A 33-year-old woman with a 5 cm intramural fibroid presents with heavy menstrual bleeding and a hemoglobin of 10.2 g/dL. She wishes to avoid hormones. Which of the following is the most appropriate non-hormonal medical therapy?
- A Mifepristone
- B Dienogest
- C Tranexamic acid ✓
- D Medroxyprogesterone acetate
Correct answer: C. Tranexamic acid
Explanation
Tranexamic acid is an antifibrinolytic agent and the only non-hormonal medical option among the choices for heavy menstrual bleeding due to fibroids. It reduces menstrual blood loss by inhibiting plasminogen activation in the endometrium. Mifepristone, dienogest, and medroxyprogesterone are all hormonal agents. NICE and FIGO guidelines recommend tranexamic acid as first-line non-hormonal therapy for heavy menstrual bleeding.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.