The Effect of Tranexamic Acid for Treatment Irregular Uterine Bleeding Secondary to DMPA Use
A-jaree Senthong MD*, Surasak Taneepanichskul MD*
Affiliation : * Deapartment of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective : Evaluate the efficacy of tranexamic acid and placebo for controlling irregular uterine bleeding in
depot-medroxyprogesterone acetate (DMPA) users.
Material and Method: A double-blind, placebo-controlled study was conducted on 100 DMPA users attending
the Family Planning Clinic King Chulalongkorn Memorial Hospital. All users had abnormal bleeding. They
were randomly divided in two groups; a group of 50 received tranexamic acid, 250 mg four times a day for 5
days and another group of 49 received placebo in the same manner. One subject dropped out from the study.
Total day of bleeding/spotting and percentage of women in whom bleeding was stopped were analyzed at the
end of weeks 1 and 4.
Results : The percentage of subjects in whom bleeding was stopped during the first week after initial treatment
was significantly higher in the tranexamic acid group than the placebo group (88% vs. 8.2%, p < 0.001).
During the follow-up period (4 weeks after initial treatment), a bleeding-free interval of > 20 days was found
in 68% of subjects treated with tranexamic acid and 0% treated with placebo( p < 0.001). The mean number
of bleeding/spotting days were also significantly different between the groups (5.7 + 2.5 vs. 17.5 + 7.2 days,
p < 0.05).
Conclusion : Tranexamic acid was more effective than placebo in short-term treatment of irregular uterine
bleeding/spotting associated with DMPA use.
Keywords : Medroxyprogesterone 17-acetate, Tranexamic acid, Uterine hemorrhage
