Why Your Nose Bleeds During Pregnancy

Do you wonder why your nose bleeds during your pregnancy? We'll tell you why this happens and when you should see your doctor.

Nasal bleeding (or epistaxis ) is a very common symptom of pregnancy and is mainly due to the adaptive changes that the woman’s body undergoes in order to carry the baby. In addition to these, in some cases, there are other factors that increase its incidence. Although it’s usually a mild and rapidly resolving condition, it’s important to know what to do when your nose bleeds during pregnancy and what symptoms require a consult with your doctor.

Why your nose bleeds during pregnancy

From the beginning of pregnancy, the hormonal changes that the mother’s body experiences affect all her devices and systems. This is a response to the biological needs of survival to this new state.

Below, we’ll describe the factors involved in the development of epistaxis during pregnancy:

Circulatory changes

One of the most significant modifications of pregnancy occurs in the circulatory system (veins and arteries), as it’s essential to ensure the blood supply to the baby to provide the necessary nutrients.

These changes have to do with increased pregnancy hormones (estrogens and progesterone) and are as follows:

• In the first half of pregnancy, there’s a marked increase in maternal blood volume, in order to meet the needs of the new baby.
• Estrogens cause the vessel walls to relax and dilate, making it easier for blood to reach all tissues. This, in turn, produces more blood congestion in the mucous membranes, such as the nasal and oral (gums).
• Progesterone is responsible for the increase in blood pressure. This manifests itself in all the vessels of the body, including those of the nose.

As a consequence, the changes generated in the nasal mucosa make the pregnant woman more prone to bleeding from minimal trauma. For example, after blowing or scratching your nose.

Dryness of the mucosa of the nose

When the outermost layer of the nasal mucosa becomes dry, such as occurs during winter or due to dehydration, this tissue becomes weaker and breaks easily.

For this reason, experts recommend moisturizing the nose. This can be either by applying creams with petroleum jelly or by controlling the humidity levels of the environment.

The use of nasal medications

The use of drops or medications directly in the nose can alter the structure of the mucosa. These changes range from increased congestion to a weakening of the wall, and in both cases, it increases the rate of bleeding.

Previous maternal illnesses

Certain maternal diseases, such as bleeding disorders, can increase the risk of bleeding and may be the reason why your nose bleeds during pregnancy.

At the same time, some congestive conditions, such as allergies or chronic rhinitis, tend to flare up during pregnancy and, therefore, can trigger epistaxis. All of these changes usually improve within a few days after birth.

What to do if your nose bleeds during pregnancy?

Every time a pregnant woman has epistaxis, it’s important to take the following measures to control it and avoid complications:

1. Sit with your head upright or slightly tilted forward.
2. Press firmly on the soft part of the nose, just above the nostrils.
3. Hold down for 10 to 15 minutes.
4. Breathe through your mouth.
5. Apply cold to the area, at the level of the bridge of the nose, to help reduce inflammation.

In most cases, the bleeding subsides after a few minutes, so you don’t need to consult the emergency department. In any case, it’s important to discuss this with your GP during the follow-up.

When should I see the doctor?

Faced with a nosebleed that doesn’t subside after adopting the aforementioned measures, it’s important to consult a doctor promptly.

In this context, it’s essential that you rule out some more complex causes of bleeding, such as posterior epistaxis. These occur due to the injury of larger vessels, which are difficult to control with the usual measures.

In the case of recurrent epistaxis or when the blood loss is so extensive that it causes symptoms in the pregnant woman (dizziness, vomiting, or general ill feeling), it’s best to seek emergency services.

Can nosebleeds affect the baby’s health?

In the case of light and sporadic bleeding, the risk to the health of the mother and the baby is low. But in the case of heavy (massive) or repeated bleeding, it’s important to assess the potential risk to the health of both.

Some massive bleeds that occur in the third trimester can threaten the well-being of both individuals and are sometimes the cause of pregnancy termination. This decision depends, among other things, on the gestational age of the baby and the health conditions of the mother.

Finally, studies have been published that suggest a possible relationship between epistaxis of pregnancy and an increased risk of postpartum hemorrhage. While this association may exist, more studies are needed to make an accurate determination.

How can I prevent nosebleeds in pregnancy?

Although it’s a frequent and not very relevant symptom, there are some preventative measures that you can apply:

• Avoid nasal scratching and the application of topical medications (such as nasal sprays).
• Maintain adequate body hydration.
• In case of living in areas with a dry climate, regulate the humidity of the environment.
• Use drops of physiological solution to moisten the nasal mucosa.
• When dry skin or mucosa of the nose is observed, apply creams with petroleum jelly in the nostrils.
• Blow your nose gently.
• After an episode of nosebleeds, avoid exertion (intense physical exercise or lifting heavy things off the floor).

Some final considerations

Nasal bleeding is a very common condition of pregnancy. Although in most cases it doesn’t imply a risk to the health of the mother and the baby, it’s important to know how to proceed if it occurs and what symptoms merit a doct0r’s visit.