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Dear Prudence: Migraines and Scent Sensitivity
Older column.
Q. Fragrance sensitivity: I began dating “Kara” about a year ago. When we first met, she told me she suffered from migraines, often induced by strong smells. I switched my deodorant and stopped burning scented candles in my home (a big change for me—scented candles had previously helped me control my anxiety). I’ve changed other things too; we’ve even left parties early because hosts had plug-in air fresheners. This has been challenging for me, but I do love her and I want her to be well.
A month ago, Kara tested positive for COVID after losing her sense of smell and taste. She had some gastrointestinal symptoms, and, without thinking, I sprayed scented air freshener to cover up bathroom smells. Kara couldn’t smell the air freshener, and she didn’t have a migraine. I feel disconcerted that I’ve been “cleansing” my life of all scented fragrances for a year, only to realize this is perhaps all in her head. I don’t want to bring this up because I don’t want to upset her during a difficult time. But I also don’t want to raise children with someone who is either a hypochondriac, seeking attention, or unable to exist with the normal fragrances that are part of daily life. Is it worth bringing up with her? Should I seek some sort of medical opinion? Does it matter whether it’s all in her head or a legitimate physical response? Please help.
A: I confess I had rather the opposite response you did: Since Kara can no longer smell anything, at least for now, it stands to reason that scents would stop being a significant migraine trigger too. And at the risk of sounding glib, where else would migraines and fragrance sensitivity be a problem, if not “in the head”? I’m not at all inclined to take this sudden change in her migraine triggers as evidence that she’d previously been faking them.
But you say you don’t want to raise children with someone who can’t “exist with the normal fragrances that are part of daily life,” so even if we set aside the “Kara is a hypochondriac” hypothesis, you’ve apparently realized something pretty significant about your future together. Part of me wants to argue that things like changing deodorant brands and occasionally leaving parties early because your hosts used artificial air fresheners aren’t so challenging that they’re worth ending an otherwise good relationship over, although I can understand the difficulties of finding certain smells relaxing or anxiety-relieving when your partner can’t abide them. But if you consider this a deal breaker, I don’t want to try to convince you to stay with her, mostly for her sake—I think she deserves a partner who finds accommodating her fragrance sensitivity manageable, and who doesn’t assume a temporary respite in her triggers means she’s been faking migraines. I think you should do your best to put your suspicions aside and enjoy your relationship with Kara, but if you can’t, do her a favor and let her find someone else.
Q. Fragrance sensitivity: I began dating “Kara” about a year ago. When we first met, she told me she suffered from migraines, often induced by strong smells. I switched my deodorant and stopped burning scented candles in my home (a big change for me—scented candles had previously helped me control my anxiety). I’ve changed other things too; we’ve even left parties early because hosts had plug-in air fresheners. This has been challenging for me, but I do love her and I want her to be well.
A month ago, Kara tested positive for COVID after losing her sense of smell and taste. She had some gastrointestinal symptoms, and, without thinking, I sprayed scented air freshener to cover up bathroom smells. Kara couldn’t smell the air freshener, and she didn’t have a migraine. I feel disconcerted that I’ve been “cleansing” my life of all scented fragrances for a year, only to realize this is perhaps all in her head. I don’t want to bring this up because I don’t want to upset her during a difficult time. But I also don’t want to raise children with someone who is either a hypochondriac, seeking attention, or unable to exist with the normal fragrances that are part of daily life. Is it worth bringing up with her? Should I seek some sort of medical opinion? Does it matter whether it’s all in her head or a legitimate physical response? Please help.
A: I confess I had rather the opposite response you did: Since Kara can no longer smell anything, at least for now, it stands to reason that scents would stop being a significant migraine trigger too. And at the risk of sounding glib, where else would migraines and fragrance sensitivity be a problem, if not “in the head”? I’m not at all inclined to take this sudden change in her migraine triggers as evidence that she’d previously been faking them.
But you say you don’t want to raise children with someone who can’t “exist with the normal fragrances that are part of daily life,” so even if we set aside the “Kara is a hypochondriac” hypothesis, you’ve apparently realized something pretty significant about your future together. Part of me wants to argue that things like changing deodorant brands and occasionally leaving parties early because your hosts used artificial air fresheners aren’t so challenging that they’re worth ending an otherwise good relationship over, although I can understand the difficulties of finding certain smells relaxing or anxiety-relieving when your partner can’t abide them. But if you consider this a deal breaker, I don’t want to try to convince you to stay with her, mostly for her sake—I think she deserves a partner who finds accommodating her fragrance sensitivity manageable, and who doesn’t assume a temporary respite in her triggers means she’s been faking migraines. I think you should do your best to put your suspicions aside and enjoy your relationship with Kara, but if you can’t, do her a favor and let her find someone else.

Chat Comment
I also think the letter writer needs to interrogate why “she’s clearly a hypochondriac who was making it all up for attention” was their first thought in this scenario. It seems obvious to me that if she can’t smell the air freshener, it can’t trigger a migraine. I wouldn’t want to date someone who had as low an opinion of me as the letter writer seems to have of Kara.
A: I agree that “My God, she must have been faking it the whole time; I could never have children with her” is such an overblown response to Kara’s brief respite from migraines (after having gotten COVID!) that I’m inclined to suspect the letter writer was looking for reasons to downplay or dismiss her migraines. If the letter writer is at all inclined to do some reflecting first, it might be worthwhile to read up on migraines and that history of sexist dismissal you mention here—not so the letter writer can say, “My God, I’m a monster, I hate myself,” but so they can hopefully contextualize some of their attitudes and assumptions about migraines and do their best to shed some of them. Even if you two don’t stay together, you can at least break up respectfully.
Re: Chat Comment
That Bad Advice Re: Chat Comment
Of course, being a neurologist with an expertese in migraines, you can immediately tell that, if the sensation of smell being absent, Kara does not have migranes, she must have been lying all along. After all women lie all the time especially about disorders which disproportionately affect us (or are thought of as being more common to women). Please break up with Kara immediately so you can stop despising her and get busy despising the next imperfect female you find yourself saddled with, and so on throughout your charmed life.
Re: That Bad Advice Re: Chat Comment
I kind of get that and feeling confused or betrayed, but idk, I think if you see a future with someone who has a chronic illness, you should be motivated to learn how it works from a place of compassion. Vs basically just like... Doing what you need to for your partner to Shut Up about it so you can ignore it (except for the simmering resentment).