Thursday, February 16, 2012

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 (Drug Name: Centchroman. Also known as Ormeloxifene) is the world's first non-steroidal oral contraceptive pill. Launched in 1991, 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.

How to take Saheli?
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.

*UPDATE 11-26-2012*
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. The other way to continue taking it is to take it every four days, five days, or six days. This method is used by women who have gone down to once a week, and realized that their periods get heavier again. By taking it every four, five, or six days, they are able to find what works best for them. I would suggest taking it every seven days (like they recommend) and seeing if that works. If not, change to every six days for the next cycle, then every five days for the next cycle... and so on until you get to where you need to be.

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.

*UPDATE 11-26-2012*
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.
  • Saheli has been found to be effective in managing Dysfunctional Uterine Bleeding.
Does Saheli have any side effects?
Apart from prolongation of menstrual cycle in some women, intake of non-steroidal contraceptive pill Saheli, is not known to cause any side effects. 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.

What are the contraindications?
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.


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.

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. Personally I only use it during my period, and I use Tylenol (if needed) during the rest of the month.

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.

Ordering Saheli is fairly simple in and of itself. Each package contains 8 pills at $0.81 a package. You can order a years worth at a time, as it has a very long expiration period. You would need 8 packages ($6.48) for the first year, and 7 ($5.67) for all consecutive years. Unless you have Menorrhagia and want to take a double dose, then you would need 16 packages ($12.96) for the first year, and 13 ($10.53) for all consecutive years. Now don't get to excited, there is a $25 shipping and handling charge. But even for the highest amount, that is only $37.96 for a one year supply. Better then most co-pays for a year. It takes a couple of days to get from India to the USA, but then it sits in customs for 2-3 weeks. Can be a bit inconvenient if your period starts before you get it, and you have to wait until the next cycle. Plus you have to remember at least a month in advance before you run out, so you don't have to start the pill cycle over.

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:
  • Is not available in the USA, you must order it from India
  • Takes a long time to ship
  • 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)
  • If your period starts on a Thursday, that is the ay you take it until you quit using them
  • Does not cause acne, but not sure if it can help clear it up

When searching for it, search for Centchroman, Ormeloxifene, Saheli, or Centron.









Since this is pretty long as it is, I will put my personal experience with Saheli in a different post. Also, I am not a doctor or a pharmacist. Whoever makes Sahili doesn't pay me to say any of this. I am just a normal person, who had to go to 100 different pages to get all this information. It's not my fault if you take this and something goes wrong!!!

27 comments:

  1. Wow - you've done a lot of research on this! I have been searching for a non hormonal birth control. I am concerned about the health hazards associated with hormonal birth control pills and I am particularly concerned because traditional pills have caused all the women in my family (my sisters and mom) to gain about 30 lbs while taking it, which was lost after they stopped. For this reason and other safety concerns i've never taken the pill. I have been doing research for a while and this sounds like a miracle drug! However I'm concerned that it seems shady to order it from India and I'm also concerned if it will cause infertility after I go off and want to have children...how long have you been taking it now? any advice would be much appreciated

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    1. I had the same concerns ordering it from India. I was very nervous, but I have since ordered it several times no problem. Heres the thing, it's an over the counter drug there, so you don't need a prescription there to get it. Here, it doesn't exist, you cant get it here, so it's not a prescription drug here. Since it's only illegal to order prescription drugs from other countries, this drug is kind of in a grey area. A very small amount of people have had their order confiscated in customs, but they just reordered it and it went through just fine. I have personally had no problems. So this is one of those things where you just have to decide what you want to do, and what you feel comfortable with. This is the only birth control that has actually fixed my problems without causing more problems through side effects, so it's worth it to me.

      The company that makes it states that it will reverse back to normal after six months of none use. I couldn't have any more children before I started taking it, so I am not really the right person to ask. However, I have seen tons of threads on the forum that I link to above, that discuss pregnancy during and after taking Saheli. You should definitely go check it out!

      I actually read a study recently that someone had done using Saheli in place of Clomid to produce a pregnancy. So my guess is that if it can help people get pregnant, it isn't likely to cause infertility. HOWEVER, I am not a doctor, scientist, pharmacist, or anything else. That is just my own uneducated interpretation and opinion. Again, you take this at your own risk, and you have to decide if its worth it to you.

      I have been taking it off and on for two years now. Part of why it was off and on was so that I could test out a few things to better write about it. Hope this helps!

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    2. Thank you so much for your advice and your site! Ordered Saheli problem free (only took 3 weeks to receive it) and started taking it in December. Has been working very well for me since. I did experience missed periods for the first few months or 2x a week dosage but that stopped once I switched to once a week. May try your updated suggestion about taking it every 6 days or every 5 days though as I've noticed longer/heavier periods the past two months. Other than that this is the best birth control out there for me and I have suggested it to friends who hate being on hormonal birth control pills!
      Thanks again!!

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  2. An Indian female gyno here in the US says that saheli has a low dose of estrogen and that loestrin is the same thing. Is this true?

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    1. I'm not a doctor, or a pharmacist, or a chemist, or any kind of professional that can give you a for sure answer on that. What I can tell you is that from what I have read, that is untrue.

      Having actually used both Loestrin and Saheli, I can say they are not, by any means, the same thing. Loestrin gave me all sorts of yucky side effects. The only one I get from Saheli is hot flashes, which went away after the first three months of use.

      Again, I'm not a professional, I've just used both products and would pick Saheli hands down every time. Let me know if you have any more questions!

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  3. hey dear,i have few questions,actually am going to get married in few months & as am an indian girl &, as am a virgin so,will i have to take this before my marriege on my 1st day of periods?
    i mean without keeping any sexual relation ,to work this pill effectively or should i use it after the first sex?but as this pill have to take on first day of periods so if after having sex should i wait for my periods to start taking the pill or not?
    My second question is after the delivery will i have to start taking the pill again like a new user or should i continue it taking once in a week?
    Please help & tell me..

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    1. If you want to prevent pregnancy, you need to start taking this 3 months before you first have sex, or use a backup method (like condoms) until the 3 months is up. You do not need to wait to have sex to take this. If you have already had sex, yes you still need to wait for the first day of your period to start, incase you are already pregnant. After pregnancy and delivery, you would wait for your first period to start (not the 4-6 weeks of discharge bleeding that happens after delivery) and take it as a new user again. Just remember, some women don't have a period for several months after giving birth, so you just need to wait for the first day of your period, whenever it happens.

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  4. Wow, great website! I just found out about this drug yesterday and was searching for more info before I purchase this myself.

    Wikipedia said a side effect could be uterine prolapse. Have you ever came across that info?

    And did you use AllDayChemist or a different site? I've read so many times people getting fraudulant charges on their credit card after using ADC so I'm a little leary of using it. Thanks so much!

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    1. I have not personally come across any information about uterine prolapse. My advise would be to check the sources that Wikipedia lists and read about it for yourself. It's possible that it is a bad source, it is also possible that the chance of that happening is really low. Thank you for pointing it out, I plan on checking it out for myself!

      I do use AllDayChemist. I buy a years worth at a time, so I have only made three orders. I have never had fraudulent charges on my credit card, and I have also never had customs confiscate the package (also something I've heard of happening). My experience has been good, but I am one in how many people? So you might check the forums I've linked to above, and see what other people have to say (if you haven't already).

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  5. Hi there,

    Do you think the Saheli pill would still be effective after its expiration date. For eg...one month after exp date?

    Your response is much appreciated.

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    1. My knowledge is limited in this area. What I know is about medication in general, not Saheli specifically. In general, medication is still effective after it's expiration date, that is just when it starts to loose it's potency or strength. Some things still work even a year after they expire.

      Now as far as birth control is concerned, I personally wouldn't want to use it if there was a possibility that the effectiveness has declined. If your trying to prevent pregnancy, ask yourself just how important it is for you to not have a baby. If your doing it for health reasons like I do, one month expired might make your period a little heavier and your cycle a little shorter, but it might be better then going off the medication while you are waiting for a shipment to arrive.

      I AM NOT A HEALTH CARE PROFESSIONAL, YOU TAKE THIS ADVISE AT YOUR OWN RISK. Again, I don't know about expired Saheli specifically, you would be taking my advise at your own risk to your health. This is your personal decision.

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  6. Wonderful and very helpful blog, Aubrey! Thanks for sharing your personal experiences and research. I recently started taking Saheli after reading about it online and it has been wonderful thus far. I also ordered from AllDayChemist without incident. Actually, I had trouble with the website so I phoned in my payment information and all was fine. The pills arrived really quickly, too. I ended up choosing to do the "loading dose" method versus following the three month plan recommended by the manufacturer.

    To do so, I took 2 pills (60 mg) on the first day of my cycle, which was a Saturday. I then took another pill (30 mg) on Tuesday, and I have continued to take one pill a week since. That said, I was away from my partner in the first month of taking Saheli; however, if he had been around, I would have used a back-up method during this time. Thus far, I haven't had any side effects to date, aside from one day where my body temperature felt moderately more hot, which was the day after my first double dose. I can confidently say that Saheli has saved me from the horror of hormonal birth control pills as well as the stress of getting an IUD. I couldn't be happier with this product!

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  7. Dear Madam

    Warm greetings.

    I am 31 years old healthy lady (having no medical history as such). I am newly married and want to use Saheli as contraceptive.

    So my main question is, should I consult any doctor for it or should I start using it as mentioned on the leaflet inside the pack. For using Saheli, doctor's guidance is necessary or not?

    My 2nd question is, does Homeopathy treatment affect the effect of Saheli?
    Please provide me this information. It will be very helpful.

    Regards

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    1. Consulting a doctor is up to you. I personally do not consult a doctor, but I do feel very comfortable in researching my health and taking a risk. If you feel like you should consult a doctor, then please do! But if you feel comfortable trying this out yourself, it isn't required in order to purchase it.

      I have never come across any conflicts with Saheli and homeopathy, that is something you might have to look into yourself.

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  8. Hi i have two question please help me. actually i want to know that if i start to take this pill on 4/6/2013(as an example of my first period date of this month) then in which day i take next pill.my 2nd question-After one month in which day i take this pill, again 4/7/2013 or my first period day of next month.

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    1. You always start on the first day of your period. So if that were on Saturday 4/6/2013, you would then take your next pill on Tuesday 4/9/2013. Then you will continue to take it every Saturday and every Tuesday for 12 weeks (3 months). After three months, Saheli recommends dropping down to once a week, which would be the Saturday pill that you had originally started. Let me know if you have any more questions!

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  9. Aubrey , I must hugely appreciate all the effort taken by you to bring awareness about Centchroman. This is so much useful!

    Having gone through blog and other sources (primarily aphroditewomenshealth.com), it seems like a very promising contraceptive for those who cannot adjust to usual hormonal birth-control pills.

    India is where I belong and am extremely surprised to see low adoption and awareness in country which discovered and marketed it (only country rather)!! In fact this drug is not stocked by most chemists given lack of adoption by doctors.
    I can image low adoption in India due to below reasons.
    - This drug is priced at ~10% of typical hormonal birth-control pills which means almost no profit for suppliers to sell it or for doctors to prescribe it.
    - Less side effects mean less visits to doctor.
    - Medical research in India is still not commercialized and this drug was discovered and manufactured by government run organizations (Central drug Research Institute (CDRI) discovered and is marketed by HLL Lifecare). So private company has no interest to market it.

    Have below specific questions which stop me from trying out this method of contraception.
    - http://en.wikipedia.org/wiki/Ormeloxifene states that Centchroman may cause urinary incontinence and uterine prolapsed (ref: - Obstetrical & gynecological survey|date=2008 Mar|volume=63|issue=3|pages=163–81|pmid=18279543). While I know that none on this forum has experienced this, this doesn’t appear minor enough side effect to ignore (if there was to be true).
    - As per http://www.ncbi.nlm.nih.gov/pubmed/21777048 (published government case report) suggests that long term usages can likely cause permanent damage to uterus? Doesn’t appear like this adverse effect is yet reported by Centchroman users or studied in details under clinical trials. Any perspective on this?

    I intend to request Singh’s 2001 paper (original research) from MyrtleWarbler and Green Tea to read it myself.

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    1. I would suggest reading up on the numbers. Look at probability. Then maybe look up and see if any other birth control pills cause those and what there probability is. Lastly, how severe are these problems and how would they affect you. As someone who can't have children, when I read about a drug lowering fertility rates over long term use, I don't care. I can't have more kids anyway, so what should I care that less then 1% of women who take some random drug see a decrease in fertility? You are the only one who can make that decision for you. I would just suggest lots and lots of research to see what the likelihood of any of that happening really is.

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  10. hello mam
    warm greetings....
    i am going to get marry in 2 weeks !
    my question is :
    should i start taking Saheli pill ( my first day of period has passed ) or wait for the first day of next period ??
    will it work, if i starts taking the pill a week before having sex with my husband ?

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    1. I cannot tell you if Saheli would be effective or not starting it in the middle of your cycle. I would suggest that you go look around on the forum I link to above and see if anyone else has any experience with that. Also, it is recommended that you use some sort of backup method, such as condoms, for at least a month, if not the first three months to prevent pregnancy.

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  11. I dicovered the existing of these pills just this morning, and I'm so excited: I have history of embolism in my family and breast cancer, so I' can't safely take any hormonal birth control drug, and the use of condoms (and I' tried various types, even the anti-allergenic ones) leave me with intense pain and itch in my intimate zone, even if combined with lubes. I was searching for another method of birth control and this one seems to be just the thing I need. The thing that disappoint me is that this prescription isn't publicized enough, I discovered it by very chance. I think that -not because I'm a fanatic of natural or side medicine- women needs to know more about any possibility they could intake about pregnancy and pain control, even if these resources don't goes to fatten big pharmacies industries. Thank you.

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  12. MAM IN M DEPRESSION I HAD SEX ON 27TH AUGUST 2013.WITHOUT CONDOM BUT I WAS USING SAHELI (Drug Name: Centchroman. Also known as Ormeloxifene)30 MG from 6th august 2013 .i want to know COULD I BE PREGNANT?MY LAST PERIOD STARTED ON 19TH AUGUST AND ENDS ON 26TH AUGUST 2013.I HAD INTERCOURSE ON 27TH AUGUST .ON 19TH ITSELF I HAD PILLS. PLZ TELL ME MAM IM IN STRESS.

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    1. I am not a doctor. I have absolutely no way of knowing if you are pregnant. Technically speaking, if you have had sex, at all, ever, you could be pregnant. There is no 100% effective birth control out there. If you are this freaked out about being pregnant, first you should go see your doctor. Second, Saheli may not be right for you because you will have late and missed periods on this drug. Most women don't ovulate the day after their period ends, but you never know. Go see a doctor, which I am not one.

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  13. Hi Aubrey! This is an extremely useful blog. Thank you. I am 34 years old,have been sexually active since the age of 20. Never once have I ever had unprotected sex with my partner. Im extremely careful for obvious reasons. I am getting married to a wonderful man I have been dating for 9 years,in Dec this year. To further commemorate the union n make it special,I have decided to refrain from using protection on our honeymoon(2nd week Dec 2013). Looking forward to this new experience,but a little nervous at the same time,as i have never used birth control pills in my life. After having read the info you put up,you mentioned that one has to still use condoms for the first 3 months. So if I take the first pill in the last week of Oct 2013,I have to wait till last week Dec -1st week Jan 2014? :( ...Please advise..thanks a ton deary

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    1. I don't reply to comments very often. Sorry. I hope everything went well for you! Saheli isn't perfect, and does require a backup method while your body adjusts. The problem is that some women adjust faster then others, so they have to use a two to three month marker because that is the average for most women. I advise it to be used based on your desire to not become pregnant. If I was fertile and I was using this to prevent pregnancy, getting pregnant would not be the end of the world for me if we didn't use a back up method in those first three months. I'm married to a wonderful man, and we already have one child, so another unplanned wouldn't be the end of the world for us. But I'm not everyone. Everyone has to asses their own risks, their own lives, their own needs, and even their own bodies. Sometimes that means taking a chance, and sometimes that means putting off something you look forward to. Congratulations on your marriage, best of luck to you both!

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  14. i am 25 years old .my question is if i go on pills so when can i start having unprotected sex.

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    1. As I have stated in the blog, and in previous comments, two to three months before unprotected sex is advised. Three months if you really don't want to take any chances. But you can always use a back up method like condoms in those two to three months.

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