by Dr.M.D.Mazumdar, MD

Centchroman (or 'Ormeloxifene') is a potent non-steroidal non-hormonal birth control method. Although it does not contain hormones, it acts on the hormones produced in the body, especially progesterone. It is a once-a-week oral contraceptive which has been proved to be not only highly effective but also safe.

Developed by the Central Drug Research Institute of India in the late nineties, Centchroman has undergone extensive clinical trials. It has a failure rate of only 1.63% which compares favorably with other birth control pills which have a failure rate of 1 to 1.5%.

Synthesized in 1967, it completed pre-clinical and clinical studies in 1989. This drug was approved for marketing in 1991, social marketing in 1995 and was introduced into the National Family Planning program in April 2016.

Centchroman is a SERM - a Selective Estrogen Receptor Modulator. It acts on estrogen receptors in the body to either stimulate or suppress the receptors.

What is interesting about Centchroman is that it suppresses the receptors in the reproductive organs like the ovaries, uterus and breasts. But it stimulates the estrogen receptors of other organs like the bones. So, while it acts as a birth control pill, it can prevent breast cancers, uterine cancers and stimulate the formation of new bones.

It is the only contraceptive which neither suppresses ovulation nor interferes with the hypothalamic-pituitary-ovarian axis. It has a high level of safety and is virtually free from side effects except for a delay in about 8% menstrual cycles which is not confined to any women/cycle.

Besides contraception, this SERM is also clinically useful in the management of Dysfunctional Uterine Bleeding (DUB), menorrhagia, breast pain (mastalgia) and fibroadenoma. It has also been successfully used in endometriosis and has been very effective in controlling the condition.

It has shown promising therapeutic efficacy in a variety of cancers including breast cancer. Due to estrogenic activity, this drug also has anti-osteoporotic and cardioprotective activity.

Centchroman is believed to be more effective than other birth control methods like condoms, the intrauterine contraceptive devices (IUDs), the rhythm method and the oral contraceptive pills .

Centchroman is also a safe and reversible postcoital contraceptive with curative and prophylactic activity in many disorders.

How does Centchroman prevent pregnancy?

Centchroman acts at four points in the reproductive cycle:

• Its main function is in preventing implantation of the blastocyst in the endometrium.
• It increases the movement of the fertilized ovum through the fallopian tubes so that it reaches the uterus too early when the endometrium is not ready for implantation at that time.

• It increases the rate of maturation of the ovum so that it is hypermature when it reaches the endometrium and fails to implant in it.

• It slows down the growth and development of the endometrium so that it is not adequately prepared to receive the fertilized ovum when it reaches the uterus.

Dosage Schedule of Centchroman

Centchroman is available as 30mg tablets. A single tablet should be taken twice a week (on a sunday and a wednesday) for the first three months and then weekly (every sunday) thereafter. The first pill is taken on the first day of the period or the first sunday after the first day of the period. Additional contraceptives like condoms should be used for the first month.

Advantages of Centchroman

• It is highly effective.

• It is safe to use. Since Centchroman has no effect on either the ovaries or the uterus, it can be started without a pelvic examination.

  But s birth control pills cannot be prescribed without a thorough pelvic examination since estrogen and progesterone can affect both these organs.

• It can be safely used by breastfeeding women.

• Being non-hormonal, it does not cause the nausea, dizziness, weight gain and other side effects associated with birth control pills.

• It has no adverse effect on blood coagulation, liver function and lipid profile. So there are no chances of blood clots or increase in the cholesterol level due to centchroman.

• It is not toxic. In women who became pregnant while on centchroman, no congenital anomalies were noted in the babies.

• It is less expensive than the traditional estrogen-progesterone pills. While a single month's course of the estrogen-progesterone pills costs between $35-$45, Centchroman costs about $50 to $60 for a 12 months course.

• Since it does not stop ovulation, return to fertility is faster once the pills are stopped.

• Risks of infertility are minimal.

Disadvantages of Centchroman

• Centchroman causes delayed periods in some women. But this occurs in less than 10% of users and usually in the first three months. The periods tend to settle down to a rhythm once the body gets used to the drug.

• There may be heavier periods in the first three months with tender breasts, water retention and some amount of acne.

• Periods can get scanty over time in some women.

• It is contraindicated in some conditions like PCOS and irregular or delayed ovulation due to any cause.

But most users have agreed that this is a safe and effective alternative to the the estrogen-progesterone birth control pills.

Also Read-

• Other Birth Control Methods.
• Vaginal Itching without Discharge.
• Trichomoniasis - a common sexually transmitted disease .
• Causes of Female Infertility.