Nosebleeds (epistaxis) are common during pregnancy, occurring in about one in five pregnant individuals—three times more often than in the general population. While seeing blood can be alarming, pregnancy-related nosebleeds are generally normal, temporary symptoms and rarely indicate a serious complication.
Why Nosebleeds Occur During Pregnancy
The increased frequency is primarily due to physiological changes in the circulatory and hormonal systems. Total blood volume increases by up to 50 percent to support the fetus, putting additional pressure on all blood vessels.
Hormonal shifts, specifically a rise in estrogen and progesterone, cause the delicate blood vessels (capillaries) lining the nose’s mucous membranes to swell, dilate, and become more fragile. These vessels expand under elevated blood volume pressure, making them susceptible to rupturing.
Vascular congestion can lead to pregnancy rhinitis, causing a stuffy or congested nose. When combined with external factors like dry air or blowing the nose, these swollen vessels are easily provoked into a bleed. Minor trauma or irritation can trigger an episode when the nasal lining is hyper-sensitive.
Managing Nosebleeds at Home
Prevention
Keeping nasal membranes moist reduces the likelihood of a nosebleed. Use a humidifier, especially while sleeping or in dry climates, to prevent the nasal lining from drying out. Applying a small amount of petroleum jelly or antibiotic ointment just inside each nostril creates a protective barrier against moisture loss.
Proper nasal hygiene avoids irritating the vessels. Avoid forceful nose blowing; use a gentle technique, one nostril at a time. Maintaining good hydration helps keep mucous membranes naturally moist. Saline nasal sprays or drops can also be used safely to lubricate the nasal passages.
Treatment (First Aid)
If a nosebleed begins, stop the flow quickly. Sit upright and lean your head slightly forward to prevent blood from dripping down the throat, which can cause nausea or vomiting. Firmly pinch the soft part of the nose, just above the nostrils, using your thumb and forefinger.
Maintain continuous pressure for 10 to 15 minutes without releasing the pinch. Breathe steadily through your mouth. Applying a cold compress to the bridge of the nose or the back of the neck may help constrict blood vessels. After the bleeding stops, avoid strenuous activity, blowing your nose, or bending over for at least 24 hours to allow a stable clot to form.
Identifying When Medical Attention is Necessary
While most nosebleeds are benign, certain symptoms warrant immediate contact with a healthcare provider. Professional medical intervention is needed if a nosebleed continues to bleed heavily despite 20 minutes of continuous pressure, or if blood loss is excessive or rapid.
Nosebleeds occurring alongside other alarming symptoms may suggest a condition beyond simple vascular fragility. Warning signs include severe headache, vision changes, or high blood pressure readings (potentially related to gestational hypertension or preeclampsia). Dizziness, fainting, or feeling weak during the episode also requires prompt evaluation. Frequent nosebleeds (more than two per week) should be discussed with a doctor to check for clotting disorders or other risk factors.
Understanding the underlying reasons for this phenomenon and knowing how to manage it can help relieve any concern.
Why Nosebleeds Occur During Pregnancy
The increased frequency of nosebleeds during pregnancy is primarily due to significant physiological changes in the body’s circulatory and hormonal systems. During this period, the total blood volume can increase by as much as 50 percent to support the developing fetus. This substantial increase in fluid puts additional pressure on all blood vessels throughout the body.
Hormonal shifts, specifically a rise in estrogen and progesterone, also play a major role in affecting the nasal passages. These hormones cause the delicate blood vessels lining the nose’s mucous membranes to swell, dilate, and become more fragile. As these tiny vessels, known as capillaries, expand under the pressure of the elevated blood volume, they become more susceptible to rupturing and bleeding.
This vascular congestion can also lead to a condition called pregnancy rhinitis, which causes a stuffy or congested nose, further irritating the membranes. When combined with common external factors like dry air or the simple act of blowing the nose, these delicate, swollen vessels are easily provoked into a bleed. Even minor trauma or irritation can trigger an episode when the nasal lining is already hyper-sensitive.
Managing Nosebleeds at Home
Prevention
Taking proactive steps to keep the nasal membranes moist can significantly reduce the likelihood of a nosebleed. Using a humidifier, especially while sleeping or in dry climates, introduces moisture into the air and prevents the sensitive nasal lining from drying out and cracking. Applying a small amount of petroleum jelly or an antibiotic ointment just inside each nostril can also create a protective barrier against moisture loss.
Proper nasal hygiene is important to avoid irritating the delicate vessels further. Individuals should avoid forceful nose blowing and instead use a gentle technique, one nostril at a time, to clear the passage. Maintaining good hydration by drinking plenty of water helps keep the body’s mucous membranes, including those in the nose, naturally moist from the inside. Saline nasal sprays or drops can also be used safely to lubricate the nasal passages without causing irritation.
Treatment (First Aid)
If a nosebleed begins, the immediate goal is to stop the flow quickly and effectively. First, sit upright and lean your head slightly forward to prevent blood from dripping down the back of your throat, which can cause nausea or vomiting. Firmly pinch the soft part of the nose, just above the nostrils and below the bony bridge, using your thumb and forefinger.
Maintain this continuous pressure for a minimum of 10 to 15 minutes without releasing the pinch to check if the bleeding has stopped. During this time, breathe steadily through your mouth. Applying a cold compress or a bag of ice wrapped in a cloth to the bridge of the nose or the back of the neck may help constrict the blood vessels, though the evidence for this is not consistently strong. After the bleeding has stopped, avoid strenuous activity, blowing your nose, or bending over for at least 24 hours to allow the small vessel to form a stable clot.
Identifying When Medical Attention is Necessary
While most nosebleeds are benign, certain symptoms warrant immediate contact with a healthcare provider to rule out a more serious underlying issue. A nosebleed that continues to bleed heavily despite 20 minutes of continuous pressure is a clear sign that professional medical intervention is needed. Similarly, very heavy blood loss that seems excessive or rapid should prompt an urgent call.
Nosebleeds that occur alongside other alarming symptoms may suggest a condition beyond simple vascular fragility. These warning signs include severe headache, vision changes, or high blood pressure readings, which could be related to gestational hypertension or preeclampsia. Dizziness, fainting, or feeling weak during the bleeding episode also indicates a need for prompt evaluation. Frequent nosebleeds, such as more than two per week, should be discussed with a doctor to check for potential clotting disorders or other risk factors.