What if tranexamic acid does not relieve heavy periods?

Tranexamic acid helps reduce bleeding by supporting clot stability, but it does not treat every cause of heavy periods. Fibroids, adenomyosis, polyps, hormonal changes, thyroid problems, bleeding disorders, medicines, or pregnancy-related problems may need separate assessment. The prescribed timing matters, and a clinician may review whether doses were taken as directed. Ongoing bleeding can also lead to iron deficiency and tiredness, so the effect on daily life is part of the review.

Record how often you change pads or tampons, any flooding or clots, bleeding between periods, pain, dizziness, and missed activities. Contact the prescriber rather than taking extra tablets. They may discuss an examination, pregnancy testing where relevant, blood tests for anaemia, or imaging, followed by options suited to your symptoms and plans for pregnancy. Ask whether iron assessment or treatment is appropriate.

Seek urgent medical care if bleeding is soaking through protection repeatedly, you feel faint or unusually weak, have severe pelvic pain, shortness of breath, chest pain, or may be pregnant. Call emergency services for collapse, severe breathlessness, or sudden one-sided weakness. Do not wait for a routine appointment if bleeding is making you light-headed or unable to function safely.

Could fibroids, adenomyosis, polyps, hormones, or a bleeding disorder be contributing? Do I need blood tests or imaging? What alternatives fit my health and pregnancy plans? How should I manage tiredness or possible iron deficiency?