Heavy Menstrual Bleeding (HMB)
A 47-year-old multiparous woman comes to the clinic with a one-year history of heavy menses affecting her daily activities. You categorize her bleeding as abnormal uterine bleeding (AUB) with adenomyosis. She requests nonsurgical, nonhormonal treatment. The non-hormonal treatment with the highest likelihood of decreasing her menstrual flow and improving her quality of life is:
- Mefenamic acid
- Tranexamic acid
Heavy menstrual bleeding (HMB) can severely affect premenopausal women’s quality of life.
Both hormonal preparations and surgery are deemed very effective in the treatment of HMB. However, other medical therapies have established their efficacy.
Tranexamic acid, a synthetic derivative of the amino acid lysine, is an antifibrinolytic agent that acts by binding to plasminogen and blocking the interaction with fibrin, thereby preventing the dissolution of the fibrin clot. In multiple large randomized trials, tranexamic acid significantly reduced blood loss compared with placebo in a variety of surgical procedures.