How does tranexamic acid work as a painkiller?

Please can someone explain this to me, as I know it's not a painkiller but it does stop pain, and I would like to know why and how.

If it stops the pain, can you conclude that the pain is due to bleeding and therefore due to endo?

I'm not diagnosed and my GP is trying me on tranexamic acid before referring me to a gynae.

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  • Hi, I have found that it does stop pain somehow, not sure how but it does, I have been put back on this and Mefinamic acid aswell. This combination seems to reduce my pain quite abit.

    Although the Tranexamic acid does reduce my pain it does not seem to control the bleeding even though that is what it is designed to do. Keep us posted if you do find out how it stops pain.

    Hope you get sorted.

    Rachel x

  • Hi, All I know is that it is used to treat blood clots in many conditions and in the case of endo, helps the blood clot in the womb around the time of your period which is supposed to reduce the blood loss therefore reducing pain. I have never taken it as my mother had thrombosis (I read I shouldnt take it with family history) I just take mefanamic acid, the non steroid anti inflammatory tablets as mentioned above.

    regards, Jules.

  • Hello DiamondFire

    In answer to your question about tranexamic acid, it promotes blood clotting. Women with heavy menstrual bleeding seem to have higher concentrations of a protein that inhibits blood clotting in the lining of the womb, so bleed longer and more heavily. Tranexamic acid counteracts this excess and helps the womb lining to seal the tiny capillaries off after the shedding of the top layers of cells. It doesn't increase the risk of clots in the blood. It is being used in trauma for stopping massive blood loss and trialled in the developing world for treating post childbirth haemorrhage.

    The womb also contracts to try to squeeze the blood vessels shut and expel the shed cells. I don't know if has been definitely proved, but presumably if you are bleeding more, then the womb will contract more and cause pain. So if you can reduce the bleeding, you can reduce the pain. In that sense, tranexamic acid is not a painkiller, in the way you might consider paracetamol. It is quite often prescribed with mefenamic acid, which is in the same class of drugs as ibuprofen but works on decreasing the uterine contractions.

    Both drugs are effective in reducing heavy menstrual bleeding, as is the Mirena coil. This statement is based on the average effect on a group of women - unfortunately there will be some women, like Rachel above, for whom it doesn't work and some for whom it works very well.

    Hope this helps

    PS Tell your GP that the results of the ECLIPSE study will be out soon.

  • Hi GynaeResearcher,

    Thanks for your really helpful reply! So if someone i.e. me, has quite light periods and terrible cramps in both usual and unusual places, and tranexamic acid works to stop the pain, what does that mean????

    I have just spoken to my GP and she said that tranexamic doesn't stop bleeding but reduces other chemicals like prostaglandins which reduces the pain - I think it sounds like she was talking about something else and I'm not sure she's right.

    To me it sounds like if you can say that tranexamic acid reduces the pain, then that pain is due to bleeding, and bleeding in unusual places is not right and would suggest endometriosis... is that right?

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