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January 22, 2013 at 8:00 AMComments: 6 Faves: 0

Periods and Nose Bleeds: Vicarious Menstruation

By Claire Franklin More Blogs by This Author

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.

Vicarious Menstruation

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.


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  • This is me down to a tee! I have trawled the internet to find anyone that has this... left nostril.... pmt.... every month!!!

  • If the menstrual lining is able to slough from the uterine wall, defy gravity by moving upwards, burrow through the uterine wall, keep itself contained so as not to mix with other blood, eventually burrow INTO the sinus cavity and exit the body as a nose bleed then there must be "vicarious menstration." Of course, the hormonal surge, possible crying jags with excessive nose blowing or dry air couldn't be the cause of the monthly nosebleeds. I bet all those other women who get monthly migraines are actually experiencing it too only their menstrual blood is male which refuses to stop and ask for directions and ends up in the brain.

    For all that is holy tell me this site is sarcasm based so I can once again,have hope for humanity.

  • Thank-you for this information. I have had a doctor suspecting endometriosis as the cause of my monthly nosebleeds. Now that I have this information, I can avoid exploratory arthroscopic surgery as I now understand my nosebleeds could simply be hormones causing the blood vessels of my nose to burst. And in my explorations of these nosebleeds I have come across documented medical cases in medical journals of endometriosis in the sinuses. It is possible. There have been documented cases of endometrial tissue strangling the intestines, choking the appendix and presenting as appendicitis, and cases of endometrial tissue infiltrating the lungs. Just because it is difficult to understand doesn't mean it's not possible.

  • Thing with me is don't get bloody noses but when I do blow my nose the boogers (the only way I know what to call them) they come out covered in blood. I'm not sure what to do about it.

  • I get this but on my right side. Nose bleeds with blood clots. When I tried to stop the bleed it went into my throat and choked me.

  • not had many nosebleeds in my life - usually due to injury. In February this year, I had several nosebleeds - heavy, choking, gagging - for minimum of 30 minutes each, mostly longer. Ended up in urgent care, they said it was due to "dry air". I had been on my period, but it was ending, so bleeding had let up. Started period yesterday - and have my first bloody nose since Feb today at work! This is so crazy. Left nostril, dark red blood. I still have the nose pincer I was given at the urgent care, and some nasal gel, so I can treat but if I am going to have a nosebleed when I have my cycle - UGH!!!

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