According to UCLA Health System, menorrhagia (heavy menses) is defined as bleeding more heavily (passing large clots; needing to change protection during the night; soaking through a sanitary pad or tampon every hour for two to three hours in a row) or bleeding for more than seven days. Causes for menorrhagia include fibroid tumors, polyps, and hormonal imbalances. In some cases, the excessive bleeding is unexplained. According to a new study, published in the American Journal of Obstetrics & Gynecology, a new non-hormonal treatment may help. Tranexamic acid is an oral non-hormonal anti-fibrinolytic agent that has been shown to be associated with improvement in menorrhagia. (An anti-fibrinolytic agent is a substance that inhibits the breakdown of blood clots). The study group was comprised of 304 women with unexplained menorrhagia (80 or more mL of blood losss); they were randomly assigned to receive either 1.95 grams/day or 3.9 grams/days of tranexamic acid or placebo for up to five days of menstrual bleeding. Blood loss was measured subjectively by the patient and objectively by weighing sanitary pads. On average, the participants used their treatment for 3.3 days per cycle. Both tranexamic acid doses were associated with a significantly greater reduction in blood loss compared with placebo. The mean reduction in the volume of blood loss was 65.3 mL (38.6%) with the 3.9-g dose, 46.5 mL (26.1%) with the 1.95-g dose, and 3 mL (1.9%) with placebo. Both drug doses were associated with significant improvement in social, leisure, and physical activities. Side effects were rare and were similar in all three study groups.
Based on this study, tranexamic acid appears to be an effective non-hormonal treatment for menorrhagia with minimal side-effects. It can be taken on a monthly basis to control menorrhagia and maintains a woman’s child-bearing potential. For women who have completed their family, permanent options are available. Endometrial ablation involves inserting instruments through the cervix and destroying the uterine lining with a laser beam, heat, or electrical current. For some women, who have related problems such as pelvic relaxation (dropped uterus) and/or pain, a hysterectomy is a permanent solution.
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