Type of contraceptive
• Nonsteroidal oral contraceptive
Name the active ingredient and what is its pharmaceutical action?
The active ingredient is “Ormeloxifene”16 also known as “centchroman.” Centchroman is a selective estrogen receptor modulator (SERM). It has some estrogenic effect (e.g., in bones) and some antiestrogenic effect (e.g., in uterus and breast).
What is the mechanism of action of centchroman?
• Its antiestrogenic activity on the endometrium inhibits the fertilized ovum from implantation.
• It hastens the transfer of ovum from the fallopian tubes to the endometrial cavity, before it is ready for implantation.
Mention the recommended dosage schedule for contraception.
For the first 3 months: For initiation of the Centchroman (Ormeloxifene), the first pill is to be taken on the first day of period (as indicated by the first day of bleeding) and the second pill three days later. This pattern of days is repeated through the first three months.
After the initial 3 months: from the fourth month, the pill is to be taken once a week (the same day of the week on which the first pill was taken) and should be continued on the weekly schedule regardless of her menstrual cycle
Mention the side effects.
• Delay in menstrual cycle in some women,15 but this occurs in around 8% 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.
• Periods can get scanty over time in some women. This is not harmful and will subside on its own.
Has it been introduced in Indian family welfare program as a contraceptive?
Mention the failure rate of centchroman as a contraceptive.
Failure rate is 1 – 2 pregnancies per HWY.
What if a Period is missed while on Centchroman (Ormeloxifene)?
With Centchroman (Ormeloxifene), occasionally the menstrual cycle may get prolonged in some users. The contraceptive makes the periods lighter and the interval longer, which is not harmful and can actually be helpful for anaemic women.
However, if periods are delayed by more than 15 days, pregnancy needs to be ruled out
Mention the advantages of centchroman.
• Convenience of infrequent dose, i.e., once a week.
• Does not have the side effects which are commonly seen with hormonal contraceptives, e.g., nausea and weight gain.
• Does not have the adverse metabolic effects which are reported with hormonal contraceptives, e.g., no adverse alteration of serum lipids and no increase in platelet adhesiveness.
• Quick reversibility of fertility when the use is stopped.
• It is a safe drug with an excellent therapeutic index.
• Has shown potential as a postcoital contraceptive also.
• No congenital or developmental anomalies have been reported in births in case of contraceptive failure.
Mention the disadvantages of centchroman.
• Need for a fair level of understanding in the user to follow the proper schedule
What may be the potential therapeutic uses other than contraception?
Centchroman has shown potential in the therapy of following conditions:
• Dysfunctional uterine bleeding
• Premenstrual syndrome
• As a serum lipid lowering agentsaheli HLL
• Recent research demonstrates potential in treatment of some kinds of benign and malignant breast tumors
1. GOI March 2016. Reference Manual for Oral Contraceptive Pills. Family Planning Division Ministry of Health and Family Welfare. New Delhi
2. Park K. Demography and family planning. In: Park K. Park's Textbook of Preventive and Social Medicine, 24th ed. Jabalpur, India: Banarsidas Bhanot Publishers, 2017; pp. 525-52.
3. Saheli. Hindustan Latex Family Planning Promotion Trust (HLLFPPT). Available at: http://www.hlfppt.org/images/saheli.pdf. Accessed November 1, 2011.
4. Singh MM. Centchroman, a selective estrogen receptor modulator, as a contraceptive and for the management of hormone-related clinical disorders. Med Res Rev 2001;21(4):302–47.
5. Srivastava S, Sharma R, Balapure AK. Morphological and biochemical basis of centchroman as a novel antineoplastic agent in Mcf-7 human breast cancer cells. Indian J Pharmacol 2004;36:238–43.
6. Dhar A, Srivastave A. Role of centchroman in regression of mastalgia and fibroadenoma. World J Surg 2007;31(6):1178–84
7. Contraceptives. In: Mastering Practicals – Community Medicine. Eds. Tiwari P, Tiwari S. Lippincott William & Wilkins; Wolters Kluwer. New Delhi Buy at: https://www.amazon.in/Mastering-Practicals-Community-Medicine-thePoint/d...
CENTCHROMAN TABLETS FAQs: http://www.ihatepsm.com/blog/centchroman-tablets-faqs
Condom FAQ: http://www.ihatepsm.com/blog/condm-faqs
Features of an ideal contraceptive: http://www.ihatepsm.com/blog/features-ideal-contraceptive