Do you routinely use antifibrinolytics for patients with heavy menstrual bleeding who are already on hormonal therapy?

Yes. Counsel patients about theoretical increased risk, but more recent studies do not support increased thrombotic risk with antifibrinolytics.

• Ker et al., PMID 39461793
• Meschino et al., PMID 40680937
• Muradashvili et al., PMID 41139079