A recently reported side effect of menopause—an acute and sometimes unbearable heightening of the sense of smell—has cast light on an under-recognised health issue affecting women globally, including in Thailand. While hot flashes, mood swings, and sleep problems are well-documented hallmarks of menopause, women are coming forward with distressing accounts of ordinary smells becoming intolerable, wreaking havoc on daily life and relationships. Medical professionals admit that the problem is little understood, and concrete solutions remain elusive, leaving many women without adequate support.
Menopause, the gradual cessation of menstrual periods and fertility typically experienced by women between 45 and 55 years old, is already recognised as a challenging period, with symptoms arising from the dropping levels of key hormones such as estrogen and progesterone. For generations, Thai women—like their counterparts around the world—have accepted hot flashes, night sweats, and vaginal dryness as parts of this natural aging process. However, the emergence of highly sensitive olfactory changes in some women is adding a difficult dimension to an already complex health transition (Wikipedia).
Recent headlines have given voice to women experiencing extreme shifts in how they perceive smells. In one widely shared account, a woman entering perimenopause described common symptoms she could manage, such as sweating and dryness. But she found herself blindsided when her sense of smell intensified to the point where everyday odors became unbearable. Even previously neutral scents, such as a partner’s skin or food in the fridge, turned stomach-churning, straining her intimacy and social interactions (Daily Mail; Slate).
Medical experts agree that menopause and its precursor, perimenopause, directly affect the olfactory system. Hormones regulated by the ovaries, particularly estrogen and progesterone, help maintain the network of sensory nerves and brain structures responsible for smell. When hormonal levels start to fluctuate, the nerves and olfactory bulb—which processes smell in the brain—become less stable. Scientific reviews have shown that while some women lose sensitivity and find scents dulled, others, like the woman above, experience the opposite: overwhelming and sometimes aversive sensitivity (PubMed, 2013 - Rhinological manifestations; A.Vogel; Winona Health).
Notably, menopause’s impact on the nose and taste buds goes beyond anecdote. A 2023 survey of over 2,000 women over 45 revealed that roughly half noticed changes to their sense of taste and smell, with a subset suffering particularly acute effects (MSN). Research found that during both pregnancy and menopause, hormonal status can reshape how the limbic system and reticular formation—parts of the brain closely tied to olfactory perception—react, potentially increasing sensitivity (PubMed, 2002 - Olfactory perception).
Despite growing reports, there is little consensus about how common these olfactory changes are. Doctors and researchers point to individual variability, with factors like baseline hormone levels, genetics, lifestyle, and psychological state all playing a role. Some studies focus on interventions such as black cohosh, an herbal remedy, but mainly for loss of smell, not heightened sensitivity (PubMed, 2024 - Black Cohosh). Others underscore that heightened olfactory perception may precede menopause by several years during perimenopause, as hormone levels first begin to waver (A.Vogel).
Evidence also points to hormonal impacts on mental health, which can in turn affect how the brain processes sensory information. Heightened anxiety, a common menopausal symptom, can intensify the experience of odors, compounding distress (Healthline). Some women even develop “phantosmia,” the perception of smells that aren’t actually present, representing 10–20% of smell disorders among menopausal women (Daily Mail).
Medical practitioners in Thailand are increasingly encountering such cases, though cultural factors can make it difficult for patients to discuss symptoms openly. In Thai society, where discreetness and composure are valued, sharing problems related to body odor, intimacy, or senses is often avoided or trivialised. This underscores the importance of accessible health education and open public conversation about menopause’s full spectrum of impacts, not limited to the visible or widely known symptoms.
Globally, hormone replacement therapy (HRT) is considered the gold standard to alleviate disruptive menopausal symptoms like hot flashes, mood changes, and sometimes sensory changes. HRT balances out declining estrogen and progesterone, potentially restoring equilibrium to the olfactory system. Yet, experts note that controlled studies specifically targeting smell changes are lacking; much of the evidence remains anecdotal. Some women report improvements, while others see no impact. In Thailand, HRT is available but may still be viewed with skepticism in certain demographics, especially given past concerns about associated health risks. Current medical guidelines recommend HRT for moderate to severe symptoms under close supervision (Wikipedia).
Other strategies—such as using air purifiers to reduce exposure to strong household odors, choosing unscented skincare products, and minimizing trigger food smells—can offer incremental relief. Cognitive-behavioral therapy and mindfulness may help women manage distress linked to sensory overload, though these are more effective for emotional symptoms than physical ones. Importantly, patients should be encouraged to discuss any change in their senses with healthcare providers, as it could signal rare but serious underlying causes beyond menopause.
Looking at the broader Thai context, menopause marks a significant life transition, one historically observed quietly within families. Thai women often rely on herbal or traditional remedies such as black cohosh and tamarind supplements, coupled with lifestyle adjustments like diet, meditation, and gentle exercise. As awareness grows, healthcare providers are urged to take sensory symptoms seriously and actively inquire about them during consultations, ensuring women don’t suffer in silence.
Going forward, researchers are calling for large-scale studies to clarify how common and disruptive these sensory changes are among menopausal women, both in Thailand and globally. Public health campaigns should aim to destigmatize talking about menopause’s less visible effects, empowering women to seek help and share experiences. At a policy level, increasing access to menopause-specialized healthcare, especially outside major Thai cities, will be critical as the population ages.
In summary, the discovery that menopause can radically disrupt the sense of smell—and, by extension, intimacy and social wellbeing—reminds us that no symptom, however invisible, should be dismissed. Thai women and families are encouraged to initiate honest conversations about all aspects of the menopausal experience, inform their healthcare providers of new or distressing symptoms, and consider a combination of medical and lifestyle interventions. Policymakers and health professionals alike must prioritise research, support, and education to ensure every woman can navigate this life stage with dignity and comfort.
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