Tranexamic Acid for Heavy Menstrual Bleeding

Understanding How TXA Works and When It Can Help

Heavy or prolonged menstrual bleeding is one of the most common concerns women bring to Complete Healthcare in Richland, WA. When bleeding is heavy enough to affect daily activities, cause fatigue, or lead to iron deficiency, it becomes more than an inconvenience. It affects quality of life, energy levels, and emotional well-being. One highly effective and often underused treatment option is tranexamic acid, commonly known as TXA.

TXA offers a non-hormonal, evidence-based option for women who want meaningful reduction in menstrual bleeding without the side effects of hormones. Below is a clear explanation of how it works, who benefits most, and what to expect while using it.

What Is TXA

Tranexamic acid is a medication that helps stabilize blood clots. It is not a hormone. Instead, TXA slows the body’s natural breakdown of clots, helping reduce blood loss. For menstrual use, TXA is taken only during bleeding days, not throughout the month.

ACOG supports TXA as a first-line option for heavy menstrual bleeding, especially when a patient desires a non-hormonal treatment.

How TXA Works

During menstruation, the body naturally sheds the uterine lining. As this happens, small blood vessels are exposed and bleeding begins. The body forms tiny clots to slow this blood loss. Certain enzymes break down these clots, which can increase bleeding in women who are prone to heavy flow.

TXA blocks these enzymes, allowing the body to maintain normal clot stability during menstruation. This helps significantly reduce the volume of bleeding.

How Effective Is It

Clinical studies consistently show that TXA can reduce menstrual blood loss by about 30 to 50 percent. Many women notice improvement during the very first cycle. It is especially helpful for women who want to avoid hormones or for those who do not tolerate oral contraceptives.

Women with the following conditions often experience excellent results:• Heavy regular periods without a known structural cause• Bleeding related to fibroids or adenomyosis• Bleeding that worsens with age or perimenopause• Iron deficiency from menstrual loss

TXA can also be combined with other treatments such as NSAIDs or hormonal therapy if needed.

How to Take TXA

TXA is taken only on days of active bleeding. A common dosing schedule is:• 1300 mg three times daily for up to five days during the period.

Patients do not need to take it before the period starts. If bleeding begins unexpectedly, TXA can be started right away.

This short-course dosing helps women achieve good control of bleeding while minimizing long-term medication use.

Who Is a Good Candidate

Most healthy women can safely use TXA. It is particularly helpful for:• Women who prefer non-hormonal treatment• Women planning pregnancy who cannot use hormonal birth control• Women who have side effects with birth control pills, patches, or rings• Women seeking an option that works immediately rather than after several cycles

Who Should Avoid TXA

While TXA is safe for most patients, some women should avoid it. These include:• Women with a personal history of blood clots• Women on certain medications that increase clotting risk• Women with rare clotting disorders• Women with severe kidney disease

As with any therapy, a full medical history review helps determine whether TXA is appropriate.

Common Side Effects

Most women tolerate TXA extremely well. Possible side effects include:• Mild nausea• Stomach upset• Headache• Muscle aches

These symptoms are usually temporary and improve within a cycle or two. TXA does not cause weight gain, mood changes, or hormonal symptoms.

TXA vs Other Treatment Options

When discussing treatment for heavy bleeding, women often compare TXA to other therapies. Here is how TXA fits into the broader treatment landscape:

NSAIDsIbuprofen and naproxen can help decrease bleeding and cramping. TXA is typically more effective at reducing blood loss.

Hormonal birth controlBirth control pills, patches, and rings regulate cycles and reduce bleeding. TXA is an excellent choice for women who prefer to avoid hormones or cannot take them safely.

Levonorgestrel IUDThe hormonal IUD is one of the most effective treatments for heavy bleeding. TXA is ideal for women who do not want a device or prefer an as-needed medication.

Surgical optionsProcedures such as endometrial ablation or hysterectomy are reserved for women who do not improve with other treatments. TXA offers a noninvasive option before considering surgery.

When to Seek an Evaluation

Any woman experiencing heavy bleeding should be evaluated to rule out underlying causes such as fibroids, polyps, thyroid disorders, or hormonal imbalance. An ultrasound or blood work may be recommended before starting TXA.

If heavy bleeding leads to fatigue, low iron levels, missed days of work, or limitations in daily life, treatment is absolutely appropriate.

Complete Healthcare in Richland, WA offers comprehensive evaluation and management for menstrual disorders, including medication options such as TXA. To schedule an appointment, contactus at 509-392-6700.

Complete Healthcare - Obstetrics and Gynecology

509-392-6700

Richard Lorenzo, D.O.

Kortney Jones ARNP