It was a typical morning. My mother was getting ready; this was her usual routine: bustling around the house. When she suddenly stopped and shouted, blood was oozing from her nose. As kids, my siblings and I were terrified. We scrambled to help, but it wasn't until later that we learned the cause of that alarming moment: high blood pressure. That day was our first lesson in the silent yet powerful effects of hypertension. Nosebleeds, or epistaxis, are common, and nearly everyone experiences at least one in their lifetime.

While most are minor and often caused by dry air or irritation, some can signal underlying health concerns. One recurring question is whether high blood pressure causes nosebleeds or is merely coincidental.

Where Exactly Does a Nosebleed Occur?

The nose is covered by a rich plexus of small blood vessels, making it prone to bleeding. Most nosebleeds are anterior in origin, occurring at the front of the nose, and are relatively benign. They often occur because of irritants such as dry air, frequent nose-blowing, or trauma.

On the other hand, posterior nosebleeds are caused by a source that is located deeper within the nasal cavity. They are less common but more severe, as the blood tends to flow backward into the throat, making them more difficult to control. Common causes of posterior nosebleeds include trauma, medical conditions, or high blood pressure.

Connection Between Nosebleeds and High Blood Pressure

Hypertension is the condition whereby the pressure of blood against the arterial walls is consistently too high. Over time, this may damage the fine blood vessels in the nose, causing them to rupture more easily.

Significant studies have shown a strong relationship between hypertension and severe cases of nosebleeds necessitating urgent care. A certain study showed that patients diagnosed with high blood pressure had 2.7-fold increased chances of having nosebleeds that were not slight.

However, it should be noted that mild hypertension by itself does not cause nosebleeds. Nosebleeds are more likely to happen during a hypertensive crisis when the blood pressure suddenly rises to above 180/120. A hypertensive crisis can also have other symptoms such as a severe headache, shortness of breath, and anxiety. Therefore, it is considered a medical emergency.

Why Does Hypertension Increase the Risk?

Chronic hypertension makes the walls of blood vessels weaker and less elastic, which easily causes them to tear. In the nose, this is especially vulnerable because the blood vessels are close to the surface. Sudden surges in blood pressure, such as in a hypertensive crisis, can cause tears in these weakened vessels, resulting in nosebleeds.

While hypertension is a contributing cause, nosebleeds occur infrequently as the only manifestation of high blood pressure. This makes regular monitoring for blood pressure all the more crucial, as hypertension has the reputation of being the "silent killer" since people often do not present symptoms until the disease has run its course.

Other Causes of Nosebleeds

• Dry Air: Cold weather or house heating dries out membranes that line the nose, hence susceptible to cracking.
• Trauma: Blows in the nose, nose picking or excessive nose blowing can traumatize blood vessels.
• Intrinsic Disease: Liver disease and kidney disease and drug therapy that affect clotting such as blood thinners enhance the risk of nose bleeding.
• Foreign Bodies: Children especially tend to insert objects up their noses, which can be irritating and bleed.
• Allergies or Infections: Chronic nasal inflammation resulting from allergies or colds causes irritation to the nasal mucosa.

Managing Nosebleeds at Home

For most nosebleeds, you can manage them yourself at home:

1. Sit up and lean slightly forward to prevent swallowing blood.

2. Press your nostrils together for at least 10 minutes.

3. Use a cold compress on the bridge of your nose to constrict blood vessels.

4. If the bleeding continues, use a nasal decongestant spray.

Consult a doctor if the bleeding persists beyond 20 minutes, is heavy, or follows a head injury.

Preventing Nosebleeds

Preventive measures can decrease the incidence of nosebleeds:

• Use a humidifier to maintain moisture in the air.
• Apply saline sprays or gels to keep nasal passages hydrated.
• Avoid nasal trauma by being gentle when blowing your nose.

For patients with hypertension, managing blood pressure is the best way to minimize the risk of complications. A combination of lifestyle changes, such as maintaining a healthy diet, regular exercise, and prescribed medications, can help keep blood pressure in check.

When to Worry About Nosebleeds

Most nosebleeds are harmless, but they can sometimes be signs of an underlying health condition. In adults with high blood pressure, frequent or severe nosebleeds should never be ignored. A health provider should be consulted in order to rule out any serious conditions and ensure appropriate treatment.

Regular check-ups, a healthy lifestyle, and awareness about the relationship between nosebleeds and high blood pressure would go a long way to protect your health. Indeed, prevention is always better than cure.

Epistaxis and hypertension. Post Graduate Medical Journal. 1977

As wildfire smoke continues to affect communities across North America and Europe, fertility experts are recommending people undergoing vitro fertilization (IVF) to pay attention to an overlooked factor before embryo implant: air quality.

A new study suggests that exposure to unhealthy levels of air pollution, particularly from wildfire smoke, could significantly reduce the chances of a successful pregnancy after IVF.

Researchers, therefore, recommend discussing the timing of embryo transfer with a fertility specialist when air quality deteriorates.

Wildfire Smoke May Interfere With Embryo Implantation

The study, published in the journal Human Fertility, indicates that air pollution may affect reproductive health.

Between June and July 2023, researchers from Northwell Fertility in New York examined 190 fresh and frozen embryo transfers, when smoke from massive Canadian wildfires caused hazardous air quality across the northeastern United States.

They then compared the rate of successful pregnancies based on the Air Quality Index (AQI) on the day of embryo transfer.

Clinical pregnancy rates were approximately 62% on days with good air quality and 65% on days with moderate air quality.

But when the AQI rose above 100, a level considered unhealthy for sensitive groups; the pregnancy rate dropped to just 27%.

Although only 11 embryo transfers took place on days with unhealthy air quality, the researchers say the findings raise concerns about whether temporary exposure to wildfire smoke could affect one of the most critical stages of IVF.

Also read: Miles Apart, But Planning A Family Together: The Fertility Reality Of Long-Distance Marriages In India

How Can Air Pollution Affect Fertility And IVF Success Chances?

IVF embryos are created and stored in strictly controlled laboratories, meaning they are protected from polluted air and other contaminants in the environment.

Instead of damaging the embryo, researchers believe that wildfire smoke can affect the woman's body by increasing inflammation and oxidative stress. This could create a less favourable environment for the embryo to implant in the uterus.

Air pollution contaminant, PM2.5, a fine particulate matter, is one of the main pollutants in wildfire smoke. It is minute enough to enter the lungs, bloodstream, and trigger inflammatory responses throughout the body.

Previous studies have already indicated that PM2.5 exposure could cause pregnancy complications and harm fertility.

Dr. Randi Goldman, Program Director at Northwell Fertility and co-author of the study, said the research suggests patients and physicians should consider environmental conditions when planning embryo transfer.

Also read: Global Female Infertility Could Affect 80 Million Women Aged 35+ by 2036: Lancet Study

"The embryo is safely protected inside the laboratory. The effect we're seeing is more likely related to how air pollution influences the body before and after embryo transfer rather than the embryo itself," Goldman said.

She opines that patients experiencing severe wildfire smoke or hazardous air quality should discuss whether delaying embryo transfer by a few days could improve the chances of success.

"Patients invest enormous emotional, physical and financial resources into IVF. Delaying treatment is difficult, but when air quality reaches unhealthy levels, it may be worth discussing timing with your fertility specialist," Goldman said.

Expert-Recommended Tips To Improve IVF Success

Adopt a Fertility-Boosting Lifestyle: Eat a balanced diet, exercise daily, and enjoy a healthy BMI. Reduce alcohol intake, do not smoke, and avoid recreational drugs.

Take Key Supplements: Folic acid, CoQ10, and vitamin D can improve egg quality and overall fertility.

Stress Management Is Key: Elevated cortisol levels can affect reproductive hormones. Practice mindfulness, yoga, or acupuncture.

Sleep Well: Aim for at least 7–8 hours of restful sleep to support hormonal balance.

Address Underlying Health Conditions: Conditions such as PCOS, thyroid issues, and endometriosis can interfere with fertility outcomes if left unmanaged.

Start Early, If Possible: The earlier IVF is initiated—especially for women over 35—the better the chances.

Skin breakouts are often common occurrences during the monsoon season, but not all outbreaks of bumps that occur during this period are traditional cases of acne.

The combination of humidity along with sweat and sebum production makes the skin susceptible to different skin conditions, making it easy to mistake fungal acne for a regular one.

While acne and fungal acne may appear almost identical, the factors that trigger them are not the same. Identifying the right condition early makes it easier to choose the most appropriate treatment and maintain healthier skin in the long run.

How Monsoon Weather Triggers Different Breakouts?

It is quite common to experience frequent breakouts during monsoon season. This usually happens due to the accumulation of humid conditions, sweat, and increased oil production.

When sweat mixes with sebum, dead skin cells and skincare products, pores may become clogged, which eventually results in acne. At the same time, the environment also supports the growth of Malassezia, a yeast that naturally lives on the skin.

When it grows excessively, it can trigger fungal acne, medically known as Malassezia folliculitis. Since both conditions tend to flare up during the rainy season, they are frequently confused with one another.

Also read: Besides Sunscreen, What Everyday Habits Can Help Reduce Sun Exposure And Skin Damage?

Acne vs. Fungal Acne: A Closer Look at the Differences

There are several indications which one may use to differentiate between normal acne and fungal acne. Regular acne mostly develops as a combination of blackheads, whiteheads, inflamed pimples, and sometimes painful cysts.

On the other hand, fungal acne presents itself in the form of tiny bumps that usually appear itchy and develop in clusters. These bumps commonly occur on the forehead, chest, shoulders and upper back, especially in areas where sweat tends to collect.

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Choosing the Right Treatment Path

Since regular acne and fungal acne occur due to different reasons, they also require different treatment approaches. Although proper skin care can help in reducing the possibilities of outbreaks, it does not entirely prevent breakouts.

Over-the-counter acne products are usually intended to unclog the pores and control the growth of bacteria causing acne; however, they do not work on fungal infections. In fact, in some cases, using the wrong products can even worsen irritation or allow the breakouts to persist.

Therefore, always consult a dermatologist for targeted skin issues, particularly when acne scars are also a concern. In such situations, many experts may suggest modern treatments such as Harmony XL Pro for personalised results.

This multi-application platform combines numerous energy-based technologies to address specific acne-related concerns and is also used in a variety of aesthetic procedures such as acne-scar removal and overall skin rejuvenation.

Small Changes That Support Healthier Skin

A minimal skincare routine can go a long way during the monsoon. Always start with a gentle cleansing after excessive sweating. Choose non-comedogenic moisturisers and make sure not to apply multiple oily or occlusive products that could result in clogged pores.

If you develop a breakout, do not pick or squeeze the acne, as doing so can increase inflammation and the risk of scarring.

In the end, recognising whether a breakout is regular acne or a fungal one is the first step towards appropriate treatment. Although both conditions become more common during humid weather, they are not managed in the same way.

Paying attention to symptoms such as itching, the pattern of the bumps and how the skin responds to treatment can make a meaningful difference.

By Dr. Anwesha Poddar, Dermatologist, Dr. Anwesha Poddar Skin, Laser & Hair Clinic

People think of menopause as just hot flashes and irregular periods, but menopause is more than that.

Perimenopause and menopause can bring a host of emotional and cognitive shifts for many women, including mood swings, anxiety, easily irritated, trouble sleeping, or having what some refer to as “brain fog.”

What Is Perimenopause?

Perimenopause is the period leading up to menopause that can last anywhere from two to eight years. This is when hormonal changes take place, especially a drop in estrogen.

These hormonal changes also impact neurotransmitters like serotonin and dopamine that are essential for mood, memory, sleep and emotional wellness.

Consequently, a woman can suffer from forgetfulness, lack of concentration, mental tiredness, low energy levels, dry skin, loss of libido and less productivity.

Brain Fog During Menopause

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Brain fog can be a frustrating and overwhelming experience during menopause, particularly if a woman is juggling her career, family, ageing parents and personal obligations.

Many women suffer from anxiety symptoms, even if they have no mental health background. Hormonal changes, poor sleep and stress can exacerbate these symptoms.

But not all symptoms are due to the menopause or "normal ageing". Thyroid disorders, vitamin deficiencies, depression and other medical problems can have similar symptoms.

Therefore, if symptoms start to impact life, work, relationships or emotional wellbeing, it is important to seek medical advice and have a proper health check-up.

How To Manage It?

Management is often comprehensive, and may involve lifestyle modifications. Regular exercise, balanced nutrition, stress management and healthy sleep patterns.

In a few instances, you may additionally be suggested to take Menopausal Hormone Therapy (MHT). As more research is done and preparations of lower doses and greater safety, earlier misconceptions about hormone therapy are gradually decreasing.

Medically, women can make a difference in their quality of lives and manage menopause with greater physical, mental and emotional wellness with early recognition and timely intervention.

By Dr. Nidhi Sharma Chauhan, Gynaecologist, Saifee Hospital