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In my experience, though, it's usually due to the causes listed in the bullet points, not due to high blood pressure. To answer your question, your Japanese acquaintance is right that in real life, a bloody nose would normally just mean that the person was excited in general, and it would not necessarily have anything to do with sexual excitement. Blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, may cause or worsen nosebleeds. Repeated nosebleeds may be a symptom of another disease such as high blood pressure, a bleeding disorder, or a tumor of the nose or sinuses.
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