Efficacy of Short-Course Tamoxifen versus Combined Oral Contraceptive Pills in Managing Unscheduled Bleeding among Levonorgestrel Implant (Jadelle) Users

INTERVENTION: Experimental Drug,Active Comparator Drug Participants will receive Tamoxifen 10 mg (tablet form) to be taken orally twice daily (every 12 hours) for a duration of 10 consecutive days.,Participants will receive a Combined Oral Contraceptive Pill containing Ethinyl Estradiol (EE) 0.03 mg and Levonorgestrel 0.15 mg per tablet. The medication is to be taken orally once daily at the same time each day for a duration of 21 consecutive days. Tamoxifen (10 mg twice daily for 10 days),Combined Oral Contraceptive Pills (COCs) CONDITION: Levonorgestrel; Combined Oral Contraceptive Pills; Contraceptive implant ; Abnormal uterine bleeding; Tamoxifen; Breakthrough Bleeding ; Randomized Controlled Trial Unscheduled bleeding in levonorgestrel‐releasing contraceptive implant (Jadelle) users ; Levonorgestrel; Combined Oral Contraceptive Pills; Contraceptive implant ; Abnormal uterine bleeding; Tamoxifen; Breakthrough Bleeding ; Randomized Controlled Trial PRIMARY OUTCOME: Duration from completion of treatment to cessation of bleeding at 30 days after end of the intervention A digital daily bleeding diary recorded SECONDARY OUTCOME: the total number of bleeding days after end of the intervention at 30 days after end of the intervention A digital daily bleeding diary recorded,time to recurrence of unscheduled bleeding at 30 days after end of the intervention A digital daily bleeding diary recorded,incidence of treatment‐related side effects, including hot flashes, mood swings, headache, nausea, breast tenderness, and fatigue within 30 days after end of the intervention A digital daily diary recorded INCLUSION CRITERIA: 1. Female aged 18‐45 years 2. Current use of the Levonorgestrel contraceptive implant (Jadelle) for more than 3 months 3. Patients experiencing abnormal uterine bleeding having abnormal bleeding lasting for more than 7 days