Tranexamic Acid to Reduce Contraceptive-related Bleeding Side Effects

Eligibility Criteria

• * English or Spanish speaking
• * In good general health
• * Have etonogestrel (ENG) subdermal contraceptive implant (must be palpable to prove that an ENG implant is in place at time of screening and enrollment)
• * Experience frequent or prolonged bleeding while using ENG implant (\>7 days of continuous bleeding/spotting in the last 30 days, or 2 or more episodes of bleeding/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 a daily text or email message to assess bleeding and use of study drug
• * Negative gonorrhea/chlamydia screening performed at screening visit
• * 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 daily or \>= 14 days per month)
• * Currently using oral contraceptives in addition to implant (to be eligible, needs to have 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 could have used Cannabidiol, THC, or marijuana chronically in the past, but must have a washout 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 used cigarettes chronically in the past, but must have a washout time period of no use for at least six months prior to the study)