Topics of Interest

New Medication for Heavy Menstrual Bleeding

Tranexamic Acid Treatment for Heavy Menstrual Bleeding

Journal: Obstetrics and Gynecology. 2010;116:865-75

Authors: Lukes AS, Moore KA, Muse KN, Gersten JK, Hecht BR, Edlund M, Richter HE, Eder SE, Attia GR, Patrick DL, Rubin A, Shangold GA

Study from: Carolina Women’s Research and Wellness Center, Durham, North Carolina

Problem: Heavy menstrual bleeding is a common problem for women and often leads to surgery or other treatments. Birth control pills help some women, but not all. Another oral medication option would be welcome.

Study: Adult women with heavy menstrual bleeding were randomized to receive either tranexamic acid (Lysteda) or a placebo for up to 5 days per menstrual cycle for six cycles. The amount of bleeding and health-related quality of life was measured using a questionnaire.

Results: Women who received tranexamic acid had a significant reduction in menstrual blood loss and this reduction was considered meaningful to women, in that they had improvements in limitations in social or leisure and physical activities and work inside and outside the home. Gastrointestinal side-effects were no more than with the placebo.

Authors’ Conclusions: Oral tranexamic acid treatment was well tolerated and significantly improved both menstrual blood loss and health-related quality of life in women with heavy menstrual bleeding.

Dr. Parker’s Comments: Tranexamic acid has been available in Europe for more than 15 years and has been found to be an effective treatment option for many women with heavy bleeding. Unfortunately, the drug had been around so long that it could not be patented in the US (the down side of the patent system). Recently, a slightly different compound was able to be patented and is now available here.

The medication works by allowing the blood to clot faster, so less is lost. There is some evidence that this medication also works for women with fibroids and may be worth trying, since there are minimal side-effects.

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