Heavy Bleeding? How Tranexamic Acid Works & Your Medical Next Steps

Heavy bleeding can be physically exhausting and emotionally stressful. Whether it's a very heavy menstrual period, bleeding between periods, or unexpected heavy bleeding after a procedure, it's important to understand what's happening in your body—and what your options are.

One medication often used to treat heavy bleeding is tranexamic acid. Below, we'll explain how tranexamic acid works, when it's used, what to expect, and what medical steps you should consider next.

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What Counts as Heavy Bleeding?

Heavy menstrual bleeding (sometimes called menorrhagia) is more than just a "bad period." You may be experiencing heavy bleeding if you:

• Soak through one or more pads or tampons every hour for several hours
• Need to use double protection (tampon and pad together)
• Wake up at night to change menstrual products
• Pass large blood clots (larger than a quarter)
• Have periods lasting more than 7 days
• Feel tired, weak, or short of breath (possible signs of anemia)

Bleeding between periods (intermenstrual bleeding) is also not considered normal and should be evaluated.

If you're unsure whether your symptoms are typical, you can use a free symptom checker for bleeding between periods to help identify what might be causing your symptoms and determine if you need medical care.

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What Is Tranexamic Acid?

Tranexamic acid is a prescription medication that helps reduce heavy bleeding. It does not contain hormones and does not affect your menstrual cycle timing. Instead, it works directly on your blood's clotting process.

Tranexamic acid is commonly used for:

• Heavy menstrual bleeding
• Bleeding after surgery
• Bleeding after dental procedures (especially in people with bleeding disorders)
• Certain types of trauma-related bleeding
• Postpartum bleeding (in hospital settings)

For heavy periods, tranexamic acid is typically taken only during the days of active bleeding—not every day of the month.

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How Does Tranexamic Acid Work?

To understand how tranexamic acid works, it helps to know a little about how your body controls bleeding.

When you bleed, your body forms blood clots to stop the flow. At the same time, your body also has a natural process to break down clots once they are no longer needed. This breakdown process is called fibrinolysis.

In heavy menstrual bleeding, the body may break down clots too quickly. This can lead to prolonged or excessive bleeding.

Tranexamic acid works by:

• Blocking the breakdown of blood clots
• Helping clots stay in place longer
• Reducing overall blood loss

In simple terms, tranexamic acid helps your body "hold onto" the clots it forms, so bleeding slows down.

Studies show that tranexamic acid can reduce menstrual blood loss by about 30–60% in many women. However, it does not stop periods completely and does not treat the underlying cause of heavy bleeding.

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What Tranexamic Acid Does Not Do

It's important to understand the limits of tranexamic acid:

• It does not regulate hormones
• It does not shrink fibroids
• It does not prevent pregnancy
• It does not treat infections
• It does not cure underlying structural problems

It helps control symptoms—but identifying the cause of heavy bleeding is still essential.

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Common Causes of Heavy Bleeding

Heavy bleeding can happen for many reasons, including:

• Uterine fibroids
• Polyps
• Hormonal imbalances
• Polycystic ovary syndrome (PCOS)
• Adenomyosis
• Thyroid disorders
• Bleeding disorders
• Certain medications (like blood thinners)
• Miscarriage or pregnancy complications
• Rarely, cancer of the uterus or cervix

Because some causes are more serious than others, medical evaluation is important—especially if heavy bleeding is new, worsening, or happening after menopause.

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How Is Tranexamic Acid Taken?

For heavy menstrual bleeding, tranexamic acid is usually:

• Taken as a tablet by mouth
• Started when bleeding begins
• Taken for up to 5 days during your period

Your doctor will determine the correct dose based on your health history.

It's very important to follow your prescribed instructions carefully. Do not take more than directed.

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Is Tranexamic Acid Safe?

Tranexamic acid is considered safe for most people when prescribed appropriately. However, it is not right for everyone.

You should not take tranexamic acid without medical guidance if you:

• Have a history of blood clots (deep vein thrombosis, pulmonary embolism)
• Have certain clotting disorders
• Have had a stroke
• Have serious kidney disease

Because tranexamic acid works by helping clots stay in place, it can slightly increase the risk of blood clots in some individuals. Your doctor will assess your personal risk before prescribing it.

Possible Side Effects

Most side effects are mild and may include:

• Nausea
• Diarrhea
• Headache
• Muscle cramps

Serious side effects are rare but require urgent medical attention. Seek emergency care if you experience:

• Sudden leg swelling or pain
• Chest pain
• Shortness of breath
• Sudden vision changes
• Weakness on one side of the body

These could be signs of a blood clot and require immediate treatment.

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When Should You Seek Immediate Care?

Heavy bleeding can sometimes be dangerous.

Go to urgent care or the emergency room if you:

• Soak through a pad or tampon every hour for 2+ hours
• Feel faint or pass out
• Have chest pain or trouble breathing
• Are pregnant or could be pregnant and have heavy bleeding
• Have severe abdominal pain

These symptoms may signal a medical emergency.

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Medical Next Steps: What to Expect

If you're experiencing heavy bleeding, here's what your doctor may do:

1. Medical History and Physical Exam

You'll be asked about:

• Cycle timing
• Amount of bleeding
• Clots
• Pain
• Pregnancy possibility
• Medication use

2. Blood Tests

These may check for:

• Anemia
• Thyroid problems
• Clotting disorders
• Hormone levels

3. Imaging

An ultrasound may be used to look for:

• Fibroids
• Polyps
• Thickened uterine lining

4. Treatment Options

Depending on the cause, treatment may include:

• Tranexamic acid
• Hormonal birth control
• Progesterone therapy
• Hormonal IUD
• Treatment for thyroid or bleeding disorders
• Surgical procedures (in some cases)

Tranexamic acid is often chosen when:

• Hormones are not desired
• Hormonal treatment is not safe
• Fertility preservation is important

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Can You Take Tranexamic Acid Long-Term?

Some people use tranexamic acid safely for multiple cycles under medical supervision. However, ongoing heavy bleeding should not be ignored.

If you find yourself relying on tranexamic acid month after month, it's worth having a deeper conversation with your doctor about identifying and addressing the root cause.

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Managing Heavy Bleeding at Home (Supportive Steps)

While medical care is essential, you can also:

• Track your cycles and bleeding patterns
• Eat iron-rich foods (spinach, red meat, lentils)
• Ask your doctor if you need an iron supplement
• Stay hydrated
• Rest when needed

If fatigue is significant, you may need testing for anemia.

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The Bottom Line

Tranexamic acid is an effective, non-hormonal medication that helps reduce heavy bleeding by stabilizing blood clots. For many people, it significantly improves quality of life during heavy periods.

However, it treats the symptom—not always the cause.

Heavy or abnormal bleeding deserves medical attention. In some cases, it may signal a hormonal issue, fibroids, a bleeding disorder, pregnancy complication, or—rarely—something more serious.

If you're experiencing unusual bleeding, consider starting with a free symptom checker for bleeding between periods to get personalized insights before your doctor's visit.

Most importantly:

If your bleeding is severe, you feel weak or faint, or you have symptoms that could signal a blood clot or pregnancy complication, seek emergency care immediately.

For anything persistent, worsening, or concerning, speak to a doctor. Early evaluation can prevent complications, improve your quality of life, and ensure that any serious conditions are caught and treated promptly.

You don't have to just "live with" heavy bleeding—and you shouldn't ignore it either. Help is available, and effective treatments like tranexamic acid may be part of the solution.