Why is my bleeding not stopping?

Bleeding that does not stop can be alarming. There are many potential causes for prolonged or excessive bleeding, most of which are not life-threatening. However, in some cases, bleeding that does not stop on its own can signal a medical emergency.

Table of Contents

What are some common causes of prolonged bleeding?

Here are some of the most common reasons why a wound or bleeding episode may not stop:

Minor cuts or scrapes – For small wounds, bleeding should stop within 10 minutes with proper first aid and pressure. If it does not, it may be a sign that the wound is deeper than it appears.
Nosebleeds – Most nosebleeds can be stopped within 30 minutes by applying pressure and using proper first aid techniques. Persistent nosebleeds may require medical treatment.
Gum bleeding – Bleeding from gums when brushing or flossing typically stops once pressure is applied. Persistent gum bleeding may indicate gingivitis, vitamin deficiencies, or blood disorders.

Menstrual bleeding – Heavy periods are defined as losing more than 80ml of blood per cycle. Bleeding is considered prolonged if a period lasts more than 7 days.
GI bleeding – Stomach ulcers, hemorrhoids, diverticula, and gastrointestinal tumors can all lead to bleeding from the digestive tract. GI bleeding requires medical evaluation.
Postpartum bleeding – Some vaginal bleeding after giving birth is normal. However, excessive bleeding, passing large clots, or soaking more than one pad per hour is not normal.

Miscarriage – Bleeding from a miscarriage may persist until all pregnancy tissue has passed. Excessive bleeding with clots, cramping, or low blood pressure needs prompt medical care.

When should I seek emergency medical care for bleeding?

Seek immediate emergency medical care if you experience any of the following:

Bleeding does not stop after applying direct pressure for 15 minutes.

Blood is spurting from the wound.
Blood loss exceeds 500ml or 2 cups.
You are losing consciousness, feeling faint, or have low blood pressure.

Bleeding is accompanied by severe pain.
You have sudden, severe stomach/back pain with bloody vomit or stool.
You are coughing up blood or vomit that looks like coffee grounds.

You have heavy vaginal bleeding with severe cramping during pregnancy.
A head injury is accompanied by bleeding from the ears or nose.

Do not drive yourself – have someone else take you to urgent care or an emergency room immediately if any of the above warning signs are present. Severe bleeding can quickly become life-threatening.

How emergency medical care treats severe bleeding

Emergency medical providers have various tools to treat severe bleeding and prevent further blood loss:

IV fluids – Fluid replacement helps manage low blood pressure and prevent shock.
Blood products – Blood transfusions can replace lost blood and replenish essential oxygen-carrying red blood cells.

Surgery – Surgery may be urgently needed to stop internal bleeding from a ruptured organ, ectopic pregnancy, aneurysm, or severe trauma.
Endoscopy – Endoscopy procedures allow doctors to view internal bleeding and potentially cauterize or sclerose bleeding sites.
Medications – Vasopressors narrow blood vessels while tranexamic acid promotes clotting.

Compression – Applying direct pressure to a wound or packing a wound can restrict further blood flow.

The specific emergency treatments used will depend on the cause and location of bleeding. Urgent treatment is vital to stabilize bleeding before it leads to hemorrhagic shock, organ damage, and even death.

When should you see a doctor for persistent minor bleeding?

While major bleeding episodes require emergency care, slower chronic bleeding may still indicate an underlying problem. Make an appointment with your primary care provider if you experience any of the following:

Any bleeding that persists for longer than one week without improvement
Bleeding between periods or irregular menstrual bleeding
Abnormal vaginal bleeding after menopause

Daily nosebleeds with no known cause
Frequent gum bleeding when brushing or flossing
Bleeding from the rectum or bloody bowel movements

Easy bruising or petechiae spots on the skin indicating bleeding under the surface
Vomit that looks like coffee grounds, indicating gastrointestinal bleeding
Blood in the urine, indicating urinary tract bleeding

A primary care doctor can run tests to evaluate the cause of unusual bleeding episodes. They may inspect the bleeding site and order blood work, urine tests, endoscopies, CT scans, or biopsies when necessary. Getting an accurate diagnosis is essential for determining the right treatments to stop recurring bleeding problems.

What self-care steps help manage bleeding at home?

For minor wounds or bleeding episodes you are monitoring at home, these self-care techniques may help:

Apply firm, direct pressure over the wound using a clean cloth or bandage. Elevate the area and ice it if possible.

Keep pressure on for a full 15 minutes without peeking. Set a timer if needed.
Once bleeding stops, clean the wound with mild soap and water, apply antibiotic ointment, and cover with a sterile bandage.
Change bandages daily, watching for renewed bleeding. Avoid reopening scabbed-over wounds.

For nosebleeds, sit upright and pinch the soft lower part of the nose for 10-15 minutes continuously.
Use sanitary pads for vaginal bleeding, changing every 2-4 hours or when saturated.
Get plenty of rest and avoid strenuous activities that may aggravate bleeding.

Drink more fluids to help replace lost blood volume.
Take an iron supplement or multivitamin containing iron if you have heavy menstrual bleeding.

Notify your doctor if bleeding persists beyond a couple days despite self-care. Bleeding episodes may sometimes spontaneously resolve, but it is still important to identify any underlying cause.

What medications help stop bleeding?

Your doctor may prescribe certain medications to help control bleeding, such as:

Antifibrinolytic agents – Drugs like tranexamic acid and aminocaproic acid help stabilize clots.
Hormonal contraceptives – Birth control pills or the Mirena IUD can help reduce heavy menstrual bleeding.

NSAIDs – Ibuprofen or naproxen helps reduce menstrual blood flow.
Antibiotics – If bleeding is due to infection, antibiotics treat the underlying cause.
Desmopressin – This synthetic hormone helps boost platelet levels to encourage clotting.

Estrogen – Hormone replacement therapy may help manage postmenopausal bleeding.
Iron supplements – Iron tablets replace iron lost due to bleeding episodes.

Medications carry side effects and risks, so follow your doctor’s specific dosage recommendations. Seek emergency care if bleeding worsens or does not improve while taking prescription medications.

When should bleeding warrant surgery?

If bleeding cannot be controlled with less invasive interventions, surgery may be required. Reasons bleeding might lead to surgery include:

Internal bleeding from trauma that requires open surgery to find and repair the source
Uterine fibroids, polyps, or adenomyosis causing excessive menstrual bleeding that has not responded to other treatments

Heavy bleeding from the GI tract due to ulcerations, diverticulosis, or angiodysplasia
A miscarriage in which bleeding persists and dilatation and curettage (D&C) is needed to empty the uterus
An ectopic pregnancy with ruptured fallopian tube causing internal abdominal bleeding

Bleeding tumor removal when cancer is present
Hysterectomy for stubborn uterine bleeding unresponsive to other measures

Surgeries to control bleeding are usually a last resort after pharmaceutical management has failed. The benefits of finally stopping the bleeding are weighed against the inherent risks of undergoing an invasive procedure.

Are there any lifestyle changes that can help manage bleeding?

Yes, certain lifestyle measures may help prevent or minimize problematic bleeding episodes:

Eat a balanced diet high in iron, vitamin K, and vitamin C to support healthy blood clotting.
Exercise regularly, but avoid overly strenuous activity that could worsen bleeding issues.

Lose excess weight – obesity can contribute to heavy periods and high blood pressure.
Limit alcohol intake – heavy drinking interferes with platelet function and blood clotting.
Quit smoking – smoking impairs circulation and small blood vessels.

Follow treatment plans for underlying medical conditions like liver disease, kidney failure, or blood disorders.
Learn to manage stress, which can influence hormonal balances and increase bleeding tendencies.

Making positive lifestyle modifications can potentially help reduce problematic bleeding or improve your response to necessary medical treatments.

Takeaway points on stopping bleeding

Here are some key takeaways to remember about controlling bleeding:

Apply direct pressure to bleeding for at least 15 minutes before expecting it to stop.
Seek emergency help for bleeding that seems excessive or does not stop with standard first aid.

Have your doctor evaluate any bleeding lasting more than 1 week or bleeding that occurs without clear cause.
Medications, surgery, and lifestyle changes may help manage underlying bleeding disorders.
Watch for signs of renewed bleeding and notify your doctor promptly if bleeding recurs.

Do not take bleeding lightly – get appropriate medical care to determine the cause.

Conclusion

Bleeding that seems abnormal in either quantity or duration should never be ignored. While some causes of bleeding are benign, others can signal potentially life-threatening medical emergencies. Don’t hesitate to call for help or seek medical evaluation if you cannot get bleeding under control quickly. With proper treatment guided by an accurate diagnosis, recurring bleeding episodes can often be successfully managed.