Individuals taking birth control often express concern about nosebleeds. While not a universal side effect, hormonal contraception can be associated with increased nosebleeds. This connection stems from how birth control hormones affect the body’s vascular system.
The Hormonal Connection
Hormonal birth control, especially combination pills, can affect the delicate blood vessels lining the nasal passages. These hormones alter the body’s mucus membranes, including those in the nose, making them more prone to bleeding. Estrogen, for example, increases blood flow to these membranes, and its fluctuating levels can make nasal capillaries more fragile.
Estrogen and progestin also affect the body’s clotting mechanisms. Estrogen can increase clotting factors while decreasing inhibitors of coagulation. While these changes generally create a state of hypercoagulability (increased tendency for blood to clot), the increased fragility of nasal blood vessels can still lead to nosebleeds in susceptible individuals. This side effect is often mild and infrequent, though some people on hormonal birth control may notice it.
Other Common Factors
Many factors unrelated to birth control frequently cause nosebleeds. Dry air, particularly in hot, low-humidity climates or heated indoor spaces, is a common cause, drying nasal membranes and making them prone to bleeding. Nose picking, forceful nose blowing, and minor nasal injuries are also frequent causes.
Allergies, colds, and sinus infections can inflame and irritate nasal passages, contributing to nosebleeds. Certain medications can also increase the risk, including blood thinners like aspirin and warfarin, as well as non-steroidal anti-inflammatory drugs (NSAIDs). Even some nasal sprays, if used frequently, can irritate the nasal lining and lead to bleeding.
When to Consult a Healthcare Provider
Most nosebleeds are not serious and can be managed at home, but certain situations warrant medical attention. If nosebleeds occur frequently, for example, more than once a week, consult a healthcare provider. Seek immediate medical care if a nosebleed lasts longer than 20 to 30 minutes, even with direct pressure.
Consult a doctor if bleeding is heavy, if you lose significant blood (e.g., more than one cup), or if nosebleeds accompany other unusual symptoms. These could include excessive bruising, heavy periods, dizziness, shortness of breath, or if the nosebleed follows a head injury. Do not stop birth control medication without first discussing it with a doctor, who can assess the situation and recommend appropriate steps or alternative contraception if necessary.