ORIGINAL RESEARCH—PSYCHOLOGY: Depression Resulting from Olfactory Dysfunction is Associated with Reduced Sexual Appetite—A Cross-Sectional Cohort Study



      Anecdotal reports from patients with smell loss provided the basic motivation for the present study on sexual dysfunction among patients with olfactory dysfunction. The aim of the present study was to investigate the sexual appetite and the subject's depression in regard to olfactory function.


      Eighty-six patients referred to our smell and taste clinic with olfactory dysfunction were investigated. Olfactory function was assessed by means of the “Sniffin' Sticks” test battery consisting of tests for odor threshold (T), odor discrimination (D), and odor identification (I). Their results were summed up to a composite score, the so-called “TDI score.” All participants completed a questionnaire including the Beck Depression Inventory (BDI) and 11 questions for evaluation of the sexual appetite in regard to the time before the onset of olfactory dysfunction and since the olfactory dysfunction. The points received for the latter questions were summed up to the so called Sexual Appetite Index (SAI).


      Olfactory testing revealed that 38 patients were functionally anosmic, 39 patients were hyposmic, and nine patients were normosmic. The average BDI score was 11.0 ± 8.4 points. Evaluation of the SAI questionnaire revealed a significant decrease (P = 0.003) of the score from 22.7 ± 4.5 points from the time before to 21.4 ± 4.9 points since the onset of olfactory loss. No significant correlation was found between olfactory function and the SAI since the onset of olfactory dysfunction. However, the BDI score correlated negatively with the SAI since the onset of olfactory dysfunction (r85 = −0.36; P = 0.001).


      The present study does not confirm the hypothesis that loss of olfactory function directly impacts on sexual appetite. It seems that depression caused by olfactory loss is the main cause for the self-reported decrease in sexual appetite as the onset of olfactory dysfunction. Gudziol V, Wolff-Stephan S, Aschenbrenner K, Joraschky P, and Hummel T. Depression resulting from olfactory dysfunction is associated with reduced sexual appetite—A cross-sectional cohort study. J Sex Med 2009;6:1924–1929.


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        • Keverne E.B.
        Importance of olfactory and vomeronasal systems for male sexual function.
        Physiol Behav. 2004; 83: 177-187
        • Spencer N.A.
        • McClintock M.K.
        • Sellergren S.A.
        • Bullivant S.
        • Jacob S.
        • Mennella J.A.
        Social chemosignals from breastfeeding women increase sexual motivation.
        Horm Behav. 2004; 46: 362-370
        • Graham C.A.
        • Janssen E.
        • Sanders S.A.
        Effects of fragrance on female sexual arousal and mood across the menstrual cycle.
        Psychophysiology. 2000; 37: 76-84
        • Huh J.
        • Park K.
        • Hwang I.S.
        • Jung S.I.
        • Kim H.J.
        • Chung T.W.
        • Jeong G.W.
        Brain activation areas of sexual arousal with olfactory stimulation in men: A preliminary study using functional MRI.
        J Sex Med. 2008; 5: 619-625
        • Bancroft J.
        Sexual desire and the brain.
        Sex Marital Ther. 1988; 3: 11-27
        • Graziottin A.
        Libido: The biologic scenario.
        Maturitas. 2000; 34: S9-16
        • Hudson J.I.
        • Pope Jr, H.G.
        • Glynn R.J.
        The cross-sectional cohort study: An underutilized design.
        Epidemiology. 2005; 16: 355-359
        • Hummel T.
        • Sekinger B.
        • Wolf S.R.
        • Pauli E.
        • Kobal G.
        Sniffin” sticks: Olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold.
        Chem Senses. 1997; 22: 39-52
        • Kobal G.
        • Klimek L.
        • Wolfensberger M.
        • Gudziol H.
        • Temmel A.
        • Owen C.M.
        • Seeber H.
        • Pauli E.
        • Hummel T.
        Multicenter investigation of 1,036 subjects using a standardized method for the assessment of olfactory function combining tests of odor identification, odor discrimination, and olfactory thresholds.
        Eur Arch Otorhinolaryngol. 2000; 257: 205-211
        • Ehrenstein W.H.
        • Ehrenstein A.
        Psychophysical methods.
        in: Windhorst U. Johansson H. Modern techniques in neuroscience research. Springer, 1999: 1211-1241
        • Hummel T.
        • Knecht M.
        • Kobal G.
        Peripherally obtained electrophysiological responses to olfactory stimulation in man: Electro-olfactograms exhibit a smaller degree of desensitization compared with subjective intensity estimates.
        Brain Res. 1996; 717: 160-164
        • Köster E.P.
        • De Wijk R.A.
        Olfactory adaptation.
        in: Laing D.G. Doty R.L. Breipohl W. The human sense of smell. Springer Verlag, 1991: 199-215
        • Hummel T.
        • Kobal G.
        • Gudziol H.
        • Mackay-Sim A.
        Normative data for the “Sniffin' Sticks” including tests of odor identification, odor discrimination, and olfactory thresholds: An upgrade based on a group of more than 3,000 subjects.
        Eur Arch Otorhinolaryngol. 2007; 264: 237-243
        • Beck A.T.
        • Steer R.A.
        • Carbin M.G.
        Psychometric properties of the Beck depression inventory: Twenty-five years of evaluation.
        Clin Psychol Rev. 1988; 8: 77-100
        • Hautzinger M.
        The beck depression inventory in clinical practice.
        Nervenarzt. 1991; 62: 689-696
        • Gudziol V.
        • Mück-Weymann M.
        • Seizinger O.
        • Rauh R.
        • Siffert W.
        • Hummel T.
        Sildenafil affects olfactory function.
        J Urol. 2007; 177: 258-261
        • Levin R.J.
        Human male sexuality: Appetite and arousal, desire and drive.
        in: Legg C. Boott D. Human appetite: Neural and behavioural bases. Oxford University Press, 1994: 127-164
        • Deems D.A.
        • Doty R.L.
        • Settle R.G.
        • Moore-Gillon V.
        • Shaman P.
        • Mester A.F.
        • Kimmelman C.P.
        • Brightman V.J.
        • Snow Jr., J.B.
        Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center.
        Arch Otolaryngol Head Neck Surg. 1991; 117: 519-528
        • Reed S.D.
        • Newton K.M.
        • LaCroix A.Z.
        • Grothaus L.C.
        • Ehrlich K.
        Night sweats, sleep disturbance, and depression associated with diminished libido in late menopausal transition and early postmenopause: Baseline data from the Herbal Alternatives for Menopause Trial (HALT).
        Am J Obstet Gynecol. 2007; 196 (e1-7): 593
        • Yang J.C.
        • Park K.
        • Eun S.J.
        • Lee M.S.
        • Yoon J.S.
        • Shin I.S.
        • Kim Y.K.
        • Chung T.W.
        • Kang H.K.
        • Jeong G.W.
        Assessment of cerebrocortical areas associated with sexual arousal in depressive women using functional MR imaging.
        J Sex Med. 2008; 5: 602-609
        • Dincer U.
        • Cakar E.
        • Kiralp M.Z.
        • Dursun H.
        Assessment of sexual dysfunction in male patients with Ankylosing Spondylitis.
        Rheumatol Int. 2007; 27: 561-566
        • Pause B.M.
        • Miranda A.
        • Göder R.
        • Aldenhoff J.B.
        • Ferstl R.
        Reduced olfactory performance in patients with major depression.
        J Psychiatr Res. 2001; 35: 271-277
        • Pollatos O.
        • Albrecht J.
        • Kopietz R.
        • Linn J.
        • Schoepf V.
        • Kleemann A.M.
        • Schreder T.
        • Schandry R.
        • Wiesmann M.
        Reduced olfactory sensitivity in subjects with depressive symptoms.
        J Affect Disord. 2007; 102: 101-108
        • Herz R.
        • Inzlicht M.
        Sex differences in response to physical and social factors involved in human mate selection the importance of smell for women.
        Evol Hum Behav. 2002; 23: 359-364
        • O'Brien E.M.
        • Atchison J.W.
        • Gremillion H.A.
        • Waxenberg L.B.
        • Robinson M.E.
        Somatic focus/awareness: Relationship to negative affect and pain in chronic pain patients.
        Eur J Pain. 2008; 12: 104-115