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.
Centchroman acts at four points in the reproductive cycle:
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.
But s birth control pills cannot be prescribed without a thorough pelvic examination since estrogen and progesterone can affect both these organs.
But most users have agreed that this is a safe and effective alternative to the the estrogen-progesterone birth control pills.
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