Many people lose their sense of smell after COVID-19 infection. Some of the consequences are obvious, but less well appreciated and not often talked about are the psychological effects on sexual and interpersonal relations.
Alone in her home, while her husband was out of town on business, a young woman was startled by the smell of smoke. Alarmed by the smoldering fire, she searched the house, sniffing for the source of the pungent odor of electrical insulation burning. The stench filled every room. She called her husband, who told her to shut off the power at the fuse box and call the fire department immediately.
The fire truck rolled up to the curb, and the firemen rushed in, but after a thorough search, they confessed that they could not smell anything. When her husband rushed home, he told her that he could not smell anything unusual. She insisted that the sickening stink of an electrical fire was strong, as the same perplexed expression the firemen had on their faces, betraying their suspicion that she had gone crazy, swept across her husband’s face. That’s when she realized what was happening to her.
It was a false alarm caused by her sense of smell gone haywire. She had recovered quickly from a mild case of COVID-19 several months earlier without the need for hospitalization. But when the disease left her body, it took with it her sense of smell.
Between 60 and 90 percent of COVID-19 patients report a partial or total loss of their sense of smell. As the sense recovers, olfactory perceptions can be abnormal. For some people, even savory aromas become fetid, and they are unable to eat. Recovering a normal sense of smell after COVID-19 can take months. Studies show that two months after COVID-19 recovery, 15 percent of patients still have not recovered their olfactory ability, and the loss persists for 6 months after recovering from the infection for about 5 percent of patients.
The lingering disability has many consequences, but how the sense of smell influences close social relationships is often overlooked. A recent paper by psychologists Anna Blomkvist and Marlise Hofer, published in the journal Chemical Senses, delves deeper into the ramifications of losing the normal function of this life-saving sense that we often take for granted. The consequences are wide-ranging, extending to impairing the most fundamental and essential aspects of human relationships where our olfactory system has a profound influence.
It is estimated that more than 127,000 pregnant women have caught COVID-19 since the beginning of the pandemic. The medical implications of the infection for mother and child are recognized, but less attention has been focused on the potential psychological effects from the loss of olfactory ability for critical infant-maternal bonding. In one seminal study published in 1987, 90 percent of women tested could identify their newborn babies by smell after having had only 10-60 minutes time with their newborn infants. If tested after mothers had been together with their infants for more than an hour, all of the women tested could recognize their newborns by smell over the smell of other infants.
The study involved 48 women in the maternity ward of a city hospital. Researchers presented the mothers with undershirts worn by three infants, only one of which was from their own newborn baby. The data show that within minutes of giving birth, mothers have an extremely powerful ability to identify their newborn babies by smell. This ability to identify their own infant is even more powerful than visual or auditory cues, the authors of the study suggest.
Knowing this, impairments in mother-infant bonding are to be expected in the population of pregnant women who have been infected with COVID-19. This is supported by a study by Ilona Croy and colleagues in the Department of Psychotherapy and Psychosomatic Medicine in Dresden, Germany. The researchers found that mothers who had bonding difficulties with their infants were unable to identify their own infant’s odor.
The effects of olfaction on other interpersonal relations and on sexual behavior are also easily overlooked, but they are well established. My own neuroanatomical research, together with many other studies on the neuroscience of pheromone reception, clearly shows that many olfactory signals influencing sexual behavior are not perceived consciously. These neural circuits from receptors in the nose do not connect with the cerebral cortex, where consciousness arises; they connect with parts of the brain that control reproductive behavior. At the same time, consciously perceived preferences in body odors can influence sexual relations. Psychologists Rachel Herz and Michael Inzlicht of Brown and New York University surveyed 198 male and female heterosexual college students and found that body odor ranked as more important for attraction than a person’s looks and several other factors.
The preferences for body odor in male-female attraction identified in this survey have biological consequences. A study published in 2020 reports that men can detect a women’s sexual arousal by smell. In this study, men evaluated the smell of sweat from sexually aroused women compared to the same women when they were not sexually aroused. Sexual arousal in the women was induced by having them watch sexually explicit videos as compared to watching neutral videos. By smelling cotton swabs from a women’s armpits taken at times when she was sexually aroused, and when she was not, the men could tell by the fragrance of the sweat when that woman was sexually excited and when she was not. In a subsequent experiment, the researchers found that exposure to the sexier-smelling female sweat increased the men’s own level of sexual arousal.
The loss of olfactory ability in COVID-19 patients could result in reduced sexual and romantic interactions. This is born out by a study conducted well before the COVID-19 pandemic and published in 2013, which shows that men with anosmia (loss of the sense of smell) from causes other than COVID-19 have fewer sexual partners.
This is only the tip of the iceberg of subtle and not-so-subtle consequences of losing the sense of smell on social behaviors. Increasing awareness of this can help patients recovering from COVID-19 to be careful in trusting their sense of smell as it slowly recovers. Moreover, these patients need to understand that this sensory disability can have psychological consequences that can impair intimate interpersonal relationships that, whether we are consciously aware of it or not, are being guided by our nose.
First published in Psychology Today