SAHELI the Non-Steroidal Oral Contraceptive Pill
Since people keep asking about the birth control I’m on, figured I would just write this up so I can direct people here as needed. Please feel free to ask any questions you have, and I will do my best to help.
The following is some of the information packet that comes with the pills:
What is Saheli?
Saheli – The non hormonal contraceptive (Weekly oral contraceptive pill)
Central drug Research Institute (CDRI), Lucknow has developed the molecule ‘Centchroman’ which was marketed by HLL under the brand name Saheli. Introduced in 1991, Saheli has the unique distinction of being the world’s first non-steroidal oral contraceptive pill. It is also unique since it is an indigenously developed drug – the first of its kind., this pill has provided contraception to over 1,000,000 women in India.
How does Saheli work?
For pregnancy to happen the following events are essentially needed:
- Production of sperm and ovum (female egg)
- Fusion of sperm and ovum (fertilization)
- Implantation of fertilized ovum to inner lining of uterus (nidation)
All contraceptives act by interfering with one or more of the above events. Saheli’s contraceptive action is not produced by influencing the Hypothalamo-Pituitiary-Ovarian (HPO) axis. Saheli’s contraceptive action is induced by prevention of implantation through localized action at the uterine environment.
Saheli has weak estrogenic and potent anti-estrogenic action. The contraceptive action of Saheli is caused by asynchrony created in preparing the uterus for implantation. This asyncrony is caused by:
- Accelerated tubal transport of embryo
- Accelerated blastocyst formation
- Delayed zona shedding
- Suppression of uterine decidualisation
Since there is no disturbance of the endocrine system, normal ovulatory cycle is maintained. Side effects commonly associated with hormonal pills are absent with Saheli. The contraceptive effect is readily reversible and subsequent pregnancy is normal. The relative safety and dosage simplicity further ensures excellent user compliance with Saheli.
Dosage Of Saheli?
Each tablet contains centchroman 30 mg, Start taking Saheli, one tablet of 30 mg twice a week for three months. For instance, if you take the first pill on a Sunday, take the second one on Wednesday. From the fourth month onwards, take only one tablet once a week (example from above would be Sunday) as long as you don’t want to get pregnant.
The first pill should be taken on the first day of the menstrual cycle.
I have since found out that another suggested use of the pill is to continue to take it twice a week for as long as you don’t want to get pregnant. There is a possibility that it will help increase the effectiveness, though that has yet to be studied for accuracy. I would suggest taking it every seven days (like they recommend) and seeing if that works.
Target audience ?
for Saheli is literate women in the age group of 20-45 years.
What should I do if I have missed taking a Saheli pill?
If you have missed taking a Saheli pill on the designated Saheli day, take it as soon as possible. If you have missed your pill dosage by one or two days but lesser then seven days, continue the normal schedule and also use condoms as additional precaution until you get your next period. If you forgot Saheli by more than seven days, you need to start taking it all over again, like a new user; that is, twice a week for three months then once a week.
What should I do if I have missed a period?
With Saheli, occasionally the menstrual cycle may get prolonged in some users. This is not a matter of concern. As Saheli acts as a contraceptive, it makes the periods lighter and the interval longer. This is not harmful for the body and can actually help increase your body’s supply of iron as you lose a less amount of blood. However, if your periods are delayed by more then 15 days consult a doctor.
Missed periods seem to be quiet common for some people while taking this drug. The instructions say to consult a doctor, but as you are doing that, please be aware that A LOT of women miss a period while taking this.
What are the health benefits?
- Saheli is free from side effects commonly associated with steroidal oral contraceptives like weight gain, nausea, vomiting, dizziness and breakthrough bleeding, breast tenderness, acne, hirsuitism. Saheli maintains normal ovulatory cycle as it has no effect on the HPO axis.
- Saheli possesses no effect on platelet aggregation, lipid profile and HDL cholesterol.
- Saheli ensures excellent user compliance because of its safety and dosage simplicity.
- Saheli exhibits contraceptive activity which is redily reversible within six months and subsequent pregnancy is normal.
- Saheli does not cause congenital anomalies and babies born to user failure present normal milestones.
- Besides its use as a safe contraceptive for long term use, Saheli is also shown to be beneficial for treating dysfunctional uterine bleeding, osteoporosis and pre-menstrual syndrome and as a drug for lowering lipid levels in the blood..
Does Saheli have any side effects?
Saheli does not have the short term side effects like nausea, vomiting, weight gain etc. which are commonly reported with the other oral contraceptive pills. The only side effects reported with Saheli (Centchroman) is the delay in the menstrual cycles in around 8% of the cases,
Clinical studies have confirmed Saheli is safe and free from typical hormonal side effects such as nausea, weight gain, fluid retention, hypertension, etc. No cases of vaginal discharge, spotting, breakthrough bleeding or menorrhagia have been reported.
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What are the contra indications?
Women with the following conditions should not use Saheli:
- Polycystic ovarian disease
- Cervical hyperplasia
- Recent history of clinical evidence of jaundice or liver disease
- Severe allergic states, chronic illnesses such as tuberculosis, renal diseases, etc.
Is Saheli safe for lactating mothers?
Studies conducted by CDRI indicate that Saheli could safely be used by lactating mothers.
How effective is Saheli as a contraceptive?
Saheli offers excellent pregnancy protection as documented during the clinical trials and post-marketing surveillance. The Pearl Index (contraceptive failure rate in 100 women years of use) of Saheli as documented in trials of CDRI is 1.63 and during the post-marketing surveillance the Pearl Index reported is 1.13.
Mechanism of Action ?
The molecule centchroman offers a unique combination of weak estrogenic and potent anti estrogenic properties. Due to this subtle mix of estrogenic and anti estrogenic action it inhibits the fertilized ovum from nidation and thus prevents pregnancy, but at the same time, it does not appear to disturb the other estrogen effects. Use of Saheli (Centchroman) as a contraceptive has been extensively evaluated in more than 2000 women of the reproductive age groups who wanted to space their children. Intensive monitoring by clinical examination, hematology and biochemical tests as well as laparoscopy and ultra sonographic examinations of ovaries and uterus have shown the drug to be quite safe. Babies born to use failure cases have shown normal milestones. The contraceptive effect is readily reversible and subsequent pregnancy and its outcome is normal. It scores over steroidal contraceptive pills because it does not disturb the endocrine system and the normal ovulatory cycle is maintained
Active Ingredient ?
Ormeloxifene is a SERM, or selective estrogen receptor modulator. In some parts of the body, its action is estrogenic (e.g, bones), in other parts of the body, its action is anti-estrogenic (e.g., uterus, breasts. It causes an asynchrony in the menstrual cycle between ovulation and the development of the uterine lining, although its exact mode of action is not well defined. In clinical trials, it caused ovulation to occur later than it normally would in some women (Singh 2001), but did not affect ovulation in the majority of women, while causing the lining of the uterus to build more slowly. It speeds the transport of any fertilized egg through the fallopian tubes more quickly than is normal (Singh 2001). Presumably, this combination of effects creates an environment such that if fertilization occurs, implantation will not be possible.Other information:
For women with Dysfunctional Uterine Bleeding or Menorrhagia (where you bleed more and longer then the “normal” amount), studies have shown a 97% decrease in fluid loss when taking 60mg. See the Ormeloxifene and menorrhagia page for more details.
Other Information :
In my research I have found that Saheli is affected by antibiotics and marijuana. Using either of those things will counteract the contraceptive effects. I know that antibiotics counteract with hormonal oral contraceptives also, but I don’t know if marijuana does or not. If you use either of those things you must use a back up method (condoms) until you stop using them AND get your next period.
For example, if your doctor prescribes and antibiotic to be used for two weeks, continue to take Saheli on schedule. As soon as you start taking the antibiotic you must use condoms until you get your first period after stopping antibiotic use. The best thing is to avoid marijuana all together, as it can stay in your system for awhile and counteract the contraceptive effects of Saheli.
Reading the forums, some people believe that ibuprofen can affect Saheli, and they say not to take it, but in all my research that is false information. Ibuprofen, when taken as directed, does not affect Saheli. If you want to be on the safe side, you can avoid taking it to often or to much.
They are doing studies with Centchroman and breast cancer. “Centchroman has also been found effective as an anti-breast cancer agent. Multicentric trials in stage III/IV breast cancer patients, who were not responsive to other modalities of therapy, were found to respond to Centchroman with an overall responsive rate of about 56%. The data is being compiled for seeking marketing permission from DCG(I).” This would be a first for contraceptives, as normal hormonal contraceptives increase your risk of breast cancer. I did not do very much research into this, but I do find it worth noting.
Saheli is 98% effective when taken correctly, verses hormonal oral contraceptives at 99% effective when taken correctly. The big difference here is “when taken correctly”. To take Saheli correctly, you take it twice a week for 3 months, and then just once a week. It can be taken any time during the day, doesn’t have to be at the same time of day every time you take it. To take hormonal oral contraceptives correctly, you take it every day at the same time. Even taking it an hour later can lower the effectiveness of the pill.
Saheli does not effect your libido like hormonal oral contraceptives do. From the research I have done, it either does not affect it at all (so your libido stays the same) or it increases it. I once had a friend who was talking about hormonal oral contraceptives and she said “Yay! I can have unprotected sex with my boyfriend… but now I don’t want to!”. Please keep in mind, after getting off of hormonal oral contraceptives it can take up to a year for your libido to get back to normal. So if you start taking Saheli within that year, your libido can still be messed up, but it won’t be because of Saheli.
Saheli says it can be used by lactating mothers, and if it were me I would, but in my research some people suggest not starting it until the baby is 6 months old. That would mean using a back-up method (condom) until the baby is 8-9 months old vs 2-3 months old if you started it right away.
Pros of Saheli:
- Easy to take
- No side effects
- Highly effective
- Doesn’t screw with your hormones
- Can lighten your periods and lengthen your cycles
- Does not cause (might even help with) breast cancer
- Inexpensive
Cons of Saheli:
- You have to use a back-up method (condoms) for the first 2-3 months
- Cannot start taking it until the first day of your period (can’t start in the middle of a cycle)
When searching for it, search for Centchroman, Ormeloxifene, Saheli, or Centron.
I Am Not A Doctor But Born To Be Lead
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