Cold sores are a common and often frustrating skin issue. While they may look like harmless blisters, cold sores are actually caused by the herpes simplex virus (HSV).

What Causes Cold Sores?

Cold sores are caused by the herpes simplex virus (HSV), which comes in two types: HSV-1 and HSV-2.

HSV-1 is the primary cause of cold sores, usually appearing around the mouth.

HSV-2 generally causes genital herpes but can also lead to cold sores.

While the appearance of cold sores caused by both HSV-1 and HSV-2 can look similar, their locations tend to differ. However, it is possible for HSV-1 to cause sores on the genitals and for HSV-2 to appear on the mouth.

How Do Cold Sores Spread?

Cold sores are highly contagious and can spread easily. The virus can be passed on through:

• Kissing or skin contact
• Sharing food, drinks, or cosmetics (such as lip balm)
• Oral sex, which can spread both cold sores and genital herpes

Even when a cold sore isn’t visible, the virus can still be spread through close contact. This makes prevention and management key to reducing outbreaks and the risk of infecting others.

Once someone contracts HSV, it stays in the body for life. While the virus remains dormant most of the time, it can reactivate and cause new sores, especially during periods of:

• Stress
• Illness
• A weakened immune system

Unfortunately, there’s no cure for the herpes virus, but the symptoms can be managed.

Symptoms of Cold Sores

Cold sores don’t just appear out of nowhere. Before the sore is visible, you may notice a tingling or burning sensation around the lips or face, which can occur several days before the sore forms. This is the best time to begin treatment to shorten the outbreak.

When a cold sore does appear, it often looks like a red, raised blister filled with fluid. The blister can be painful to touch, and there may be more than one. Cold sores usually last around two weeks and are contagious until they crust over and heal.

The Five Stages of a Cold Sore

Cold sores go through distinct stages as they develop and heal:

• Tingling and itching: You may feel these symptoms about 24 hours before the blister appears.
• Blisters: Small, fluid-filled blisters form, typically around the mouth.
• Bursting: The blisters burst and form painful sores.
• Scabbing: The sores dry out, scab over, and may itch or crack.
• Healing: The scab falls off, and the cold sore heals.

Risk Factors for Cold Sores

Certain factors can trigger the reactivation of HSV, leading to cold sores. These include:

• Infection, fever, or cold
• Sun exposure
• Stress
• Menstruation
• Dental work or injury
• Weakened immune system due to conditions like HIV/AIDS, eczema, or chemotherapy

Managing and Treating Cold Sores

There’s no cure for cold sores, but several treatments can ease the symptoms and help manage outbreaks.

Topical Ointments and Creams

Over-the-counter antiviral creams like docosanol (Abreva) or prescription ointments like penciclovir (Denavir) can help reduce the duration of an outbreak, especially if applied at the first sign of a cold sore.

Oral Medications

Prescription antiviral medications like acyclovir, valacyclovir, and famciclovir can also help, particularly for people who have frequent or severe outbreaks. Your doctor may recommend taking these medications regularly to prevent future outbreaks.

Home Remedies

There are also some home remedies that may provide relief, such as:

• Applying ice or a cold washcloth to the sore
• Using aloe vera gel or lemon balm lip balms
• Applying petroleum jelly to ease discomfort

Canker Sores vs. Cold Sores: What's the Difference?

While cold sores and canker sores may seem similar, they are quite different:

Cold sores are caused by the herpes virus, appear around the mouth, and are contagious.

Canker sores are not contagious and appear as ulcers inside the mouth or throat.

Preventing the Spread of Cold Sores

To avoid spreading cold sores:

• Wash your hands frequently
• Avoid close contact with others during an outbreak
• Don’t share food, drinks, or personal items like lip balm

Cold sores can be a persistent issue, but with proper care and management, you can reduce the frequency of outbreaks and prevent spreading the virus to others.

The manosphere is a network of male-centric online groups, forums and communities that focus on men’s issues, masculinity definition and the changing roles and treatment of men in today’s world. Oftentimes, the content produced in the manosphere leans heavily towards promoting misogyny online, distorting the definitions of feminism and masculinity.

A recent Lancet report highlights this issue, stating that these online communities that promote misogyny, male victimisation and hostility towards feminism are actually a growing public health problem. The report also suggests that this public health concern should be addressed in the same way as obesity or smoking.

The researchers say that the so-called manosphere not only normalises violence and misogyny towards women but also affects men’s mental health, fueling issues like social isolation and discouraging them from seeking help.

In the paper, titled Reframing the manosphere: a public health response to a commercial ecosystem, authors Sarah J Hawkes and Kent Buse describe the manosphere as a “diffuse commercial ecosystem and loose collection of online communities united by shared beliefs about masculinity, misogyny, and male victimisation”.

These communities often promote the idea that men are facing masculinity crisis and social isolation and that feminism has systematically disadvantaged and exploited them. The authors argue that these narratives can wrongfully make young men believe that their personal difficulties are due to women, which could direct their frustration towards the opposite gender.

The authors wrote, “Men’s problems are framed [in the manosphere] as the result of feminism rather than structural conditions, and masculine identity is commodified through products and paid content that normalise and reinforce health-harming and performance-oriented masculinities.”

Manosphere And Men's Mental Health

Also read: Gender-based Violence Surging Global Antimicrobial Resistance, Say Experts

The authors identify several conditions that can make boys and young men vulnerable to manosphere content, including loneliness, educational disengagement, social exclusion, financial insecurity and uncertainty about their future.

Prof Sarah Hawkes, the report’s other author, said, “The manosphere offers boys and young men belonging, identity and an explanation for why life feels hard."

She added, “Those needs are real. A response that only removes the manosphere, without offering something credible in its place, will fail. We need to offer boys something better, not just tell them what to avoid.”

The authors also say that they may also reinforce resentment towards women and promote toxic ideas about masculinity, gender, relationships and success. They also say that these communities can harm men's mental health, contribute to body image concerns and discourage them from seeking professional support.

The authors argue that this business model can exploit insecurity while presenting structural problems as individual failures or the result of feminism. Some influencers promote twisted ideas of masculinity and encourage followers to purchase supplements, hormones and financial products.

Prof Kent Buse, a co-author of the paper and co-founder of the social justice thinktank Global 50/50, explained, “This is a business model, not a fringe. Outrage and grievance are good for business, so the system rewards the most extreme content. Expect the playbook that served tobacco so well: blame the individual, and call regulation an attack on freedom. Public health has a tested toolkit for commercial harms and we should use it.”

Online Misogyny Contributes To Violence Against Women

Also read: 'Put Up with the Pain': UK Report Exposes Gaps in Women's Reproductive Healthcare

The report also examines the consequences of following manosphere for women and girls. The authors warn that the manosphere can normalise misogynistic outlooks, reinforce gender inequality and create an environment in which violence against women and girls is more readily accepted.

The concern is not limited to individual posts or influencers. The researchers describe a commercial network in which content creators can benefit from extreme expressions of gender and hostility.

They compare the strategies used by this online ecosystem with those of industries such as tobacco and ultra-processed food, arguing that both can shift responsibility towards individuals while resisting regulation.

“Outrage and grievance are good for business, so the system rewards the most extreme content,” said co-author Kent Buse.

He added, “Boys and men are not the problem. The problem is the conditions that leave them isolated and without a secure future, and the companies that profit from their anger and insecurity.”

Just Censoring Harmful Content May Not Be Enough

Also read: Amid Changing Health Laws In The US, Would Abortion Become Illegal?

The authors argue that simply removing misogynistic content or restricting access to certain communities will not address the reasons why young men are drawn to them.

Co-author Sarah Hawkes said, “The manosphere offers boys and young men belonging, identity and an explanation for why life feels hard. Those needs are real. A response that only removes the manosphere, without offering something credible in its place, will fail. We need to offer boys something better, not just tell them what to avoid.”

The report also calls for a coordinated response involving governments, schools, healthcare services and community organisations. This includes improving access to education, skills training and employment opportunities, addressing social isolation and ensuring that boys and young men can access mental health services.

Manosphere Is A Public Health Issue

The researchers identify six priorities for action: addressing the social and economic conditions that make young men vulnerable, improving collaboration between health and education services, developing effective communication strategies, regulating harmful platforms, investing in research and monitoring, and confronting the bigger misogyny and anti-gender equality attitudes that keeps these communities running.

They argue that regulation should focus on the commercial incentives that amplify harmful content, rather than placing the entire responsibility on individuals who consume it.

Menopause is gradually finding its well-deserved place in mainstream media. For the first time in a dozen years, the American College of Obstetricians and Gynecologists (ACOG) has revised its clinical guidance on treating key menopause symptoms like including hot flashes, night sweats, sleep disturbances and mood swings.

The new guidance, released in October 2026, talks about hormone therapy as the most effective treatment for moderate to severe hot flashes.

It also highlights non-hormonal options like cognitive behavioural therapy, mindfulness and clinical hypnosis for women who do not want to opt for hormone therapy.

The update comes after certain boxed safety warnings on hormone-based products were removed by the US Food and Drug Administration (FDA).

Hormone Therapy Recommended For Women With Menopause

Also read: Beyond “Just Ageing”: Why Menopause Deserves a Place in India’s Mainstream Healthcare Conversation

Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms, which include hot flashes and night sweats. These symptoms occur as changing hormone levels affect the body's temperature.

ACOG recommends systemic hormone therapy containing oestrogen and a progestogen for women with a uterus. Women who do not need endometrial protection may receive oestrogen alone.

The guidance also suggests considering hormone therapy for sleep disturbances, which is also one of the vasomotor symptoms.

However, hormone therapy may not be a viable option for everyone. Decisions should be made jointly by patients and their doctors, which may be taken after taking into account age, medical history, cardiovascular disease risk, breast cancer risk and the risk of venous thromboembolism, or blood clots.

ACOG also recommends starting treatment before the age of 60 or within 10 years of the onset of natural menopause for.

Women Who Cannot Take Hormone Therapy

Also read: Perimenopause & Cardiovascular Health: Why Neglecting Heart Warning Signs During Perimenopause Can Lead to Heart Issues

Women who cannot take hormone therapy have several other non-hormonal options. ACOG recommends selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), which are antidepressant medicines that can also help manage hot flashes.

Another option is neurokinin receptor antagonists. These medicines act on pathways involved in regulating body temperature and can reduce hot flashes and night sweats. Fezolinetant and elinzanetant are examples of medicines in this category.

Gabapentin may also be considered when other non-hormonal medicines are ineffective .

Lifestyle And Behavioural Changes

The updated guidance also recognises lifestyle and behavioural changes for managing menopause symptoms. ACOG suggests cognitive behavioural therapy (CBT) to help with hot flashes, sleep disturbances and mood symptoms.

Mindfulness-based interventions and physical exercise may help improve sleep and mood, while clinical hypnosis may reduce hot flashes and improve sleep and anxiety symptoms.

Acupuncture is also an option that may help tackle vasomotor symptoms and improve sleep and mood.

These alternative options can be used alone or alongside medication, depending on a woman's symptoms and treatment preferences.

Menopause can affect several aspects of health and daily life. Hot flashes and night sweats can disrupt sleep, while mood changes and other symptoms may affect work, relationships and overall quality of life.

For a long time, concerns about the risks of hormone therapy have influenced how patients and doctors approach treatment.

The new guidance reinforces that hormone therapy remains an effective option for many women, while stressing the importance of individual risk assessment and preference.

When we think of perimenopause, irregular periods, hot flashes and mood changes usually come to mind. But the transition to menopause is not limited to the menstrual cycle. Behind the scenes, changing ovarian hormones—particularly fluctuating and eventually declining estrogen—can influence body composition, insulin sensitivity, cholesterol levels, bone health and cardiovascular risk.

For many women, these metabolic changes begin years before their final menstrual period.

Why does weight suddenly behave differently?

A common concern during perimenopause is: “I haven’t changed my diet, so why am I gaining weight around my abdomen?”

Ageing itself contributes to gradual loss of muscle mass and changes in energy expenditure. At the same time, the menopausal transition is associated with a shift in fat distribution, with a greater tendency to accumulate visceral or abdominal fat.

This matters because visceral fat is metabolically active. An increase in abdominal fat can be associated with insulin resistance, abnormal cholesterol levels and a higher risk of metabolic disease. So, the change in waist circumference may sometimes tell us more about metabolic health than the number on the weighing scale alone.

Also read: After Menopause, These Breast Changes Shouldn’t Be Ignored

Blood sugars may raise up too

Estrogen interacts with several pathways involved in glucose and fat metabolism. During midlife, changes in body composition, reduced physical activity, sleep disturbance and hormonal changes can collectively make insulin sensitivity less favourable.

This does not mean every woman going through perimenopause will develop diabetes. However, women who already have risk factors—such as overweight or obesity, prediabetes, a history of gestational diabetes or a strong family history of type 2 diabetes—should be particularly mindful.

Cholesterol and heart health deserve attention

The menopausal transition can also be accompanied by unfavourable changes in the lipid profile, including changes in LDL cholesterol. Cardiovascular risk increases with age, and menopause is an important time to reassess risk factors such as blood pressure, glucose, cholesterol, smoking, physical activity and body composition.

Women often spend years focusing on reproductive health while overlooking these equally important metabolic markers.

Also read: World Menopause Day: Is It Empty Nest Syndrome Or Menopause Symptoms? Expert Explains

Muscles and bones need attention as well

Midlife is also an important period for protecting muscle and bone. Declining estrogen after menopause accelerates bone loss, while ageing contributes to loss of muscle mass.

Resistance training therefore becomes especially valuable. Adequate protein intake, regular weight-bearing exercise, sufficient calcium and vitamin D, good sleep and avoiding smoking can support healthier ageing.

What should women do?

Perimenopause should not be viewed as a disease, nor should every symptom or kilogram gained in midlife automatically be blamed on hormones. Instead, it is an opportunity for a metabolic health check.

Women should discuss appropriate screening for blood pressure, blood glucose or HbA1c, lipid profile, weight and waist circumference monitoring , DEXA scan for bone health, depending on their individual risk factors.

Most importantly, don’t wait for menopause to start thinking about metabolic health. The perimenopausal years can be an important window to build muscle, improve fitness, optimise nutrition and identify metabolic risk early.

Perimenopause is more than a change in periods—it is a transition in whole-body health. Understanding these changes early can help women enter the next phase of life stronger, healthier and better prepared.

(By Dr. Seema Daksh, MBBS, MD (Internal Medicine), DM (Endocrinology), Consultant Endocrinologist,Kailash Hospital, Greater Noida)