Treatment of Idiopathic Menorrhagia with Tranexamic Acid
Sukanya Srinil MD*, Unnop Jaisamrarn MD, MHS*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine,Chulalongkorn University
Objective : To determine the efficacy of tranexamic acid in the treatment of idiopathic menorrhgia and to
investigate the effect of medical treatment with tranexamic acid on the quality of life of the women with
idiopathic menorrhagia.
Design : Open, non-comparative study.
Setting : Department of Obstetrics and Gynecology King Chulalongkorn Memorial Hospital
Subjects : 40 women with idiopathic menorrhagia was confirmed by menstrual blood loss greater than 80 ml/
cycle (PBAC score > 100) and mid-luteal serum progesterone concentration greater than 5 pg/ml.
Intervention: Treatment with tranexamic acid 1 g orally, three times daily, for five days from day 1 of the
menstruation for two consecutive menstrual periods.
Main outcome measures: Menstrual blood loss was measured using the pictorial blood loss assessment chart
(PBAC). Hematological assessments were made at the beginning, after the first treatment cycle and at the end
of the study. Questionnaires were given to assess subjective endpoint, quality of life. Patients were asked to
report any adverse event during the study period.
Results : Tranexamic acid reduces the mean PBAC score by 49%, from 350.5 to 178.6. Regarding the change
in the quality of life measures, the proportion of women who felt a considerable degree of impairment during
the menstruation was reduced from nearly 60% to less than 5% during their third menstruation. No serious
adverse events were reported.
Conclusion : Tranexamic acid is a safe and effective form of medical therapy in women with menorrhagia; also
increases quality of life in these women.
Keywords : Menorrhagia, Idiopathic, Tranexamic acid, Quality of life
