Title: Centchroman - A Magical Pill or a Myth
Authors: Natasha Thakur, Nadeem Ul Nazeer, Sahil Sandal, Muzefer Ahmad Ahangar, Mohammed Omer Shah, Mudasir Habib Shah, Bilal Ahmed Wagay, Rouf A Wani
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.133
Abstract
MASTALGIA is a common symptom experienced by most of the females and most common complaint encountered in outpatient department. Many agents have been tried but till now ideal treatment still awaits. Centchroman (ormeloxifene) is a selective estrogen receptor modulator.
Method: 56 Eligible patients of cyclic as well as non cyclic mastalgia were enrolled in our study to evaluate the efficacy of centchroman. Patients were treated with centchroman 30 mg daily for three months. Patients were followed at 4, 8, 12 weeks up to a period of 6 months. Patients were assessed using VAS score (visual analogue pain score) and breast pain chart.
Results: At 12 weeks, 87% women achieved reduction in pain score <3. Centchroman is an effective, safe, inexpensive and easily available drug for mastalgia. Except for 3 patients who had delay of menstruation 7-10 days. Keywords: Mastalgia, Cyclic Mastalgia, Non Cyclic Mastalgia, Centchroman.
References
1. Smith RL, Pruthi S, Fitzpatrick L.A. Evaluation and management of breast pain. Mayo clinic proceedings 2004; 79(3): 353-372
2. Jawrence LA, Grube BJ, Guiliano AE. Benign breast disease In: BerekJS, editor, Berek and Novak’s Gynecology, 15TH edition Philadelphia; Pa, USA: Lippincott William and Wilkins; 2012 ; pp 667-670.
3. Salgado CJ, MardiniS, Chen H. Mastod-ynia refractory to medical therapy: Is there a role for mastectomy and breast reconstruction? Plast. Reconst. Surg 2005;116:978-83.
4. Olawaiye A, Withiam-Leitch M, Dandkas G ,Kahn K. Mastalgia: a review of management.J.Reprod Med. 2005 Dec, 50 (12); 933-9
5. Kateria K, Dhar A, Srivastava A, Kumar S, Goyal A. A Systemic review of current understanding and management of masta-lgia. Indian journal of surgery. 2013.
6. Johnson KM, Bradley KA, Bush K, Gardella C, Dobie DJ, Laya MB. Freq-uency of mastalgia among women veter-ans; association with psychiatric conditi-ons and unexplained pain syndrome. Journal of General Internal Medicine. 2006; 21 (supplement 3): 870-875.
7. Gateley CA and Mansel RE. Management of cyclic breast pain. Br.J Hosp. Med. 1990 May; 43(5):330-2.
8. Ader DN, South-Paul J, Adere T et al. Cyclic mastalgia: prevalence and associated health and behavioral factor. J Psychosom obstet Gynecol; 2001; 22:71-76.
9. Hadi MS. Sports brassiere: is it a solution for mastalgia? Breast J 2006;6: 407-409.
10. Goodwin PJ, Miller A, Del Giudia ME, Singer W, Connelly P, Ritchie JW. Elevated high density lipoprotein cholesterol and dietary fat intake in women with cyclic mastopathy. Am J obstet Gynecol. 1998;179: 430-437.
11. Minton JP, Foeeking MK, Wehster DJ, Mathew RM.Caffenine, cyclic nucleotides and breast disease. Surg 1979,86:105-9
12. Dhar A,SrivastevaA .Role of centchroman in regression of mastalgia and fibroade-noma. World J Surg 2007 ;31:1178-84i
13. Robert MM, Elton RA Robinson SE, French K. Consultation for breast disease in general practice and hospital referred pattern. Br J surg 1987;74:1020-2
14. Mansel RE,Goyel A,Preece P, Leinster S, Maddon PR, Gateley C et al. European Randomized multicentric study of gosser-elin (Zoledex) in the management of mastalgia. Am J obst.gynecol 2004;191 (6):1942-9 (DOI)
15. Lal J. Clinical pharmokinetics and intera-ction of centchroman- A mini review . contraception . 2010;81(4):275-80. 16. Lal J, Nitynand S, Asthana OP, Nageraja NV,Gupta R.L. Optmization of contrac-eptive dosage regime of centchroman . contraception. 2001;63(!):47-51
17. MakkherA, Tandon I, Goel MM, SinghM, Singh MM. Effect of ormloxifene, a selective estrogen modulator on bio markers of endometrial receptivity and pinpode development and its relation to fertility and infertility in indian subjects. Fertil. Stenl . 2009;91(6): 2298-307.
18. Singh MM. Centchroman A selective estrogen receptor, as a contraceptive and for the management of hormone related clinical disorder. MedRes Rev. 2001;21 (4): 301-347 doi 10.1002/ med1011.
19. Tejwani PL, Srivastava A, Nerkar H, Dhar A, Hari S, Thakur S et al. Centchroman regresses mastalgia; A randomized comparison with danazol. Indian J Surg. 2011;73:199-205
20. Udaya kumar, Rajswaroob, Rajendran Kannan, Narayanasamy subbaraju Kannan, T tirouaroul. Effectiveness of centchroman on regression of fibroadenosis and Mastalgia. Journal of clinical and Diagn-ostic Reaserch 2016; oct, vol, 10(10): pl10-pl14. 21. Jalaj Rathi, Inderjit Karnail singh, Arjun Chawla. Centchroman as first line treatment for mastalgia, Result of an open label single arm trial. The breast journal vol 22, Issue 4, july 2016 pages407-412
22. Seema Khanna ,Dayanand Gupta, R.L Shukla, A.K Khana, Rahul Khanna. Int J Biol Med Res 2016, 7(2) 5563-5568. 23. Kumar S, Rai R, Agarwal GG, Dwlvedi V, Das V. Randomazied,double blind plac-ebo-controlled trial of ormeloxifene in breast pain and nodularity. The National Medical journal of Indian 2013;26(2) : 69-74.