Periods and Nose Bleeds: Vicarious Menstruation
A friend of mine suffered a bloody nose for five straight hours before going to the emergency room. Doctors there ran a few tests and sent her home, suggesting she was not in immediate danger, but that she should schedule a visit with her regular doctor as soon as possible. So, Erica went home, and, the next day, she called her physician’s office. They were able to see her right away.
Check-up from the Neck Up
Her doctor, an older gentleman who has seen Erica for routine check-ups for many years, performed a fairly thorough examination. After which, he pronounced her healthy and sat down in a chair across from her. He eyed her seriously and said, “Tell me about this bloody nose.”
Erica provided the details and watched as he made notes on her chart. He looked at her again and asked if she is on birth control, to which Erica positively affirmed she has an IUD. At last, the doctor got to the proposed point of this discussion. “Well, where do you think all of that menstrual blood goes? It has to come out somehow.”
Presumably, Erica’s doctor meant that her bloody nose was the result of her IUD and that the menstrual blood she would typically release from her vagina came out instead from her nose.
When I heard this story, I was beyond stunned. I’ve never had an IUD, so I’m not familiar with this type of contraceptive, but surely the doctor wasn't serious. Perhaps he was trying to make light of Erica’s bloody nose, which seemed to come out of nowhere and with no medical explanation. Or, at the very least, I hope he was kidding and expected Erica to know this.
But she didn’t, and she called me to ask if it was possible for menstruation to cause a bloody nose. Without a ready answer, I conducted some research and found a few surprising facts.
First, I looked at IUDs, some of which actually are hormonal birth control.
- Mirena IUD- relies on hormones. Stops ovulation and can stop periods.
- ParaGard - relies on copper. Stops ovulation, but not monthly period. Period may in fact, be heavier than normal.
Here’s the interesting part - according to the Estronaut Forum for Women's Health "nose bleeds may periodically occur in some women following the hormonal fluctuations of the menstrual cycle." This is apparently called "vicarious menstruation." It's rare, but can happen as a boost in blood estrogen levels cause the delicate vessels of the nose's mucous membranes (similar to those of a woman's uterus) to fill up and burst.
Symptoms of a Vicarious Menstruation Nose Bleed:
- Use of IUD
- Start of menstrual cycle
- Happen in the left nostril
- Blood is dark
- Symptoms decrease as normal menstrual flow increases
So it turns out it's no joke! Erica’s doctor was referring to this very condition.