The Effect of Cyclofem® for the Treatment of Irregular Uterine Bleeding in Implant Contraceptive Users

Inclusion Criteria: * Implant (Jadelle or Implanon) inserted before enrollment with the symptom of bleeding disturbances for eight or more continuous days or a current bleeding-free interval of 15 days or less * Regular menstruation at least 1 cycle before the usage of implant contraceptive * Willingness to participate in a placebo-controlled study and ability to keep an accurate daily menstrual record * No gynecological or serious medical diseases Exclusion Criteria: * Contraindication to estrogen or progesterone use such as * breast cancer * Liver cancer or tumor * Uncontrolled blood pressure (BP ≥160/100 mmHg ) * History of atherosclerosis, vascular disease and high risk for VIE * History of ischemic stroke * Coagulopathy * Uncontrolled diabetes mellitus and complication * Cirrhosis * SLE with antiphospholipid positive * History of migraine with aura or age of 35 years old or more than with history of migraine non-aura * Age of 35 years old or more than with history of smoking more than 15 cigarettes per day * Postpartum 6 weeks * Plan for surgery procedure that need immobilization after surgery * Previous treatment for 3 months before enrollment * Allergic to drug component of Cyclofem® ( Medroxyprogesterone acetate , Estradiol cypionate)