{"paper_id":"dafcec9b-4122-4176-a892-9fb6205a2919","body_text":"Back to Journals » International Journal of Women's Health » Volume 4\nTranexamic acid for the treatment of heavy menstrual bleeding: efficacy and safety\nAuthors Leminen, Hurskainen R\nReceived 15 May 2012\nAccepted for publication 11 July 2012\nPublished 17 August 2012 Volume 2012:4 Pages 413—421\nDOI https://doi.org/10.2147/IJWH.S13840\nChecked for plagiarism Yes\nReview by Single anonymous peer review\nPeer reviewer comments 2\nHenri Leminen,1 Ritva Hurskainen1,2\n1Department of Obstetrics and Gynecology, Hyvinkää Hospital, Hyvinkää, Finland; 2Faculty of Medicine, University of Helsinki, Helsinki, Finland\nAbstract: 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 for medical literature published in English on tranexamic acid from Ovid Medline, PubMed, and Cinahl. Additional references were identified from the reference lists of articles. Ovid Medline, PubMed, and Cinahl search terms were \"tranexamic acid\" and \"menorrhagia\" or \"heavy menstrual bleeding.\" Searches were last updated on March 25, 2012. Studies with women receiving tranexamic acid for HMB were included; randomized controlled studies with a description of appropriate statistical methodology were preferred. Relevant data on the physiology of menstruation and the pharmacodynamics and pharmacokinetics of tranexamic acid are also included.\nKeywords: tranexamic acid, heavy menstrual bleeding, menorrhagia\n© 2012 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms and incorporate the Creative Commons Attribution - Non Commercial (unported, 3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.","source_license":"CC0","license_restricted":false}