Sharpening Of The Sense Of Smell : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 26/08/2022

An acute sense of smell (hyperosmia) is an increased sensitivity to smells. Common physiological prerequisites for olfactory disorders are hormonal changes in women during pregnancy and in the premenstrual period. The symptom is characteristic of neurological and psychiatric diseases. To determine the cause of olfactory disorders, olfactometry, ENT examination, and instrumental methods of brain imaging are performed. Medications are aimed at treating the underlying pathology, so they are prescribed only after a diagnosis has been made.

Causes of exacerbation of smell


During the gestation period, hormonal changes occur in the body of a woman, causing hypersensitivity to aromas. An increased sense of smell can be one of the first symptoms of pregnancy. Women often notice unpleasant pungent odors - fuel, fuel oil, rancid fat, combustion products that haunt them even indoors. Pleasant aromas, such as favorite perfumes or the smell of flowers, also seem very strong and intrusive, causing nausea and headaches. Some patients refuse to use cosmetics because of their smell.

Hyperosmia is sometimes accompanied by a change in taste preferences - too strong aromas of familiar food provoke disgust in a pregnant woman, a gag reflex. Such symptoms are considered physiological, usually exacerbation of sensitivity to smells disappears after childbirth. The appearance of a future mother against the background of a change in the sense of smell of severe headaches, dizziness may indicate serious disorders, so such women need to consult a specialist. You also need to see a doctor if hyperosmia persists in the postpartum period.

premenstrual period

A heightened sense of smell develops in women a few days before the onset of menstruation. The symptom usually disappears with the onset of menstrual bleeding. Hyperosmia is characteristic of emotionally labile patients who are prone to tearfulness, rapid mood swings. At the same time, both the usual aromas of food, flowers, and the irritating smells of gasoline, acetone, etc. are intensified. Some women cannot travel by public transport during this period, since the increased susceptibility to the smells of fuel, sweat causes nausea and headaches.

In most cases, the aggravation of the sense of smell is moderate, does not cause severe discomfort and does not interfere with the performance of daily work. Sometimes hyperosmia is combined with increased sensitivity to sounds of normal volume. In some women, the unpleasant symptoms of PMS persist during menstrual bleeding and even after the end of menstruation. This condition indicates hormonal disorders in the body, in which a consultation with a gynecologist or endocrinologist is indicated.

Diffuse toxic goiter

The aggravation of the perception of various odors occurs due to a change in the work of olfactory receptors in the nasal mucosa, which is provoked by a sharp increase in the level of thyroid hormones. With thyrotoxicosis, patients react sharply to unpleasant odorous substances: they notice even faint odors of drugs, fuel combustion products. Patients complain of the constant presence of stench that bothers them both at home and on the street. Due to the increased sense of smell, taste is disturbed, some people develop an aversion to their favorite dishes.


With this disorder, an aggravation of the sense of smell occurs even before the onset of headaches. This condition is called migraine with aura, and its frequency is about 3.5%. Hyperosmia persists even after the onset of an attack - patients notice that even the presence of faint aromas worsens the condition, increases the intensity of headaches. In a severe form, hypersensitivity to odors is combined with vomiting that does not bring relief. Exacerbation of the olfactory function and increased perception of smells can serve as a provoking factor for migraine, which is observed in 60% of cases.


Brain diseases

Various pathologies of a neurological nature cause damage to specialized centers in the cerebral cortex that are responsible for the recognition of aromas. At the same time, the sense of smell often increases gradually, complaints of intolerance to sharp medicinal or chemical odorous substances are typical. Patients also note an increased sensitivity to floral and herbal aromas, exhaust gases. The symptom is accompanied by headaches, periodic dizziness and fainting, sometimes disturbed by visual impairment. With the development of hyperosmia proceed:

  • Brain tumors : astrocytoma, glioma, meningioma, etc.
  • Degenerative diseases : multiple sclerosis, dyscirculatory encephalopathy.

mental illness

Exacerbation of the sense of smell is manifested as serious diseases - schizophrenia, epilepsy, depression, and disorders of the neurotic register - neurasthenia, psychasthenia. Schizophrenia is characterized by olfactory hallucinations, when the patient constantly feels a certain aroma (the smell of feces, decay). The sense of smell may increase shortly before the onset of an epileptic seizure as a component of the sensory aura. With depression, patients complain of a sensation of stench from an unknown source, some patients believe that this smell appears due to the decay of their own body.

Rare Causes


Since the exacerbation of the sense of smell is more often due to dysfunction of specific nerve centers in the brain, a consultation with a neurologist is indicated. During the diagnosis, the doctor assesses the degree of impairment of the olfactory function, examines in detail the state of the central nervous system in order to find the root cause of the symptom. For this, a comprehensive examination of both the nervous system and the peripheral part of the olfactory analyzer is carried out. The most informative are:

  • Olfactometry . Recognition of certain odorous substances from test tubes allows an objective assessment of the quality and degree of increased perception of odors. The method of quantitative olfactometry is designed to measure the threshold of smell and the rate of adaptation of the olfactory analyzer.
  • X-ray examination . To exclude organic brain damage, which could provoke an exacerbation of sensations during the perception of aromas, computed tomography is prescribed. With insufficient information content, the method is supplemented with MRI for accurate visualization of brain structures.
  • EEG . The study of the electrical activity of the brain is necessary for the diagnosis of pathologies such as epilepsy, migraine, degenerative neurological diseases. With the help of electroencephalography, the frequency and amplitude of the waves, the presence of foci of increased excitability in the brain tissue are determined.
  • ENT examination . All patients with an exacerbation of the sense of smell are recommended to perform rhinoscopy to visualize the mucous membrane of the superior nasal concha, which contains olfactory receptors. If a suspicious altered tissue is detected, a biopsy and cytomorphological examination are performed.
  • Laboratory tests . Women of reproductive age measure the concentration of sex hormones on different days of the cycle. Also evaluate the levels of thyroxine and triiodothyronine, insulin. To exclude pregnancy, a blood test for human chorionic gonadotropin is prescribed.

In the absence of neurological causes of an acute sense of smell, women are prescribed an examination by a gynecologist. If hyperthyroidism or other endocrine disorders are suspected, patients are referred to a specialist for further diagnosis and treatment. If there are suspicious symptoms, a psychiatric evaluation may be required.

Olfactometry - a method for studying the olfactory function


Symptomatic therapy

The aggravation of the sense of smell, which occurs in pregnant women and in women before menstruation, does not require medical treatment. With severe disorders in such cases, psychotherapy methods and relaxation exercises can be effective. If hyperosmia violates the quality of life of patients, interferes with daily activities, causes disgust for food, light sedative herbal remedies are used. When an exacerbation of olfactory sensitivity is associated with an organic pathology, treatment is prescribed only by a specialist after carrying out diagnostic measures and making an accurate diagnosis.

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