The Effect of Cyclofem® for the Treatment of Irregular Uterine Bleeding in Implant Contraceptive Users
The Effect of Cyclofem® for the Treatment of Irregular Uterine Bleeding in Implant Contraceptive Users
The purpose of this study is to determine that once-a-month injectable contraceptive(
 Cyclofem® ) has the effect on treatment of irregular uterine bleeding in implant
 contraceptive users or not.
Stratified randomization Implanon and Jadelle group were done using block randomization. The
 participants and investigators were blinded to treatment allocation, using drug coding that
 not revealed until the end of study. Research assistants and nurse who did not have involve
 in analyses data would follow the recruitment criteria and drug injection follow the code of
 drug.

 All participants were collected demographic data, medical history, obstetrical and
 gynecological history, bleeding pattern before enrollment. Then physical exam and pelvic
 examination were performed for all participants. Participants received single dose
 intramuscular injection of Cyclofem® 0.5 ml or normal saline 0.5 ml as placebo on that day of
 recruitment to the study. Daily record of bleeding, spotting and side effect was done on
 record form.
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)