THE EFFECT OF TRANEXAMIC ACID ON MEASURED MENSTRUAL LOSS AND ENDOMETRIAL FIBRINOLYTIC ENZYMES IN DYSFUNCTIONAL UTERINE BLEEDING

Fibrinolytic activity of the menstrual fluid is increased in dysfuncti onal uterine bleeding (DUB). We measured the effect of tranexamic acid on the menstrual blood loss and endometrial fibrinolytic enzymes in w omen with DUB (>80 ml menstrual loss /cycle). Endometrial biopsies wer e taken between 24 and 36 hours after the onset of menstruation. Enzym e activity was assayed by measuring the rate of conversion of Glu-plas minogen to plasmin, using a chromogenic plasmin substrate. Antigen lev els were measured using an enzyme linked immunoassay (ELISA) technique . Tranexamic acid reduced menstrual blood loss by 58% (p<0.05). Endome trial tissue plasminogen activator activity and antigen and plasminoge n activator inhibitor - type 1 antigen levels were significantly decre ased by tranexamic acid. The effect of tranexamic acid on the fibrinol ytic enzymes at local endometrial level may be responsible for its suc cess in the treatment of menorrhagia.