menorrhagia

Question 1

What is it?

Answer 1

heavy menstrual blood loss

Question 2

treatment

Answer 2

tranexamic acid 500mg (P)

• once bleeding starts 2x 500mg tabs TDS
• if still heavy can inc to max 8 tabs daily
• for max of 4 consecutive days

+- paracetamol/ibuprofen

Question 3

licencing for tranexamic acid

Answer 3

18 - 45 years

with regular 21-35 day cycles

Question 4

referral

Answer 4

TRANEXAMIC ACID:
- no reduction in bleeding after 3 cycles
- irregular periods
- Hx thrombotic disease
- anticoagulants
- oral contraceptives (shouldn’t have periods)
- tamoxifen
- pregnancy
- breastfeeding
- PCOS
- obese
- diabetic

GENERAL:
- unusual vaginal discharge
- fever (infection?)
- O45yrs developing heavy periods
- persistent intermenstrual or postcoital bleeding
- Hx endometrial cancer in 1st degree relative