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

More women in the US and UK are seeking testosterone to manage menopause symptoms, with some turning to online pharmacies without a prescription, according to media reports.

There are no US Food and Drug Administration (FDA)-approved testosterone products specifically indicated for women. Australia has approved a low-dose testosterone product for postmenopausal women, while the UK and New Zealand permit some female-dosed formulations, although availability varies.

What’s Happening In The US?

Reuters reported that off-label testosterone use is rising in the US, mainly to treat persistently low sexual desire associated with menopause. Some clinicians are also prescribing testosterone for symptoms such as fatigue and loss of muscle strength, despite a lack of medical guidance supporting these uses.

Prescriptions for low sexual desire reportedly rose 146% between January 2023 and July 2026. However, many pharmacies and health insurers continue to deny these prescriptions.

Also read: US Congress To Hold First-ever Menopause Hearing: Why It Matters For Women

Why Are UK Women Turning To Testosterone?

The BBC reported that some women in Wales are posing as men to buy testosterone from online pharmacies because of difficulties accessing NHS prescriptions.

There has also been a “very sharp increase” in testosterone referrals to the NHS for postmenopausal women.

Menopause specialist Dr Michelle Olver said she had seen women with testosterone levels up to 12 times the safe level after buying the hormone online, putting them at risk of permanent side effects.

Why Is Testosterone Gaining Attention?

Also read: ‘I Was Vocal About Cancer But Silent About Menopause Out Of Shame’, Says Actress Lisa Ray

Although testosterone is often called a male hormone, women also produce it, primarily through the ovaries and adrenal glands. Levels generally decline with age.

Some women are prescribed testosterone for distressing loss of sexual desire. Others are seeking it for fatigue, impaired thinking, low mood and loss of muscle strength.

The FDA is set to hold a public workshop on September 17 to examine testosterone use in menopausal women. The agency says off-label use is growing, while questions remain about its effects on sexual function, mood, cognition, muscle and bone health, as well as long-term cardiovascular and breast cancer safety.

What Does The Evidence Say?

Menopause does not automatically mean a woman has a “testosterone deficiency.”

Notably, there is no established testosterone level below which an otherwise healthy woman is diagnosed as testosterone deficient. A blood test alone also cannot determine whether low testosterone is responsible for symptoms such as fatigue, low mood or loss of sexual desire.

However, the Menopause Society and other medical organizations support testosterone use in menopausal women with hypoactive sexual desire disorder.

“We do not have any evidence in women that it will improve muscle mass or bone density or mood or well-being or really any other metric,” said Dr Stephanie Faubion, director of Mayo Clinic's Center for Women's Health and medical director of The Menopause Society.

“What testosterone is being touted for in the lay public and on social media is not really what we have data for,” she said.

Are There Any Side Effects?

According to Cleveland Clinic, testosterone treatment generally isn’t recommended for women with cardiovascular disease, liver disease or hormone-sensitive cancers such as breast or uterine cancer.

Excess testosterone can cause acne, increased facial or body hair and scalp hair loss. Higher doses may also lead to voice deepening and clitoral enlargement, some of which can be irreversible.

Testosterone should therefore not be used in higher doses as a way to boost energy, muscle strength or libido.

You've probably seen gallon jugs with stuff like "BORG o'clock somewhere" scrawled on them in Sharpies, often showing up at parties. Well, there's actual research on them now, and it's not great.

The study by Rutgers University, published in the Journal of Studies on Alcohol and Drugs, surveyed over 100 college students about their BORG habits. The study finds significant health risks.

What Is BORG?

BORG stands for "Blackout Rage Gallon," and it's basically a personal-sized jug loaded with liquor, water, and whatever flavoring you're into. It started gaining traction around 2020 and hasn't slowed down since the hashtag #borg has racked up millions in views on TikTok alone.

Here's the number that stands out, though. A full BORG can pack up to a fifth of liquor. That's about 17 standard drinks. In one jug. And it is meant for one person.

ALSO READ: Alcohol-Linked Cancer Deaths Doubled In US: Colorectal Leads In Men, Breast Leads In Women

The study pointed out that drinking games have always been part of college culture. But BORG drinks might be worse than most, mainly because of how they're made. Mixing hard liquor with sweet flavors can make people drink more without realizing how much alcohol they're actually consuming, and the fact that people often share sips of each other's jugs only adds to the risk.

"Excessive drinking in young adults has been fueled by drinking games for many decades. But the mixing of hard liquor and additive flavorings in BORGs may be particularly harmful given the sweetness of the beverage and the lure of sharing one's BORG and tasting others' concoctions," said lead researcher Andrea King, a professor of psychiatry and behavioral neuroscience at the University of Chicago, US.

When Can BORG Drinks Go Wrong?

The actual numbers from the study are rough. Almost a third of students said they'd blacked out from a BORG at some point, not just "drunk," actually blacked out, meaning their brain stopped saving memories from that stretch of time.

Nearly 20 percent of students said they threw up, and nearly 6 in 10 admitted to saying or doing something embarrassing. And this is just the students who actually admitted to having done this. The actual count could be much higher. Some cases were serious enough to end in injuries or trips to the emergency room.

According to the World Health Organization, there is no safe level or risk-free amount of alcohol consumption that does not affect health.

READ MORE: Exclusive: From IPL To Olympics — How Sport Became A Marketing Tool For Junk Food And Sugary Drinks

BORGs: The ‘Safe Drinking’ Myth

What's even more interesting, however, is how this trend began in the first place. BORGs were initially promoted on social media as the more responsible choice when it came to drinking. The idea was for everyone to bring their own jug instead of sharing cups, so as to avoid the spread of germs during the pandemic.

Some recipes online even threw in electrolytes or caffeine, supposedly to dodge hangovers or keep people from getting too drunk. Students still shared their BORGs constantly, and the added ingredients did nothing to stop the harmful effects of drinking so much alcohol at once.

Even knowing all this, however, a lot of students said they're not planning to stop. That's part of why this study seems to emphasize the fact that awareness matters so much, both for students and for their parents.

As King put it, "There are choice points along the way, ranging from whether to attend a BORG event, and if one does attend, whether to bring a BORG beverage and how much (if any) alcohol to put in the beverage. It doesn't have to be all-or-none, as being aware and mindful to minimize risks can be key."

Alzheimer’s disease is normally seen as a disease of old age, something that starts when memory starts to fail in the 70s or 80s. But science has a totally different narrative. Alzheimer’s is not something you ‘catch’ suddenly in old age. It’s a sluggish, degenerative disorder that develops slowly over decades. When a person begins to forget names, ask the same questions, or have trouble with everyday chores, there may have been damage to the brain for years.

This is why neuroprotection should start much earlier, ideally in our 30s and 40s.

Today, most patients only see the neurologist when the symptoms are obvious. Unfortunately, at this stage the disease process has already progressed and therapy options are limited. Doctors and health professionals need to be more open about prevention, to teach younger folks that brain health is established well before retirement age.

Our modern lifestyle is a silent neurological risk. A busy life is making chronic stress, poor sleep, physical inactivity, bad diets and extended hours of sitting normal. But these common activities may be quietly contributing to inflammation that’s damaging blood arteries and brain cells over time. Studies increasingly connect mid-life problems like obesity, diabetes, hypertension and sleep difficulties to a greater risk of dementia in later life.

Sleep is particularly important for removing such toxic substances from the brain. Constant stress boosts cortisol levels, which may interfere with memory areas. A sedentary lifestyle lowers the blood supply to the brain and undermines cognitive resiliency. Something that seems inconsequential today may be important decades from now.

The good news is that prevention is effective. Regular exercise, good sleep, management of stress, social activity, mental stimulation and regular health checks can all help protect the brain. Neuroprotection is not about fear; it’s about awareness and action.

What we decide to do in our 30s and 40s is not just about our careers or lifestyles; it’s about the health of our brains in our 70s and 80s. We need to change the conversation around Alzheimer’s from late-stage therapy to early-life prevention.

By Dr. Neha Pandita, Senior Consultant Neurology, Fortis Noida