Chapter 1227: [1227] The medical history is ambiguous
Waiting for the results of the emergency blood tests, Xin Yanjun furrowed her brow. It wasn’t an external injury, and calling an otolaryngologist down didn’t seem clinically justified. If it were nasal diseases like nasal tumors or nasopharyngeal carcinoma, it wouldn’t suddenly lead to heavy nosebleeds prompting an emergency visit. Instead, there would likely have been a period of blood-tinged nasal discharge prompting a visit to the outpatient clinic.
"Do you have any thoughts?"
Hearing Teacher Xin’s question, Xie Wanying lowered her head and asked the patient a question: "When is your menstrual period? Is it currently happening?"
Upon hearing the student’s line of reasoning, Xin Yanjun immediately caught on and asked the patient’s friend, "Is her menstruation normal?"
"She previously mentioned that her menstrual flow has been somewhat light recently, possibly because she’s been busy with work and was considering taking medication to regulate it," the patient’s friend recalled what the patient had personally shared.
"So, during the period of her abnormal menstruation, did she experience nosebleeds?"
"She occasionally had a little nosebleed, but she said it was normal, since the climate here is relatively dry," the patient’s friend replied, feeling puzzled by the doctors’ questioning.
A group of medical staff felt like glaring at these people: earlier, when asked if the patient had symptoms of illness, they adamantly said none.
So prior nosebleeds aren’t considered a medical issue?
In the general public’s perception, occasional minor nosebleeds may indeed not be regarded as a disease.
Nosebleeds are fairly common among people. Some cities have poor climates, with dryness leading to nasal passages becoming dry—especially during autumn, when the weather tends to be arid. If the patient herself has the bad habit of picking her nose, it can frequently trigger small amounts of nosebleeding. These minor nosebleeds are generally harmless and can stop on their own without medication or intervention.
A small nosebleed isn’t alarming; the problem arises when multiple areas of your body are sending distress signals. This can no longer be dismissed as merely a minor nosebleed.
It simply illustrates that the general public, unlike doctors, has not studied systematic medical knowledge. When considering a patient’s abnormal physical condition, it’s necessary to consider all symptoms across the body to make a judgment. The human body is a unified whole, and it’s impossible to assess diseases in isolation. Some illnesses can cause symptoms that seem disconnected from the underlying cause.
"What? Her nosebleeds are related to her menstruation?" The patient’s friend picked up on the doctor’s implication and asked in shock.
This was unheard of—how could a woman’s menstruation be connected to nosebleeds?
There absolutely is a connection—and it can be significant.
In medicine, there’s a term called compensatory menstruation, also known as ectopic menstruation, which refers to periodic bleeding similar to menstruation but occurring outside of the uterus.
Breaking down the medical terminology, firstly, the periodicity of such bleeding aligns with the menstrual cycle. It may occur prior to menstruation or during the menstrual period itself.
Secondly, the bleeding does not occur in the uterus, which is why it’s termed non-uterine bleeding. Instead, it may occur in the nasal mucosa, external ear canal, mammary glands, gastrointestinal tract, bladder, or other locations.
Isn’t this peculiar? Why would the bleeding bypass the uterus and occur in these areas? The disease involves multiple causes that require detailed analysis.
To begin with, the most common symptom in such patients is nosebleeds, which account for one-third of cases.
How do compensatory menstruation-related nosebleeds occur? Starting with relevant anatomical knowledge: the primary site of nosebleeds is the anterior-inferior portion of the nasal septum, which has a richly distributed network of capillaries. These small vessels are fragile and prone to bleeding. Interestingly, the epithelial cells in this region are highly sensitive to estrogen and can be influenced or stimulated by it, leading to cyclical congestion and swelling similar to the uterine lining. When the estrogen levels suddenly drop, this area may undergo cyclical bleeding, akin to that of the uterus.