Materials and Methods: Women aged 18-40 years with heavy menstrual bleeding, who were using TCu380A IUD, were randomised to receive tranexamic acid (group 1, n = 120) or mefenamic acid (group 2, n = 90), 500 mg three times daily for 3-5 days of three consecutive menstrual cycles. Changes in menstrual blood loss volume and duration were assessed using the questionnaire form filled out before the treatment and every month for 3 months. Method of calculation of blood loss volume was instructed to all participants at the first visit. Haemoglobin (Hb) concentration level of participants were also assessed before and after the treatment. Data were analysed using t test, paired sample t test, non-parametric Mann-Whitney test, chi-squared test, and analysis of covariance (ANCOVA).

Results: After the treatment, mean blood volume decreased significantly, by 42.3% in group 1 and by 44.5% in group 2, but their difference was not significant. Mean menstrual days decreased significantly, by 64% in group 1 and by 62% in group 2; however, their difference was not significant. Hb concentration level before and after the treatment was not significantly different between the 2 groups. The peak effect of both drugs was observed at the end of the second month of treatment.

Conclusion: Tranexamic acid and mefenamic acid have the same significant effect in reducing mean blood loss volume and duration of menstruation in TCu380A IUD users.