Heavy Menstrual Bleeding Despite Taking Tranexamic Acid: What to Do?

Taking hemostatic medication, the menstrual flow is still relatively heavy?

I will undergo a dilation and curettage (D&C) procedure next week, but I am currently on my menstrual period.
After taking the prescribed transamin three times a day, the flow is still heavy, and I am experiencing blood clots.
Should I return for a follow-up appointment immediately, or wait until my period ends and ask about it during the surgery? What could be causing this situation?

Ms. Huang, 10~19 year old female. Ask Date: 2020/05/10

Dr. Huang Yuande reply Obstetrics and Gynecology

It is difficult to determine the cause from your statement; it could be due to the presence of a growth or simply a hormonal imbalance.
A clinical examination is necessary to identify the underlying reason.

Reply Date: 2020/05/10

More Info

Heavy menstrual bleeding, also known as menorrhagia, can be a distressing condition, especially when it persists despite treatment with medications like tranexamic acid. Tranexamic acid is an antifibrinolytic agent that helps to reduce bleeding by inhibiting the breakdown of fibrin, a protein essential for blood clotting. It is commonly prescribed for heavy menstrual bleeding, as it can significantly decrease the volume of blood loss during menstruation.

In your case, it is concerning that you are still experiencing heavy bleeding and passing blood clots despite taking tranexamic acid as prescribed. There are several potential reasons for this. First, it is important to consider that tranexamic acid may not be effective for every individual or every type of bleeding. Factors such as the underlying cause of your menorrhagia, the severity of your condition, and individual variations in response to medication can all play a role. Conditions such as uterine fibroids, polyps, or hormonal imbalances can contribute to heavy menstrual bleeding and may require additional treatment beyond tranexamic acid.

Given that you are scheduled for a dilation and curettage (D&C) procedure next week, it is crucial to communicate your current symptoms to your healthcare provider as soon as possible. While it may be tempting to wait until your menstrual period ends or until the day of your surgery to discuss these concerns, it is advisable to reach out to your doctor immediately. Heavy bleeding can lead to complications such as anemia, and your physician may need to adjust your treatment plan or take additional measures to ensure your safety during the upcoming procedure.

Your doctor may want to evaluate the cause of your persistent bleeding, which could involve additional diagnostic tests such as an ultrasound or blood tests to assess your hemoglobin levels and rule out any underlying conditions. Depending on the findings, they may recommend alternative treatments, such as hormonal therapy or surgical options, to address the root cause of your menorrhagia.

In summary, do not hesitate to contact your healthcare provider regarding your heavy menstrual bleeding despite taking tranexamic acid. It is essential to address this issue promptly to ensure your well-being and to prepare adequately for your upcoming D&C procedure. Your health and safety should always come first, and your doctor is the best resource for managing your symptoms and determining the appropriate course of action.

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