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

The life of a woman can be called a cycle of various physical and hormonal changes occurring at particular points throughout life. From menstruation at puberty up to menopause, there will be numerous changes experienced by the female body, which can bring about consequences for her physical and psychological well-being.

Being a healthcare professional, I should mention that although medication is sometimes unavoidable, there is no point in neglecting alternative ways, including yoga.

Yoga Can Help Women

Yoga is an exercise that involves asanas, pranayamas, and meditation. There is now scientific evidence indicating that yoga aids in coping with certain conditions in women. It achieves this by positively influencing the neuroendocrine, autonomic nervous system, and stress responses.

A significant number of women are victims of menstrual conditions such as dysmenorrhea, PMS, abnormal menstrual cycle, and heavy menses during their reproductive age. The conditions may become worse due to stress, since it affects hormone levels.

Yoga reduces the amount of congestion in the pelvic area, increases blood flow, increases body flexibility, and reduces stress hormones such as cortisol. Consequently, most women have painless and psychologically stable menstruation.

Yoga Can Improve PCOS Symptoms

Moreover, yoga can prove highly helpful in the case of women who are suffering from Polycystic Ovary Syndrome (PCOS). It is the most prevalent endocrine disorder that affects women of childbearing age.

The condition has insulin resistance, obesity, irregular menstruation, and metabolic conditions as its symptoms. Thus, yoga, along with healthy living, can provide some assistance in terms of improving insulin levels, maintaining weight, reducing stress, and balancing hormones.

Yoga in Pregnancy

Yoga has many advantages during pregnancy. It will ensure good posture, decrease lower back pain, increase flexibility, improve breath control, and prepare the body for delivery. In addition, prenatal yoga helps with dealing with emotional and mental issues related to pregnancy, which will have a positive effect on the mother and her baby.

Yoga During Perimenopause And Menopause

With the onset of perimenopause and menopause, the reduction in levels of estrogen is known to cause side effects like hot flashes, insomnia, irritability, exhaustion, aches in the joints, and thinning bones. All these factors have significant impacts on both the daily life activities and the emotional state of women.

The research shows that yoga may be helpful in overcoming the symptoms of menopause through relaxation, improvement in sleep, muscle strengthening, and better handling of emotions. Breathing techniques and meditation help in lowering stress and positively influencing the mental state of patients.

Apart from the specific diseases that yoga can alleviate, it promotes self-awareness, which plays an important role in managing one’s emotions. Nowadays, women tend to have a large number of duties, such as working, taking care of children, and doing housework. Chronic stress leads to many diseases, for instance, high blood pressure, obesity, heart issues, and psychological problems.

For all phases of female development, from menstruation until menopause, the emphasis should be on not just the treatment of diseases but the maintenance of wellness. While yoga cannot replace medical care, it remains an important supplement that aids in achieving physical fitness as well as mental and spiritual well-being. Through regular yoga practice, a woman will develop her resilience and become stronger in every phase of life.

(By Dr. Ruchi Bhandari, Director- Obstetrics & Gynecology, Yatharth Hospital, Noida)

Yoga can act as a "polypill" by addressing multiple underlying factors that contribute to lifestyle diseases, according to Dr. Rima Dada, Professor at the All India Institute of Medical Sciences (AIIMS), who has been studying yoga and its impact on lifestyle disorders for the past 20 years.

Speaking about her research, Dr. Rima said yoga is a profound science, technology, and art of living that can tackle factors that set the stage for a wide range of diseases.

Yoga May Benefit Multiple Health Conditions

According to Dr. Rima, yoga can help address conditions including hypertension,

• coronary artery disease,
• polycystic ovarian syndrome (PCOS),
• unexplained male factor infertility,
• primary open-angle glaucoma,
• autoimmune diseases,
• rheumatoid arthritis,
• Alzheimer's disease.

• accelerated ageing,
• shorter telomeres,
• persistent activation of the hypothalamic-pituitary-adrenal axis,
• a dysregulated immune system,
• high levels of stress and anxiety,
• inflammation,
• oxidative stress.

Yoga's For Oxidative Stress And Inflammation

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Dr. Rima said evidence-based studies conducted by her team have shown that yoga addresses these underlying factors.

According to the findings, yoga reduces oxidative stress by increasing the expression of various antioxidants. It also improves mitochondrial health and reduces free radicals produced as by-products of ATP production.

The studies further showed that inflammation decreases because the expression of genes coding for anti-inflammatory factors increases, while the expression of genes that promote inflammation declines.

Yoga May Support Brain Health

The research also found that yoga increases the expression of genes involved in DNA repair. In addition, yoga promotes parasympathetic dominance, resulting in increased rest, repair, and digestion.

Dr. Rima said yoga also positively modulates the epigenome and increases the expression of factors beneficial for overall health. She noted that yoga promotes brain health, improves mental well-being, and enhances the production of factors associated with neurogenesis in key areas of the brain. These changes may help improve memory and build emotional resilience.

Gut-Brain Axis and Immune Health

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Dr. Rima said yoga has also been shown to improve gut microbial flora, helping maintain the integrity of the gut-brain axis.

According to her, this supports the secretion of factors that help maintain immune, endocrine, and mental health.

Yoga Is An Entire Lifestyle

Emphasizing that yoga extends beyond physical postures, Dr. Rima said it is an entire lifestyle that includes diet, asanas, pranayama and dhyana.

She said yoga and asanas help bring the body into proper geometry and alignment, while also improving flexibility, range of motion and neuromuscular coordination.

This alignment, she explained, enables more effective breathing. Nasal inhalation and exhalation activate certain areas of the brain that promote a state of relaxed wakefulness.

Yoga Is The Need of The Day

Dr. Rima said effective breathing increases blood flow to the brain and raises nitric oxide levels, which help improve circulation while reducing inflammation and oxidative stress.

"Thus, yoga is a polypill and is the need of the day," she said.

Heavy menstrual bleeding caused by fibroids and other gynecological conditions is a major but often overlooked contributor to anemia among Indian women, said Dr. Roma Sinha, Chief Gynecologist and Director of Gynecological Robotic Surgery at Apollo Hospitals, Hyderabad, today.

Speaking at the Times Network India Health Summit 2026 at Hyderabad, Dr. Sinha highlighted how many women normalize excessive menstrual bleeding and delay seeking medical attention, often leading to severe anemia and a reduced quality of life.

Fibroids And Heavy Bleeding Behind Anemia

According to Dr. Sinha, it is not uncommon for women to visit her clinic with hemoglobin levels as low as five or six grams per deciliter.

"Most of the time, it is not nutritional anemia. Women lose so much blood during their menstrual cycles that they are unable to rebuild their hemoglobin levels," she said.

While national programs such as Anemia Mukt Bharat focus heavily on pregnant women, Dr. Sinha pointed out that anemia occurring during other stages of a woman's life often goes unnoticed.

She said many women learn from family members and friends that heavy bleeding is "normal" and simply continue to suffer without seeking treatment.

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Fatigue And Poor Quality Of Life

Beyond the underlying disease, Dr. Sinha emphasized the impact heavy menstrual bleeding has on women's daily lives.

"Many women think they are tired because of stress, work, or family responsibilities. But often it is low hemoglobin and iron deficiency causing that fatigue," she said.

The expert noted that a simple hemoglobin test can help diagnose anemia, yet many women continue to prioritize the health of their families over their own well-being.

Lack of Awareness

Dr. Sinha identified lack of awareness and negligence as two major reasons why women delay medical consultations.

"Heavy bleeding occurs only for a few days every month, so women tend to tolerate it and move on. Many don't realize that it is treatable and that ignoring it can lead to dangerously low hemoglobin levels," she said.

The expert stressed the need for greater public awareness and open conversations about menstrual health.

"It should not be a taboo to talk about heavy menstrual bleeding," she added.

Surgery Not The Only Treatment Option

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A common fear among women, Dr. Sinha said, is surgery. Many patients avoid consultations because they assume treatment will automatically mean a hysterectomy —the surgical removal of the uterus— after which pregnancy is impossible, the top gynecologist said. However, she clarified that surgery is not the only option available for fibroids.

"Fibroids are largely benign tumors. Women today have choices, including medical management, non-invasive treatments, myomectomy, or hysterectomy, depending on their individual needs and preferences," she said.

The expert added that modern technologies such as robotic surgery have significantly improved outcomes for women requiring treatment.

Dr. Sinha also highlighted long-term research conducted on women who underwent robotic surgery for fibroids.

"We followed patients for ten years and found that 86.3 per cent conceived and delivered successfully after surgery," she said.

The findings, she noted, should reassure younger women concerned about fertility after fibroid treatment.

Early Diagnosis

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While early detection cannot eliminate fibroids completely, Dr. Sinha said it can prevent severe anemia and improve overall quality of life. "Current treatments can control symptoms and act as bridge therapies, helping women avoid complications and delay more definitive treatment when appropriate," she explained.

'Don't Ignore Heavy Bleeding'

In her message to women, Dr. Sinha urged them to listen to their bodies and seek help when they notice abnormal menstrual bleeding.

"If you feel your periods are heavier than normal, don't ignore it. Get a simple hemoglobin test and consult a gynecologist," she said.

Dr. Sinha also called on families, particularly men, to support women in seeking care and to pay attention when they complain of persistent fatigue or excessive menstrual bleeding.