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

When talking about fertility in routine practice, we usually refer to the World Health Organization’s guideline of roughly 15 million sperm per millilitre (and around 39–40 million total per ejaculate) as the lower boundary of “normal.”

But the count alone doesn’t tell the full story. The quality of sperm, their motility, shape, and the couple’s overall reproductive health are equally important. We got in touch with Dr. Meenakshi Priya, Clinical Director & Fertility Specialist, Nova IVF Fertility, Coimbatore, who told us more about the same.

What Is The Normal Sperm Count To Get Pregnant?

Dr Meenakshi said, “Think of sperm count like lottery tickets. More tickets (higher count) give you better odds, fewer tickets lower your chances — but even one well-functioning ticket (a motile, properly shaped sperm) can win.”

That’s why fertility clinics look at several factors: concentration, total number, progressive motility (whether sperm swim forward), and morphology (shape). The WHO manual provides the standard method and cut-offs used worldwide in labs, serving as the referee for semen analysis.

However, numbers matter clinically. Research over decades shows fertility starts to drop gradually below about 40 million/ml (or in older studies, 40 million total per ejaculate was a useful marker). The WHO threshold of 15 million/ml marks the lower edge of normal — values between 15 and 40 are a “grey zone,” where conception is possible but may take longer. So a man with 12 million/ml isn’t infertile, but the couple might need help like IUI or IVF depending on other factors.

But don’t get fixated on one number. A “normal” semen report is a combination of factors:

• Concentration ≥15 million/ml

• Total sperm count ≥39–40 million per ejaculate

• Progressive motility roughly >30%

• Normal morphology about 4% (Kruger criteria)

What Changes A Sperm Count?

Lifestyle and health have a big impact on sperm. Smoking, heavy drinking, extra weight, prolonged heat exposure (saunas, hot tubs, tight underwear), certain medications, recent fevers, and conditions like varicocele or hormonal imbalances can all lower the numbers.

The good news? Most of these are reversible. Dr Meenakshi said, “Quitting smoking, reducing alcohol, losing a bit of weight, avoiding hot tubs for a few months, and treating infections can improve sperm.” Remember, sperm take time to renew but it usually takes 2–3 months of healthier habits for improvements to appear in a report. Be patient; your body is making changes even if you don’t see results immediately.

When To Be Concerned And Consult A Doctor?

If semen analysis repeatedly shows very low sperm (oligozoospermia), no sperm (azoospermia), poor motility, or if a couple has been trying for a year (or six months if the woman is over 35) without success, it’s time to consult a specialist. One abnormal test isn’t the final word — tests are usually repeated, and a more thorough assessment may include hormone checks, ultrasounds, or genetic tests if needed.

Dr Meenakshi said, “Sperm count gives a headline, not the full story. It’s a useful screening tool, but fertility decisions are personal. If you’re concerned, get a proper semen analysis and speak with a fertility specialist — many fertility issues are treatable, and acting early makes a real difference.”

Norovirus, often called the stomach bug, has returned. Between August 1 and December 11, health officials recorded 268 norovirus outbreaks, with numbers climbing steadily as winter travel increases and more people spend time indoors. The virus triggers stomach-related symptoms such as nausea, vomiting, diarrhea, and abdominal pain or cramping.

Some people also develop fever, headaches, and body aches. Although case numbers are not rising as sharply as flu, doctors remain concerned because norovirus spreads extremely easily. Making matters worse, norovirus is difficult to kill. Many of the common precautions used against flu and COVID offer little protection against this so-called winter vomiting bug.

How Contagious Is the Norovirus?

Norovirus is among the most infectious viruses doctors deal with. “It can tear through a household and then circle back, with people repeatedly passing it to each other,” says Amy Edwards, MD, associate professor of pediatrics at Case Western Reserve University School of Medicine in Cleveland, Ohio, who specializes in infectious diseases. “It also spreads very quickly in crowded, closed settings like cruise ships.”

While contaminated surfaces can transmit norovirus, doctors say person-to-person spread is most common. An infected person can pass on the virus even before symptoms appear, throughout the illness, and after they start to feel better, Jennings warns.

What to Do If You Get Norovirus?

For most people, norovirus symptoms ease within a few days, according to Jennings. However, the illness can be more serious for those with weaker immune systems, including young children, older adults, and people with certain health conditions.

If you think you have norovirus, focus on staying well hydrated. Ongoing vomiting can quickly lead to fluid loss and electrolyte imbalance. To prevent nausea from getting worse, Jennings recommends taking small sips of clear fluids like water, ginger ale, or coconut water.

Most importantly, seek medical care right away if you become dehydrated or if diarrhea lasts for weeks. Fischer explains that dehydration may cause sunken eyes, less frequent urination, dry skin and mouth, and extreme tiredness.

Common Norovirus Symptoms That You Should Be Aware Of

Norovirus symptoms often come on suddenly and may include:

• Nausea
• Vomiting
• Stomach pain or cramps
• Watery or loose diarrhea
• General feeling of illness
• Mild fever
• Muscle aches

Symptoms usually begin 12 to 48 hours after exposure and last for one to three days. Even after recovery, people can continue shedding the virus in their stool for weeks. In some cases, especially among those with other medical conditions, shedding can continue for months. Some people infected with norovirus never develop symptoms at all. Even so, they can still spread the virus to others.

Norovirus Causes

Norovirus spreads very easily from one person to another. Because it is highly contagious, an infection can pass quickly through homes, schools, or other shared spaces. The virus is released through stool and vomit, and a person can spread it from the moment symptoms begin until several days after they feel better. Norovirus can also survive on surfaces and objects for days or even weeks.

You can catch norovirus by:

1. Eating food that has been contaminated
2. Drinking unsafe or contaminated water
3. Touching your mouth after your hands have come into contact with a contaminated surface or object
4. Having close contact with someone who is infected with norovirus

Norovirus is especially hard to get rid of because it can survive extreme hot and cold temperatures and is resistant to many common disinfectants.

The NHS has issued fresh advice for people taking a widely prescribed medicine used to manage heart and circulation conditions. Across the UK, millions rely on beta-blockers to treat heart and blood vessel problems. Each year, more than 50 million prescriptions are written for these drugs, which help manage issues ranging from high blood pressure and abnormal heart rate to certain conditions affecting the brain and nervous system. Doctors most commonly prescribe bisoprolol, which NHS England lists as the seventh most prescribed medicine in the country.

What Is Bisoprolol Used For?

Bisoprolol, sold under brand names such as Zebeta, Bisotab, and Concor, belongs to a group of medicines called beta-blockers. It is mainly used to treat various heart-related conditions by slowing the heart rate and relaxing blood vessels. This reduces strain on the heart and helps it pump blood more efficiently, according to the CDC. The NHS also explains that bisoprolol is used to prevent chest pain caused by angina and to manage atrial fibrillation and other irregular heart rhythms. By slowing the heart, it allows the heart muscle to work more effectively.

Data from 2024–25 shows that bisoprolol was dispensed around 32 million times in England alone. The NHS notes that for people with high blood pressure, taking bisoprolol can help lower the risk of future heart disease, heart attacks, and strokes.

Bisoprolol Side Effects: Why Is NHS Warning Against Bisoprolol?

Like most medicines, bisoprolol can cause side effects, and patients are advised to stay alert to them. People starting the medication are often told to take their first dose at night, as it can make some feel dizzy. There are several common side effects that affect more than one in 100 people. According to the NHS, these are usually mild and tend to settle over time. They include:

• feeling dizzy or sick
• headaches
• cold hands or feet
• constipation
• diarrhoea

However, there are less common but more serious side effects that should not be ignored, as they may require urgent medical attention. The NHS advises contacting a doctor or calling 111 if:

• you experience shortness of breath with a cough that worsens during physical activity, swelling in the ankles or legs, or an irregular heartbeat, as these can point to heart problems
• the whites of your eyes or your skin turn yellow, which may be harder to notice on darker skin tones, as this can signal liver issues

Bisoprolol Warning: When Should You See Medical Emergency

The NHS also urges people to seek immediate help if certain symptoms appear. These include:

• chest pain, which could indicate heart trouble
• shortness of breath, wheezing, or tightness in the chest, which may suggest lung-related problems

Emergency services should be contacted straight away if there are signs of a severe allergic reaction, known as anaphylaxis. The NHS says to call 999 immediately if:

• your lips, mouth, throat, or tongue suddenly swell
• you are breathing very fast or struggling to breathe, with wheezing or a choking sensation
• your throat feels tight or you have difficulty swallowing
• your skin, lips, or tongue turn blue, grey, or pale, which may be more visible on the palms or soles in people with darker skin
• you suddenly feel very confused, extremely drowsy, or dizzy
• someone collapses and cannot be woken
• a child becomes limp, floppy, or unusually unresponsive, with difficulty holding their head up or focusing

The NHS stresses that while bisoprolol is effective and widely used, knowing when side effects are harmless and when they signal an emergency is key to staying safe.