nose bleeds during menstruation?

Question

I have searched the web but haven't been able to find much information about (very slight) nose bleeds during menstruation. Does anyone have any more information about this?

I think I read somewhere that peaks in estrogen can cause this?

Thanks!

A few extra notes about this: I had my blood pressure checked not too long ago, it was fine.

It's not a full nose bleed (and not even a mild one), it's more of a drop or two of blood, once. Weird.

Absolutely no abnormalities in my period and last pap smear was perfect.

I realised that searching for absolutely anything will suggest it's something nasty (googling anything will prob tell you you have cancer).

I appreciate the info. Thanks

Answer 1

from Scott G Chudnoff, MD, Instructor, Obstetrics, Gynecology, & Women's Health, Albert Einstein College of Medicine, Bronx, NY; Staff Physician and AAGL Fellow in Gynecologic Endoscopic Surgery, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York:

"There are 3 potential etiologies that I can think of when there is cyclical bleeding with a direct relation to menses: abnormalities in the nasal mucosa caused by changes in the hormonal milieu of menstruation, abnormalities in the hematologic system from changes in the hormonal milieu of menstruation, and endometriosis.

Although extra-pelvic implantation of endometriosis is generally rare, there are reports of its presence in various organ systems, including lung, skin, and brain. There is a case report in the French literature[1] in which biopsy confirmed endometriosis in a nasal nodule. Given the cyclical nature of the epistaxis related to menses in the current case, extra-pelvic endometriosis is a possible etiology and certainly warrants further investigation -- particularly if a nodule is present. To help determine whether endometriosis is present, one could perform an examination with rhinoscopy or imaging study immediately before the menses when an ectopic implantation of endometriosis would be at its largest size. Alternatively, the patient can be given estrogen to help create engorgement of the endometriosis, making it easier to identify. If a suspicious area is identified, biopsy would be required to confirm the diagnosis.

Cyclical changes in hematologic parameters have also been identified in relation to menstruation. These changes have been studied in several articles, but one in particular identified menstrual cycle thrombocytopenia.[2] In this article, 3 patients were described as having thrombocytopenia related to menstruation during which they experienced bruising, epistaxis, and menorrhagia. Additional case reports exist in the literature that document similar events.[3] If suspected, signs of thrombocytopenia should be inquired about: easy bruising, menorrhagia, and history of bleeding during surgical or dental procedures. Simple blood testing at the time of menses as well as during the intermenstrual period can help with this diagnosis.

Direct changes to the nasal mucosa secondary to hormonal levels throughout the menstrual cycle have been studied in several papers.[4,5] Unfortunately, there is no consensus on the effect that hormones have on the mucosa and when the hormone effect would be most pronounced, ie, during the perimenstrual phase or during the periovulatory phase. The one thing that does become evident from reviewing most of these studies, however, is that there seems to be a relationship between hormone levels and nasal mucosal status.[6] It is also known that the mucosa of the nasopharynx becomes hyperemic and edematous with increasing levels of estrogen throughout the pregnancy -- often leading to epistaxis. Therefore, the possibility of hormonal changes throughout the menstrual cycle affecting the nasal mucosa and leading to epistaxis is a plausible theory. The only problem is that we would expect to see those changes in the periovulatory phase when estrogen levels are at their peak. However, in a patient with PCOS or who is perimenopausal, and therefore likely to be oligo-ovulatory and to have elevated levels of estrogen, it seems plausible that estrogen may play a role in causing epistaxis."

Laghzaoui O, Laghzaoui MJ. [Nasal endometriosis: apropos of 1 case.] [Article in French]. Gynecol Obstet Biol Reprod (Paris). 2001;30:786-788.
Tomer A, Schreiber AD, McMillan R, et al. Menstrual cyclic thrombocytopenia. Br J Haematol. 1989;71:519-524.
Holdrinet RS, de Pauw BE, Haanen C. Hormonal dependent thrombotic thrombocytopenic purpura (TTP). Scand J Haematol. 1983;30:250-256.
Philpott CM, El-alami M, Murty GE. The effect of the steroid sex hormones on the nasal airway during the normal menstrual cycle. Clin Otolaryngol. 2004;29:138-142.
Ellgard E, Karlsson G. Nasal congestion during the menstrual cycle. Clin Otolaryngol. 1994;19:400-403.
Bende M, Gredmark T. Nasal stuffiness during pregnancy. Laryngoscope. 1999;109:1108-1110.

Answer 2

You really need to read "Endometriosis Bible & Violet Protocol" by Zoe Brown (also available in electronic format here: http://www.endometriosisbible.info ). It's about how to eradicate endometriosis disease forever. It worked for me, you will see results in only a matter of weeks. Good Luck!

Answer 3

I don't know about estrogen and nosebleeds, but please get your blood pressure checked. You don't have to go to a doctor (though it would be a good idea), most good drug stores have a free blood pressure reading station available.

BP could be spiking at that time, causing the nosebleeds.

Answer 4

never heard about this but u should have a chat with ur doctor about this ok, good luck

Answer 5

Wish I could help but don't have any idea.