Hi Spotting,abdominal cramps ,heavy bleeding may occur during the initial days of Intrauterine device insertion in women. These symptoms usually reduce between three and six months of Iud insertion.Hence you can wait and watch the bleeding pattern for a couple of weeks. Mefenamic acid and Tranexamic acid can be used to reduce heavy bleeding and cramps during this period. Prostaglandin in the menstrual blood is responsible for painful cramps. Pain killers like mefenamic acid help in reducing such cramps since they inhibit prostaglandin in the menstrual blood. Tranexamic acid is an anti-fibrinolytic drug which prevent blood clots from breaking down so that excess bleeding is prevented.Hence I would suggest you to take both drugs at the initial 4 days of periods. Hope I have answered your query. Let me know if I can assist you further. Regards Dr.Saranya Ramadoss, General and Family Physician