Tranexamic acid was so important for my teenage daughter for school and for sports. She eventually changed to continuous oral contraceptives and could not understand why anyone wouldn’t want to be rid of their period and hasn’t been off since.
It seems that continuous oral contraception isn’t prescribed very often, is it because it’s off label? Or because people believing that menstrual is somehow necessary, organic, healthy? Or healthcare providers just don’t prescribe?
Continuous oral contraception is also a great option. Like many medications, some doctors don't think to prescribe it, and not everyone can or wants to take it.
My very clear recollection to your last series of questions from a very learned Oby-Gyn I had the pleasure to work with {no name dropping, however Dr Jen would know in...LHSC Ont Canada}..
#1) correct #2) not necessary, for some once a yr... context from my perspective, upon insertion of an IUD (progesterone) most women have their menses cease. The IUD can remain in place x 5 yr's and now extended to 7 yr's ( I'll double check when I reference the monograph).
#3) having practiced for several decades, no ... Other than some oral BC forms that result in menses each 3rd month.
p.s. forgive any possible typos, yet to discover how to edit my post(s) upon sending
For a lot of women that is amazing, but I do have friends that find IUDs not feasible for various reasons (intensely painful insertion/removal, irritation, weird side effects).
Certainly no intent to debate, given there are no reasons for women to not have effective pain control during insertion/removal. There are effective measures & at the moment can't recall where I recently read about those measures. Several yr's ago a young/new graduate female Oby-Gyn was I now know to be quite cavalier in her description of possibly a Pap test but I'm thinking it was an IUD insert...NO it's not a little pinch. Ok like a man would ever know.
Your last point requires context & once again not debating nor dismissing the issues for some women, albeit likely not a large percentage.
It does not have the same molecular structure as lysine. It is only available over the counter in some countries, such as the UK, Sweden, and India. But you need a prescription in the US, Canada, and Australia.
I had an absolutely horrible experience with tranexamic acid. It caused clots around the size of a golf ball and I felt like I was giving birth every time I passed one of these clots.
What labs do you diagnose iron deficiency with? Iron or ferritin ? Or if iron normal but ferritin low? Or if both normal but TIBC is high? And what are the levels you use vs what the lab reference ranges are?
I'm not a doctor and don't really know much about this, but what I learned with my low iron experience was that "iron stores" is ferritin and that is called "non-anemia low ferritin". I had very similar symptoms to "anemia" and getting my iron stores, ferritin back up was very helpful. I got an iron infusion.
Before that I was really tired (fagitue), hard to exercise too much, had bad altitude sickness, broken toes and finger nails, finger and toe nails like "spoons", dark circles under my eyes, pale skin.
I really appreciate this post. I'm a sport & eating disorder dietitian/RD and iron deficiency is always something I'm looking out for - thank you for discussing it here. Hopefully, I can get my daughter on tranexamic acid - she's twelve and has horribly heavy periods (like misses school). What age can it be prescribed? Thanks again!
I saved this to my Sunday 'read pile' because I really wanted to be able to take it in. I wish I had been able to take it in years ago! I am grateful for the knowledge now, however, and will share it with those I encounter who may also want to know.
Ok, fellow readers particularly the ladies OMG never having seen a tampon even out of its wrapper, let a lone dampened (ok chosing not to be more descriptive) from its intended use. Feel free to LOL at this naive male but Dr. Jen initially I did a double take, not particularly squeamish with visual/true anatomy, it will be a while before the image of a tampon returns to being unwrapped 🤔
I wish I had known this when I was still getting a period, it would have been super helpful. During perimenopause, I did have some very heavy/long periods and ended up with low ferritin (non-anemia low ferritin/low iron stores). I was told to take iron supplements, which is just so hard. I tried for several months and then found out about iron infusions. You just get a large amount of iron through an infusion (iron going into your vein). It didn't really hurt, took like 45 min and I felt better within 2 weeks and my ferritin levels were back up.
Thank you so much for this post, I wish I knew about it years ago, and especially before perimenopause when my already heavy periods got both heavier and more frequent. I only take it on the heavy days but it makes everything more manageable and my iron levels (with supplements) have started to level out.
Thank you for this post. I would love to see you do a longish post about HMB and fibroids, and specifically about fibroid treatments -- my feeling is that women in Canada are woefully underinformed about options beyond Transexamic acid, Mirena, and ibuprofen, such as Uterine Fibroid Embolization. In the US, one can visit a "fibroid clinic" to get this treatment. There is also a newish treatment using something called Acessa ProVu, but it is not widely available (yet?). HMB is so underappreciated, and is devastating to quality of life.
Would this help with heavy bleeding from adenomyosis? I tried to get an IUD to help, but the insertion failed (shudder). Not really willing to try that again.
Ugh…15 years ago when I was bleeding very heavily in transition to menopause I was switched to a different contraceptive pill and that was the end of treatment. I don’t even remember being checked for anemia or low iron (in the US).
Thank you for this post. I was aware of this tx, & had read about 'clot risk.' Thank you for putting this into perspective. I understand that this is also a very expensive drug, which could mitigate against its use (& utility if OTC).
In the tranexamic acid vs placebo trial, was there a placebo response? It would be ver curious/surprising if there was one.
Thank you!
Tranexamic acid was so important for my teenage daughter for school and for sports. She eventually changed to continuous oral contraceptives and could not understand why anyone wouldn’t want to be rid of their period and hasn’t been off since.
It seems that continuous oral contraception isn’t prescribed very often, is it because it’s off label? Or because people believing that menstrual is somehow necessary, organic, healthy? Or healthcare providers just don’t prescribe?
Continuous oral contraception is also a great option. Like many medications, some doctors don't think to prescribe it, and not everyone can or wants to take it.
My very clear recollection to your last series of questions from a very learned Oby-Gyn I had the pleasure to work with {no name dropping, however Dr Jen would know in...LHSC Ont Canada}..
#1) correct #2) not necessary, for some once a yr... context from my perspective, upon insertion of an IUD (progesterone) most women have their menses cease. The IUD can remain in place x 5 yr's and now extended to 7 yr's ( I'll double check when I reference the monograph).
#3) having practiced for several decades, no ... Other than some oral BC forms that result in menses each 3rd month.
p.s. forgive any possible typos, yet to discover how to edit my post(s) upon sending
Health Canada extends the time period for use of a single Mirena intrauterine system for conception control from five years to eight years.
For a lot of women that is amazing, but I do have friends that find IUDs not feasible for various reasons (intensely painful insertion/removal, irritation, weird side effects).
Certainly no intent to debate, given there are no reasons for women to not have effective pain control during insertion/removal. There are effective measures & at the moment can't recall where I recently read about those measures. Several yr's ago a young/new graduate female Oby-Gyn was I now know to be quite cavalier in her description of possibly a Pap test but I'm thinking it was an IUD insert...NO it's not a little pinch. Ok like a man would ever know.
Your last point requires context & once again not debating nor dismissing the issues for some women, albeit likely not a large percentage.
How close is transexamic acid to the L -lysine that I take to prevent cold sores? It is available over the counter.
It does not have the same molecular structure as lysine. It is only available over the counter in some countries, such as the UK, Sweden, and India. But you need a prescription in the US, Canada, and Australia.
Thank you
I had an absolutely horrible experience with tranexamic acid. It caused clots around the size of a golf ball and I felt like I was giving birth every time I passed one of these clots.
What labs do you diagnose iron deficiency with? Iron or ferritin ? Or if iron normal but ferritin low? Or if both normal but TIBC is high? And what are the levels you use vs what the lab reference ranges are?
Ferritin is the gold standard
I'm not a doctor and don't really know much about this, but what I learned with my low iron experience was that "iron stores" is ferritin and that is called "non-anemia low ferritin". I had very similar symptoms to "anemia" and getting my iron stores, ferritin back up was very helpful. I got an iron infusion.
Before that I was really tired (fagitue), hard to exercise too much, had bad altitude sickness, broken toes and finger nails, finger and toe nails like "spoons", dark circles under my eyes, pale skin.
I really appreciate this post. I'm a sport & eating disorder dietitian/RD and iron deficiency is always something I'm looking out for - thank you for discussing it here. Hopefully, I can get my daughter on tranexamic acid - she's twelve and has horribly heavy periods (like misses school). What age can it be prescribed? Thanks again!
I saved this to my Sunday 'read pile' because I really wanted to be able to take it in. I wish I had been able to take it in years ago! I am grateful for the knowledge now, however, and will share it with those I encounter who may also want to know.
Ok, fellow readers particularly the ladies OMG never having seen a tampon even out of its wrapper, let a lone dampened (ok chosing not to be more descriptive) from its intended use. Feel free to LOL at this naive male but Dr. Jen initially I did a double take, not particularly squeamish with visual/true anatomy, it will be a while before the image of a tampon returns to being unwrapped 🤔
I wish I had known this when I was still getting a period, it would have been super helpful. During perimenopause, I did have some very heavy/long periods and ended up with low ferritin (non-anemia low ferritin/low iron stores). I was told to take iron supplements, which is just so hard. I tried for several months and then found out about iron infusions. You just get a large amount of iron through an infusion (iron going into your vein). It didn't really hurt, took like 45 min and I felt better within 2 weeks and my ferritin levels were back up.
Would tranexamic acid possibly be useful for inter menstrual spotting ?
No, I don't think so
Thank you so much for this post, I wish I knew about it years ago, and especially before perimenopause when my already heavy periods got both heavier and more frequent. I only take it on the heavy days but it makes everything more manageable and my iron levels (with supplements) have started to level out.
Thank you for this post. I would love to see you do a longish post about HMB and fibroids, and specifically about fibroid treatments -- my feeling is that women in Canada are woefully underinformed about options beyond Transexamic acid, Mirena, and ibuprofen, such as Uterine Fibroid Embolization. In the US, one can visit a "fibroid clinic" to get this treatment. There is also a newish treatment using something called Acessa ProVu, but it is not widely available (yet?). HMB is so underappreciated, and is devastating to quality of life.
I consider myself fairly well-informed and I had never heard of this treatment option before. Thank you!
Would this help with heavy bleeding from adenomyosis? I tried to get an IUD to help, but the insertion failed (shudder). Not really willing to try that again.
Ugh…15 years ago when I was bleeding very heavily in transition to menopause I was switched to a different contraceptive pill and that was the end of treatment. I don’t even remember being checked for anemia or low iron (in the US).
Thank you for this post. I was aware of this tx, & had read about 'clot risk.' Thank you for putting this into perspective. I understand that this is also a very expensive drug, which could mitigate against its use (& utility if OTC).
In the tranexamic acid vs placebo trial, was there a placebo response? It would be ver curious/surprising if there was one.
Wow, Dr. Jen you confirmed what myself & a colleague encountered with a client/patient within the past 2 wk's...thank you