What should you know about tranexamic acid and contraceptive pill?

Tranexamic acid and the contraceptive pill may be used together only after a clinician reviews the pill type, your bleeding problem, and your personal risk of blood clots. The phrase contraceptive pill can mean a combined pill or a progestogen-only pill, and their safety considerations are different. Tranexamic acid should therefore be matched to the exact pill and to the reason for treatment, rather than added to a routine without review.

Tranexamic acid helps keep clots from breaking down. Combined pills contain oestrogen and may add clotting considerations; progestogen-only pills require their own review. A past clot, clotting disorder, smoking, migraine with neurological symptoms, kidney disease, or recent immobilisation can change the discussion.

Check the active ingredients on your pill packet and tell the prescriber why tranexamic acid was suggested. Discuss any other medicines, supplements, pregnancy possibility, breastfeeding, and previous clot symptoms. Do not stop contraception or change its schedule unless advised. For further reading, see [Tranexamic Acid](/materials/tranexamic-acid/) and [Tranexamic Acid for Heavy Bleeding](/treatments/medical-gynaecology/tranexamic-acid-for-heavy-bleeding/).

Call emergency services for chest pain, difficulty breathing, coughing blood, sudden weakness, or a painful swollen leg. A new visual disturbance or severe unusual headache also needs urgent assessment. Contact the prescriber if menstrual bleeding remains heavy, worsens, or causes dizziness or faintness.

Ask which pill category you use, whether tranexamic acid is suitable for your bleeding pattern, what warning signs to watch for, and whether a different treatment would be safer.