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 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 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 …