Tranexamic acid for the treatment of heavy menstrual bleeding: efficacy and safety

International Journal of Women's Health
Henri Leminen, Ritva Hurskainen

Abstract

Tranexamic acid has proven to be an effective treatment for heavy menstrual bleeding (HMB). It reduces menstrual blood loss (MBL) by 26%-60% and is significantly more effective than placebo, nonsteroidal anti-inflammatory drugs, oral cyclical luteal phase progestins, or oral etamsylate, while the levonorgestrel-releasing intrauterine system reduces MBL more than tranexamic acid. Other treatments used for HMB are oral contraceptives, danazol, and surgical interventions (endometrial ablation and hysterectomy). Medical therapy is usually considered a first-line treatment for idiopathic HMB. Tranexamic acid significantly improves the quality of life of women treated for HMB. The recommended oral dosage is 3.9-4 g/day for 4-5 days starting from the first day of the menstrual cycle. Adverse effects are few and mainly mild. No evidence exists of an increase in the incidence of thrombotic events associated with its use. An active thromboembolic disease is a contraindication. In the US, a history of thrombosis or thromboembolism, or an intrinsic risk for thrombosis or thromboembolism are considered contraindications as well. This review focuses on the efficacy and safety of tranexamic acid in the treatment of idiopathic HMB. We searched...Continue Reading

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Citations

Jan 7, 2015·Thrombosis Research·Lilian TengbornErik Berntorp
Mar 11, 2015·The Australasian Journal of Dermatology·Michelle Rodrigues, Amit G Pandya
Dec 4, 2014·Best Practice & Research. Clinical Obstetrics & Gynaecology·Mourad W SeifMahshid Nickkho-Amiry
May 29, 2016·The American Journal of Emergency Medicine·Ramazan Güven
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May 6, 2017·Anesthesiology·Irene LeckerBeverley A Orser
Aug 28, 2020·Journal of Complementary & Integrative Medicine·Rayeesa Banu R UmaramiMohd Aqil Quadri

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Methods Mentioned

BETA
hysterectomy
PBAC

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