Tranexamic acid (TXA) is a prescription antifibrinolytic medication used primarily to manage heavy bleeding. It works by limiting the breakdown of blood clots. While TXA is highly effective at reducing the volume of menstrual flow, it does not typically stop the entire menstrual cycle. TXA specifically addresses the symptom of heavy flow, not cycle suppression.
How Tranexamic Acid Works to Reduce Bleeding
Tranexamic acid stabilizes the body’s natural process for forming blood clots. During menstruation, the body creates fibrin, a protein that forms a mesh to build a clot and stop bleeding from the uterine lining. The body also has a system to dissolve these clots, called fibrinolysis, which involves the enzyme plasmin.
TXA is a synthetic compound that mimics the amino acid lysine, allowing it to interfere with the activation of plasmin. By inhibiting plasmin, the drug prevents the breakdown of fibrin clots formed in the uterus. This action preserves the clots, making them more stable and longer-lasting, which reduces the total volume of blood lost during the period. TXA is a non-hormonal option that targets local clotting factors without altering the overall hormonal cycle.
Clarifying Its Effect on Menstruation
The primary purpose of Tranexamic acid is to treat menorrhagia, which is abnormally heavy or prolonged menstrual bleeding. Clinical studies demonstrate that TXA is highly successful, leading to a significant reduction in menstrual blood loss. Users typically see their flow decrease by approximately 30 to 60 percent per cycle.
This substantial reduction in flow can make a period feel much lighter and more manageable, but it is not intended to cause the cessation of the cycle. Unlike hormonal contraceptives, TXA does not suppress ovulation or thin the uterine lining, which means the underlying menstrual process continues. If a patient experiences a complete and sudden stop to their period while using TXA, they should consult a healthcare provider to rule out other possible medical concerns.
Proper Administration and Timing
For treating heavy menstrual bleeding, Tranexamic acid is taken orally only during the days of the menstrual period. It is not taken continuously throughout the monthly cycle. Treatment should begin immediately when bleeding starts, or on the first day of the heaviest flow.
The typical dosing regimen involves taking 1,300 milligrams three times a day for a maximum of five days during the cycle. This daily total of 3,900 milligrams is the standard recommended dosage for treating heavy flow. It is important to adhere to the prescribed schedule and not exceed the maximum daily dose or the five-day limit. Following these specific guidelines ensures the drug is active when it is needed most and helps to minimize the risk of side effects.
Potential Side Effects and Safety Considerations
Tranexamic acid is generally well-tolerated. Most reported side effects are mild and related to the digestive system, including nausea, stomach discomfort, diarrhea, or headache. These effects often lessen as the body adjusts to the medication.
A rare but serious risk associated with any antifibrinolytic agent is the potential for blood clots (thromboembolism). Because TXA stabilizes clots, it carries a risk of promoting unwanted clot formation in veins or arteries. Therefore, the medication is contraindicated for individuals with a history of blood clots, such as deep vein thrombosis or pulmonary embolism. Patients with severe kidney impairment or a predisposition to clotting should discuss their medical history with a healthcare provider before starting treatment.