Phantom Smells During Perimenopause aka Phantosmia

by | Mar 21, 2025 | HORMONES, PERIMENOPAUSE

Phantom Smells During Perimenopause and Menopause: What You Should Know

Have you ever smelled something burning, metallic, or even rotten, only to discover there’s nothing there? You’re not alone. This odd phenomenon is called phantosmia, a condition where people perceive smells that don’t actually exist. It can affect anyone. But, it’s surprisingly common in women going through perimenopause and menopause.

Most women don’t associate changes in their sense of smell with hormonal shifts, but these changes can play a significant role. Here’s what you need to know about this condition, its possible causes, why it’s showing up during menopause, and what you can do about it.

What Is Phantosmia?

Phantosmia, also known as an “olfactory hallucination,” is the experience of smelling something that isn’t actually there. Unlike odors caused by external factors (like smoke, perfume, or garbage), it originates internally, within your olfactory system. Common phantom smells include:

  • Burning (such as smoke, toast, or burnt popcorn)
  • Metallic or chemical-like odors
  • Rotting or garbage-like scents
  • Ammonia or other strong, astringent smells

These phantom smells can occur in one or both nostrils and may happen sporadically or persist for hours. While the experience can be unsettling, it’s typically not cause for alarm.

Phantosmia and Perimenopause

For women in perimenopause and menopause, phantosmia is often the result of hormonal changes. Estrogen and progesterone, the two primary hormones that regulate the female reproductive system, also influence various sensory systems, including your sense of smell. When these hormone levels fluctuate during perimenopause, it can disrupt your olfactory receptors, causing phantom smells.

Additionally:

  • Sensory sensitivity often increases during hormonal shifts, making women more prone to changes in smell perception.
  • Stress and fatigue, common during this stage of life, may also contribute to olfactory disruptions.

Many women describe smelling smoke or burning toast, which can lead to unnecessary panic. However, rest assured, phantom smells are a harmless byproduct of hormonal fluctuations for most women.

Phantosmia Is NOT an Indicator of Stroke (Usually)

For years, a burning or smoky smell was often associated with warning signs of a stroke. However, this theory has been debunked. It is not a good indicator of stroke or a neurological emergency. That being said, it’s still wise to understand the real warning signs of a stroke, such as:

  • Sudden numbness or weakness in your face, arms, or legs
  • Sudden confusion, trouble speaking, or difficulty understanding speech
  • Sudden dizziness, loss of balance, or coordination issues
  • Severe, unexplained headache

If you experience any of these symptoms along with phantom smells, seek medical attention immediately.

Could Long COVID Be Causing Phantom Smells?

An interesting twist in the phantosmia conversation is its link to long COVID. For individuals who have had COVID-19, changes to their sense of smell have been well-documented. These changes range from anosmia (loss of smell) to parosmia (distorted smells) and, yes, phantosmia.

While the exact mechanisms are still being studied, it’s believed that COVID-19 affects the olfactory nerves, which can cause phantom smells to linger long after recovery. If you’ve experienced COVID-19 and developed phantosmia, your hormonal fluctuations during menopause could further amplify these effects. The good news? For both long COVID and menopause-related phantosmia, the condition is usually temporary.

What You Can Do About Phantosmia

While phantosmia can be frustrating and sometimes alarming, there are steps you can take to manage it:

1. Rule Out Underlying Medical Causes

While phantosmia during menopause is typically related to hormonal changes, it can also result from other conditions, such as:

  • Sinus infections or allergies
  • Migraines
  • Neurological issues

If phantom smells persist or interfere significantly with your daily life, consult a healthcare provider to ensure there’s no underlying medical issue.

2. Treat Hormonal Imbalances

Since hormonal fluctuations are a significant contributor, addressing these shifts can help reduce phantosmia. Options include:

  • Supplements like vitamin D, magnesium, and omega-3s may support hormonal balance naturally.
  • Lifestyle changes, such as stress management, regular exercise, and a balanced diet, can help stabilize your hormones.
  • Testing and NOT guessing!

I can’t stress enough how crucial it is to test, not guess, when it comes to understanding your hormones. If you think you have phantosmia and then just simply take a Vitamin D supplement because of something you saw on TikTok – you’ll likely just end up feeling frustrated with the same symptoms and money down the drain. Who wants that?!

Guessing is like throwing a dart blindfolded! That’s exactly why I created my at-home hormone testing kits. So you can get real results with REAL answers. These tests are simple to use, highly accurate, and allow you to get a clear snapshot of your unique hormone profile without stepping foot outside your home. Armed with real data, you can finally pinpoint what’s happening in your body and identify where you need to make changes.

3. Practice Stress Management

Stress increases cortisol levels, which can heighten sensory sensitivities and make phantom smells worse. Techniques such as deep breathing, meditation, or yoga can help manage stress and reduce the frequency of phantosmia episodes.

4. Stay Hydrated and Rested

Dehydration and fatigue are common culprits in sensory disruptions. Drinking plenty of water and ensuring you get adequate rest can prevent symptoms from worsening.

5. Neutralize Phantom Smells

If phantom smells become overwhelming, try these tips:

  • Use a saline nasal spray to clear out your nasal passages.
  • Carry a soothing essential oil, such as lavender or eucalyptus, to counteract unpleasant phantom smells.
  • Place a fan or air purifier near you for fresh air circulation.

It’s Normal, but Don’t Ignore It

Phantosmia can feel strange and unsettling, especially when it appears out of nowhere. It’s reassuring to know that for women in perimenopause and menopause, it’s most often a harmless side effect of hormonal changes or other conditions like sinus issues or long COVID.

However, while the condition is rarely serious, it’s worth mentioning to your doctor. They’ll help rule out other causes and provide guidance on managing your symptoms more effectively.

Final Thoughts

Phantom smells may come as a surprise, but they’re more common than you think, particularly for women navigating the hormonal shifts of perimenopause and menopause. By staying informed, you can better understand your body and take practical, reassuring steps to address symptoms like phantosmia.

If this topic resonates with you, share your story in the comments below or reach out to your healthcare provider for personalized insights. You’re not alone in this, and together, we can decode the fascinating changes that come with this stage of life.

Explore more of my blog posts and reach out if you have any questions.

The information provided in this blog post is for informational purposes only. The information is a result of years of practice and experience by Dr. Francesca LeBlanc. However, this information is NOT intended as a substitute for the advice provided by your physician. Do not use the information provided in this post for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or using any treatment for a health problem. Please, do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this website.