Tranexamic Acid: Recently Approved for Heavy Menstrual Bleeding

Heavy menstrual bleeding (defined as blood loss ≥80 mL per cycle) often hinders quality of life and leads to hysterectomy. The competitive plasminogen inhibitor tranexamic acid has been used outside the U.S. for decades to treat women with this condition but can have gastrointestinal side effects. To determine whether a new oral formulation of tranexamic acid (Lysteda) can curtail bleeding, researchers enrolled 187 women (age range, 18–49) with objectively documented heavy menstrual bleeding in a manufacturer-supported 6-month trial.

Participants were randomized to receive placebo or tranexamic acid (maximum, 3.9 g daily) for ≤5 days per menstrual cycle beginning with the onset of heavy bleeding. Mean reductions in blood loss per cycle were …