hyperosmia

Hyperosmia is an increased sensitivity to odors, resulting in a perceivable smell intensity greater than typical for most people. It can be temporary or chronic and may accompany other sensory or hormonal changes. It is distinct from hyposmia (reduced smell) and phantosmia (smelling odors that are not present).

Symptoms include exaggerated perception of ordinary odors, strong or unpleasant reactions to fragrances, often accompanied by nausea, headaches, or migraines. Triggers vary among individuals and may include perfumes, cooking smells, or environmental odors. In some settings, hyperosmia can lead to avoidance of smells and social discomfort.

Causes and associations: Physiological hyperosmia can occur during pregnancy or hormonal fluctuations (puberty, menopause). It can be part of migraine disorders or temporal lobe epilepsy or other neurological conditions. It can be idiopathic or associated with nasal inflammatory disease or exposure to irritants. Certain medications or substances may influence olfactory sensitivity, though evidence is variable.

Diagnosis: Based on history and, if needed, objective testing of smell threshold and discrimination (e.g., standardized olfactory tests). A medical examination by an ear–nose–throat specialist may rule out nasal disease. If neurological symptoms are present, further evaluation may be indicated.

Treatment and prognosis: Management focuses on identifying and addressing underlying causes and reducing exposure to triggers. In pregnancy, symptoms commonly remit after pregnancy. For chronic or distressing cases, multidisciplinary care, including counseling or migraine management, may help. The prognosis varies; some individuals experience temporary hyperosmia, others may have persistent sensitivity.