Hema Sreedharan Nair1, Priyasree Jayasimhan2
BACKGROUND
Centchroman is a novel nonsteroidal contraceptive that offers a unique combination of weak estrogenic and potent antiestrogenic properties. Centchroman inhibits the fertilised ovum from implantation and thus prevents pregnancy. The development of the steroidal contraceptive in the late 1950s was a big event in reproductive research. The pill has, however, some inherent logistic limitations such as the need for continuous administration and thus associated likelihood of side effects. This underscored the need for a safer alternative for preventing pregnancy such as postcoital contraceptives and those that interfere with events between ovulation and implantation. Hence, in this study, a clinical evaluation of centchroman for its contraceptive study was carried out on 153 women and the contraceptive benefit was evaluated at monthly intervals.
MATERIALS AND METHODS
It was a prospective study done in the family planning department of Sree Avittom Thirunal Hospital. Postnatal patients reporting to the family planning department at 6 weeks postpartum and also patients opting for medical termination of pregnancy or cases following spontaneous abortion were selected for the study. Contraceptive efficacy of centchroman was studied over a 12-month period.
RESULTS
153 subjects were studied. 63% of the subjects were in the age group of 20-24 years. 93% subjects used centchroman as a spacing method after first delivery and 6% after second delivery. 43% of acceptors were following MTP or abortion, 35% were postpartum cases and 22% were interval acceptors. 5.2% of subjects in the study group had rheumatic heart disease, 2% had hypertension and 2.6% had diabetes mellitus. Duration of use ranged from 3 months in 153 subjects to 12 months in 130 subjects. The main cause for discontinuation of centchroman was menstrual irregularity. Menstrual complaints were noted in 45% of the subjects. The major menstrual complaint was delayed cycle in 26% subjects and scanty flow in 12%. Pearl index calculated for centchroman was 2. This was slightly higher compared to the product specification of 1-1.8. Of the 153 patients in the study group, pregnancy occurred in 11 patients. 4 pregnancies were user failures and seven pregnancies were drug failures.
CONCLUSION
1. Centchroman is a safe nonsteroidal contraceptive for spacing of pregnancies.
2. Centchroman does not alter carbohydrate or lipid metabolism, coagulation factors or blood pressure and hence can be safely used in women in whom steroidal pills are contraindicated.
3. Menstrual irregularity is the major reason for discontinuation of centchroman.
4. Majority of menstrual disorders revert back to normal by 6-9 months of use.
5. Centchroman does not cause pathological ovarian enlargement.
6. Pearl index of centchroman was calculated to be 2.
7. Resumption of fertility following discontinuation was prompt.
