Abstract Background: The intent of this survey was to inquire the tranexamic acid effects on Doppler indices of the uterine artery in patients with menorrhagia due to IUD insertion. Aim of Study: The aim of the study was to assess the effective role of treatment by tranexamic acid on uterine artery vascular resistance in cases of menorrhagia associated with copper IUCD (Cu380) insertion. Patients and Methods: The study was implemented in outpatient clinics of the Gynecology Department on patients with menorrhagia. We studied 212 cases of menorrhagia after 3 months of IUCD insertion to exclude insertion related bleeding and fulfilled the inclusion, they were appraised for 6 menstrual cycles. During the first 3 control cycles, the magnitude of bleeding was recorded on the Pictorial Blood Assessment Chart to affirm heavy menses. During the next 3 cycle, random assignment of cases into tranexamic acid and placebo groups was done. They were divided into two equal groups, group 1 (tranexamic acid group) and group 2 (placebo group). The group 1 received 500mg tranexamic acid four times daily from first to fifth days of the cycles, PI (Pulsatility Index) and RI (Resistance Index) were measured from Rt. and Lt. uterine arteries on the first month of the control cycles and during the third month of intervention cycles. MBL (Menstrual Blood Loss) was appraised using a validated pictorial blood chart during the intervention. SPSS version 15 for Windows was used for data analysis. Results: In group 1, the mean PI and RI fell significantly with treatment (PI 2.26-1.78, p=0. 001); (RI 0.87-0.68, p= 0.031). There was a reduction of approximately 48% in MBL with treatment (120.0-65ml, p=0.001). In group 2, there was an insignificant change in either the PI or the RI and there was no significant reduction in menstrual blood loss. Conclusion: Tranexamic acid significantly reduces uterine artery vascular resistance in patients with menorrhagia due to IUD insertion. This effect is afield to be the main role of tranexamic acid in the reduction of the menstrual blood loss.