Vicarious menstruation may be why you are bleeding from your nose and eyes

Most women are used to suffering from vaginal bleeding or menstruation every month. A menstrual cycle that usually lasts for 24-38 days is part of the reproductive system. It is important as it prepares your body for the possibility of pregnancy. But imagine bleeding from the nose, eyes and lungs. Essentially, bleeding occurs from spots outside the uterus during the menstrual cycle. You may feel this is due to an injury, but it may actually be related to surrogate menstruation. It is a relatively rare condition that can occur during your period.

What is subrogative menstruation?

“It is a rare condition that occurs in sync with the menstrual cycle from the menstrual area or outside the uterus,” says Dr. Chetna Jain, obstetrician and gynecologist. This means that bleeding may occur in place of or in addition to normal vaginal bleeding.

According to a study published in the 2023 GMS Ophthalmology Incident, it usually occurs during menstruation or within 48 hours of onset. Usually, it affects women in their 30s or 40s, following the research published in the 2021 BMJ Case Report.

What causes subrogative menstruation?

Some causes of subrogative menstruation include:

1. Hormonal changes

Variations in estrogen and progesterone during the menstrual cycle can make blood vessels more permeable and vulnerable, leading to bleeding from intolerant sites. “Some tissues outside the uterus can respond abnormally to these hormonal changes, leading to bleeding from various parts of the body,” experts say.

2. Endometriosis

In some cases, endometrial endometrial tissue (endometrial tissue, such as endometrial-like tissue) may be present in parts of the body, such as the lungs and bladder. “The tissues bleeding in response to estrogen and progesterone, which resemble the endometrium, leading to symptoms such as pulmonary bleeding (thoracic endometriosis) and nosebleeds (nasal endometriosis),” experts say.

3. Fragile or abnormal blood vessels

Some women have naturally weak capillaries in certain areas such as the nose, making nosebleeds more likely to occur during the period. “An increased vascular permeability due to hormonal changes can also lead to bleeding from unexpected locations,” says Jain.

4. Blood coagulation disorder

“Conditions such as von Willbrand’s disease, thrombocytopenia, and other bleeding disorders can make a person more likely to suffer from abnormal bleeding,” says Dr. Jain. If you have problems with coagulation, menstrual-related bleeding can occur in abnormal areas such as gums and eyes.

What are the symptoms of subrogative menstruation?

Here are some of the common symptoms of subrogative menstruation.

• Frequent or mild nosebleeds during menstruation.
• Leaks or redness of the blood of the eye due to bleeding from the conjunctival vessels.
• If your lungs are affected, they will vent blood.
• As your teeth are brushed, they become swollen or bleed, and they are synchronized with the duration.
• Blood oozing out from the skin sometimes appears as red spots or bruises.
• Blood discharge from the ears that are free from injuries or infections.
• Blood from stool or black poop during menstruation.

You may also experience pain and discomfort in the affected area. “Bleeding can be accompanied by fatigue and dizziness, especially if the bleeding is severe and leads to anemia,” says Dr. Jain.

How is subrogative menstruation diagnosed?

To diagnose subrogative menstruation, you can:

1. Medical history

The doctor asks you:

• Find out whether the timing of bleeding occurs in sync with the menstrual cycle.
• Location of bleeding, such as the nose, eyes, lungs, skin, and bladder.
• A history of endometriosis, blood disorders, or coagulation problems.

2. Physical examination

• An examination of the affected area is performed for visible signs of bleeding or lesion.
• If endometriosis is suspected, a pelvic examination will be performed.

3. test

Blood test:

• Hormonal levels (estrogen, progesterone) to check for hormonal imbalances.
• Platelet-like coagulation profiles rule out bleeding disorders.

Urine and stool tests:

• If bladder or bowel bleeding is suspected, blood in the urine and blood tests for the stool may be performed.

4. Imaging test

To check for endometriosis or abnormal tissue growth:

• Ultrasound (pelvic and transvaginal): Detects endometrial cysts or abnormal tissue growth in the reproductive organs.
• MRI (magnetic resonance imaging): Provides a detailed view of soft tissue. This helps identify endometrial implants in the lungs, nasal passages, bladder or other locations.

What is the method of subrogative menstrual treatment?

Treatment of subrogative menstruation depends on the underlying cause.

• Contraceptives: “The combination of estrogen-progesterone birth control helps regulate hormones and suppress abnormal bleeding,” experts say. A 2014 study published in the Ophthalmic Plastic and Reconstructive Surgery showed that oral contraceptive pills can help treat subrogative menstruation.
• Non-hormonal medication: “Drugs like ibuprofen and naproxen can reduce the pain and inflammation that can occur during subrogational menstruation,” experts say.
• Surgical treatment: Surgery is only considered if hormone therapy does not help treat subrogative menstruation. Bleeding in the lungs or bladder can cause surgically removing the affected tissue.

Sometimes you may experience unexplained bleeding from a rare site during your period. It may be due to subrogative menstruation, which usually affects women in their 30s and 40s. Consult with a doctor who can provide the right treatment.