Updated at 3:30 p.m. ET

President Trump unleashed one of the most vitriolic insults of his presidency Thursday morning, saying MSNBC Morning Joe host Mika Brzezinski was "bleeding badly from a face-lift" while at his Palm Beach, Fla., resort for New Year's Eve. He also described her as "low I.Q. Crazy Mika."

The president sent a pair of tweets aimed at Brzezinski and co-host Joe Scarborough, whom Trump called "Psycho Joe," apparently in response to Thursday morning's episode (although he tweeted that he no longer watches the show).

The tweets may have been in response to Thursday morning banter about the fake Time magazine covers in the president's golf clubs.

Backlash to the tweets has come from all angles.

Susan Collins of Maine, one of four Republican women in the Senate, called for "respect and civility" and said "this has to stop."

Rep. Lynn Jenkins, R-Kan., pointed to what many see as inherent sexism in the comments.

Sen. Lindsey Graham, R-S.C., who has never been shy in speaking out against Trump, said the tweet was "beneath the office and represents what is wrong with American politics, not the greatness of America."

Sen. Ben Sasse, R-Neb., a frequent Trump critic, echoed that, calling the president's comments "beneath the dignity of your office."

In a press conference, Speaker of the House Paul Ryan, R-Wis., said he didn't "see that as an appropriate comment."

In response, MSNBC said, "It's a sad day for America when the president spends his time bullying, lying and spewing petty personal attacks instead of doing his job."

Brzezinski offered her own retort, poking fun at the size of the president's hands.

The Morning Joe co-hosts have had an up-and-down relationship, to say the least, with the president since his campaign. The show averages about a million viewers a day and recently set a quarterly audience record for MSNBC for the 6-9 a.m. time slot.

As Trump's campaign was ramping up, he would call into the morning show and banter with the pair.

"You guys have been supporters," he said on the show in February 2016. "And I really appreciate it. And not necessarily supporters, but at least believers. You said there's some potential there."

But as Trump's presidency has worn on, Brzezinski and Scarborough have turned into fierce critics. Trump claims he no longer watches the show, but deputy White House press secretary Sarah Sanders implied the president was responding to something from the show, saying he was fighting "fire with fire."

"I think the president has been attacked mercilessly on personal accounts by members on that program, and I think he's been very clear that when he gets attacked, he's going to hit back," she said in a press briefing Thursday afternoon. "I don't think it's a surprise to anybody that he fights fire with fire."

That is similar to what first lady Melania Trump's spokeswoman, Stephanie Grisham, told CNN: "As the first lady has stated publicly in the past, when her husband gets attacked, he will punch back 10 times harder."

That was despite Melania Trump's focus on cyberbullying. The first lady's website says:

"Mrs. Trump cares deeply about issues impacting women and children, and she has focused her platform as First Lady on the problem of cyber bullying among our youth."

Thursday's tweets weren't the only time Trump has gotten pushback for offensive remarks he has made about women. His tweet referencing "bleeding" hearkens back to 2015, when he said Fox's Megyn Kelly had blood "coming out of her eyes, coming out of her wherever."

That came after tough questioning from Kelly during a GOP primary debate about Trump's past offensive comments about women.

It's also not the first time the president's unorthodox use of Twitter has been called into question.

In an NPR/PBS Newshour/Marist poll released this week, just 21 percent of American adults find the president's use of the social media platform "effective and informative," while 69 percent find it "reckless and distracting."

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

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