Heavy menstrual bleeding affects up to 30% of women. Combined hormonal contraceptives are a traditional treatment option to decrease menstrual flow. Oral TXA is also indicated for reduction of heavy menses. Is it safe to use both of them together? Is there an increased risk of VTE formation? In this podcast we will review a published commentary out of the journal Contraception which addresses this off-label use of TXA. (This article summary is also part of the ABOG MOC 2021 reading list).