Tranexamic Acid to Reduce Contraceptive-related Bleeding Side Effects

Inclusion Criteria:

• English or Spanish speaking

• In good general health

• Have etonogestrel (ENG) subdermal contraceptive implant (must be palpable to provethat an ENG implant is in place at time of screening and enrollment)

• Experience frequent or prolonged bleeding while using ENG implant (>7 days ofcontinuous bleeding/spotting in the last 30 days, or 2 or more episodes ofbleeding/spotting in the last 30 days)

• Implant use for at least 30 days prior to screening visit

• Willing to continue using the implant for at least 30 days from study enrollment

• Access to a reliable cell phone and must be willing to receive and respond to adaily text or email message to assess bleeding and use of study drug

• Negative gonorrhea/chlamydia screening performed at screening visit

Exclusion Criteria:

• Centers for Disease Control Medical Eligibility for Contraceptive use category 3 or 4 for contraceptive usage

• Currently pregnant

• Less than 6 months postpartum, less than 6 weeks abortion, not breast/chest feeding (cessation of lactation at least 6 weeks prior to enrollment)

• Undiagnosed abnormal uterine bleeding pre-dating placement of contraceptive implant

• Bleeding dyscrasia

• Anticoagulation use

• Active cervicitis

• Allergy to Tranexamic Acid

• Known renal insufficiency

• History of venous thromboembolism

• Current or past breast or uterine malignancy

• Concurrent use of P450 pathway inducing drug

• Implant is due to be switched out in 2 months or less from enrollment

• Routine or chronic use of non-steroidal anti-inflammatory drugs (NSAIDs once dailyor >= 14 days per month)

• Currently using oral contraceptives in addition to implant (to be eligible, needs tohave 4-6 week washout period)

• Prior pregnancy occurred while Nexplanon/Implanon was in place

• Chronic use of Cannabidiol, THC, or marijuana (>3 times per week) (patients couldhave used Cannabidiol, THC, or marijuana chronically in the past, but must have awashout time period of no use for at least one month prior to the study)

• Chronic use of cigarettes (>1 cigarette per week) (patients could have usedcigarettes chronically in the past, but must have a washout time period of no usefor at least six months prior to the study)