The Use of Tranexamic Acid (AMCA) in lUDs as an Anti‐bleeding Agent

Abstract

Menstrual blood loss was evaluated in 200 women receiving a U‐coil intrauterine contraceptive device loaded with the antifibrinolytic, tranexamic acid (AMCA). The IUDs were inserted in patients at Ain Shams University, Cairo, Egypt, in May 1974; the women were followed up for 6 months. The AMCA‐loaded U‐coil has a core containing 38 mg of crystalline tranexamic acid loaded with a silastic tube 52 mm in length with an inside–outside diameter of 1.57–2.41 mm. The daily release rate of tranexamic acid was determined to be 4.3 μg with an initial high release of 29.0 μg. This group of women was compared to a similar group previously fitted with a copper loaded U‐coil. There were no pregnancies reported in either group, and expulsions were minimal. The 6‐month removal rates for the tranexamic acid U‐coil group was 1.1 per 100 acceptors. The corresponding figure for the copper comparison group was 9.9 per 100 acceptors. Reports of heavy menstrual bleeding were more prevalent at the one‐ and 3‐month follow‐ups for the copper U‐coil acceptors than for those using the AMCA loaded U‐coil. There were no apparent differences at the 6‐month follow‐up. The demonstrated capacity of tranexamic acid to reduce menstrual blood loss based on perceptual reports suggests that this agent can be valuable in increasing the acceptability and safety of intrauterine devices.

Preventive treatment of intrauterine device‐induced menstrual blood loss with tranexamic acid in Chinese women

“…The dose of Transamin® was recommended to be 2 g per day for a Chinese population, which differs from that for a western population. Studies in western countries have also shown that Tranexamic acid, not only orally admitted but also loaded in the IUD, can effectively reduce MBL after IUD insertion (13–15), (19), (21), (22), but no data have corroborated this conclusion in China or in other Asian countries.…”

“…Tranexamic acid (Transamin®) is an antifibrinolytic agent, one of the haemostatics recommended by the World Health Organisation, which is more effective in reducing MBL than prostaglandin synthetase inhibitors and etamsylate (14), (15). As the most effective medical treatment of dysfunctional uterine bleeding (16), the agent has been used to reduce MBL by western women with IUD‐associated menorrhagia (17–22), but few studies corroborated this effect in a Chinese population. We wanted to investigate whether Transamin® therapy reduces the amount of MBL and occurrence of menorrhagia after IUD insertion in Chinese women.…”