Connect with others who understand.

Sign up Log in
Resources
About MyMSTeam
Powered By
See answer

What’s the Connection Between Multiple Sclerosis and Nosebleeds?

Medically reviewed by Evelyn O. Berman, M.D.
Posted on March 17, 2022

Understanding Nosebleeds | MS and Nosebleeds | NSAIDs | Management | MS Comorbidities | Support


Nosebleeds might happen when dry air causes the lining in the nose to crack and bleed, or when the use of certain medications affects the blood’s ability to clot. People with MS may take these drugs to address symptoms of MS or other coexisting conditions. Therefore, people with MS could experience nosebleeds from medications, but not directly from MS.

Another way that people with MS could experience nosebleeds is through trauma or injury to the nose. Sometimes, MS produces issues with balance and trouble walking. Falling and hitting your nose could result in a nosebleed.

Although nosebleeds can be scary, they are usually not serious. Nosebleeds can be treated at home, but there are several situations when a nosebleed may require medical attention.

Understanding Nosebleeds

Nosebleeds (also called epistaxis) occur when there is damage to the blood vessels in the nose that results in bleeding. This type of bleeding is rarely serious, but if you experience nosebleeds frequently or for longer than 30 minutes, you may need to seek professional medical advice.

There are several different reasons someone may experience a nosebleed. More common reasons include:

  • Dry air or heat
  • Nose picking (mainly in children)
  • Use of anticoagulants such as aspirin or warfarin
  • Use of nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Health conditions such as liver disease, kidney disease, or chronic alcohol consumption

Less common causes of nosebleeds include:

  • Trauma from an injury
  • Interior deformities or abnormalities of the nose or sinuses
  • Intranasal tumors (rarely)

MS is not considered a cause of nosebleeds.

Multiple Sclerosis and Nosebleeds

MS can produce a range of symptoms. It is a disorder in which the immune system mistakenly attacks the protective sheath (myelin) that covers nerve cells in the central nervous system (the brain and spinal cord). Symptoms of MS affect different parts of the body, and they may change or worsen as the disease progresses. Some common symptoms of MS include:

  • Numbness or weakness in the limbs
  • Shock-like sensations in the neck
  • Blurred or double vision
  • Spasticity (feelings of stiffness in the muscles and limbs)
  • Fatigue or unexplained excessive tiredness
  • Speech problems
  • Dizziness
  • Tremors or lack of coordination when moving

Although nosebleeds are not a symptom of MS, medications used to treat the symptoms of MS and the chance of injury due to MS symptoms could influence the risk of nosebleeds in people with the condition.

NSAIDs and Nosebleeds

NSAIDs, which include ibuprofen (Motrin or Advil), are a type of medication that is sometimes used to address symptoms of neuromuscular pain in people with MS. NSAIDs affect the ability of blood to clot and are indicated as a cause of nosebleeds. People who take NSAIDs regularly may be at an increased risk of nosebleeds.

Aspirin and Nosebleeds

Aspirin is another medication used to address specific MS symptoms. Fatigue is a common symptom in people with MS, and some doctors may recommend medical treatment for fatigue. A research study found that taking regular aspirin twice daily helped reduce MS-related fatigue.

Aspirin also affects blood clotting and is listed as a cause of nosebleeds. Taking aspirin regularly, whether for fatigue or other reasons, could affect your risk of nosebleeds.

MS-Related Injury and Nosebleeds

Some symptoms of MS, like spasticity, dizziness, reduced coordination and balance, and difficulty walking increase the risk of falling and injury in people with MS. According to the Cleveland Clinic, 40 percent to 50 percent of people with MS experience falls that result in injury. One member of MyMSTeam wrote, “Fell on my face — severe nosebleed.”

MS Comorbidities and Nosebleeds

Treatment options for MS comorbidities may also affect the risk of nosebleeds. Comorbidities are other diseases or conditions that exist in people with a given disease. Comorbidities are not caused by the other disease.

Common comorbidities in people with MS include:

  • Depression
  • Anxiety
  • Cerebrovascular diseases
  • Diabetes
  • Thyroid disease
  • Cardiovascular diseases

Cardiovascular disease, or heart disease, includes issues such as high blood pressure (hypertension), high cholesterol (hyperlipidemia), heart attack, stroke, and heart failure. Often, medications like aspirin or anticoagulants are used for the treatment of heart disease and the prevention of blood clots that may cause heart attacks or strokes. Aspirin and anticoagulants can cause nosebleeds, however.

“Had an issue this week with nosebleeds due to all of the heart medications I am on,” wrote a MyMSTeam member.

Tips for Managing a Nosebleed at Home

Most nosebleeds can be managed at home and do not require medical attention. If you have a nosebleed, follow these steps:

  • Sit up straight and tilt your head slightly forward. Do not tilt your head back, as doing so may cause blood to reach your stomach and result in nausea and vomiting.
  • Use a tissue or washcloth to catch the bleeding.
  • Try to breathe through your mouth.
  • Use your thumb and forefinger to pinch the lower, soft part of your nose shut.
  • Pinch your nose shut for 10 minutes, without stopping. If your nose is still bleeding, then pinch your nose shut for another 10 minutes.
  • If you have an ice pack handy, apply the ice pack to your nose and cheeks to slow the bleeding.
  • When the bleeding has stopped, you may use a saline nasal spray or antiseptic nasal cream to soothe the area. Do not blow your nose or bend over, strain, or lift anything heavy for several hours to let the area heal.

You may require immediate medical attention if you:

  • Have a severe nosebleed, or one that actively bleeds for longer than 30 minutes or causes more than one cup of bleeding
  • Vomit due to swallowing large amounts of blood
  • Have difficulty breathing
  • Have a nosebleed that was a result of a serious injury like a major fall or car accident

In these situations, you should call your doctor, call 911, or have someone drive you to an emergency room or urgent care center. Do not drive — attempting to drive with a nosebleed can cause distractions and be dangerous.

Sometimes, nosebleeds do not require immediate medical attention, but you should talk to a health care professional about them soon if:

  • You experience frequent nosebleeds
  • You have a blood clotting or bleeding disorder or take anticoagulants and the bleeding won’t stop
  • You show symptoms of anemia, including feeling weak, cold, short of breath, and having pale skin
  • The nosebleeds seem to be a result of starting a new medication

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis. On MyMSTeam, more than 182,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Do you have MS and experience nosebleeds? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on March 17, 2022
All updates must be accompanied by text or a picture.

We'd love to hear from you! Please share your name and email to post and read comments.

You'll also get the latest articles directly to your inbox.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service.
All updates must be accompanied by text or a picture.

Subscribe now to ask your question, get answers, and stay up to date on the latest articles.

Get updates directly to your inbox.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service.
Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here.
Elizabeth Wartella, M.P.H. is an Editor at MyHealthTeam. She holds a Master's in Public Health from Columbia University and is passionate about spreading accurate, evidence-based health information. Learn more about her here.

Related Articles

Five disease-modifying therapies (DMTs) given by intravenous infusion are approved to treat mult...

8 Facts About MS Infusion Treatments: Risks and Benefits

Five disease-modifying therapies (DMTs) given by intravenous infusion are approved to treat mult...
Talking about how multiple sclerosis (MS) can affect sexual function and desire can be difficult....

Can MS Cause Hypersexuality?

Talking about how multiple sclerosis (MS) can affect sexual function and desire can be difficult....
People with multiple sclerosis (MS) are at a higher risk of weight gain.Managing a healthy weight...

Can MS Cause Weight Change? 4 Tips for Maintaining a Healthy Weight

People with multiple sclerosis (MS) are at a higher risk of weight gain.Managing a healthy weight...
Disease-modifying therapies (DMTs) can be effective treatment for multiple sclerosis (MS). These ...

DMTs for MS: 3 Signs It Might Be Time To Switch and What To Know

Disease-modifying therapies (DMTs) can be effective treatment for multiple sclerosis (MS). These ...
Certain disease-modifying treatments (DMTs) for multiple sclerosis (MS) have been classified as...

What Are the Most Effective Treatments for MS? Know Your DMTs

Certain disease-modifying treatments (DMTs) for multiple sclerosis (MS) have been classified as...
Diphenhydramine — sold under many brand names including Benadryl — is a type of antihistamine tha...

Why Is Benadryl Given With Some MS Treatments?

Diphenhydramine — sold under many brand names including Benadryl — is a type of antihistamine tha...

Recent Articles

Five disease-modifying therapies (DMTs) approved by the U.S. Food and Drug Administration (FDA) ...

Schedules for MS Infusions: Monthly, Twice a Year, and Other Frequencies

Five disease-modifying therapies (DMTs) approved by the U.S. Food and Drug Administration (FDA) ...
If you’re having relapses (flare-ups) more often, or if they leave you feeling significantly wors...

Should You Take an Advanced MS Treatment? 5 Symptoms To Look For

If you’re having relapses (flare-ups) more often, or if they leave you feeling significantly wors...
Intravenous (IV) disease-modifying therapies (DMTs) for multiple sclerosis (MS) often come with ...

Financial Help With MS Infusion Costs

Intravenous (IV) disease-modifying therapies (DMTs) for multiple sclerosis (MS) often come with ...
Before you start a new disease-modifying therapy (DMT) through intravenous (IV) infusion for mult...

7 Tips To Help Prevent MS Infusion Side Effects

Before you start a new disease-modifying therapy (DMT) through intravenous (IV) infusion for mult...
This fall and winter, the Centers for Disease Control and Prevention (CDC) expects the number of ...

3 Layers of COVID-19 Protection: New Vaccines, Prevention Drug, and Tests

This fall and winter, the Centers for Disease Control and Prevention (CDC) expects the number of ...
Living with multiple sclerosis (MS) can be challenging, especially when it comes to managing symp...

Symptoms of Multiple Sclerosis

Living with multiple sclerosis (MS) can be challenging, especially when it comes to managing symp...

Thank you for subscribing!

Become a member to get even more: