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 * 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)