Subtle Olfactory Impairment in Azoospermia: Investigating the Association with Male Hormones

Background: Anosmia accompanies hypogonadism cases, which develop as a result of the deficiency of hormones such as follicule-stimulating hormone (FSH), luteinizing hormone (LH), GnRH. Although the relationship of female sex hormone change with sinonasal functions has been widely discussed in the literature, the number of studies examining males is limited.

Methods: The study group was composed of 30 patients who presented to the infertility unit and were randomized with their consent. The control group consists of 22 patients having 20 million sperms per 1 mL in spermiogram without any sinonasal disease and previous surgical history. Testosterone, FSH, LH, and prolactin levels were measured for all the patients. SNOT-22 questionnaire was administered to assess the sinonasal functions, and Connecticut (CCCRC) smell test was conducted to assess the MCT and sinonasal function for all the patients.

Results: In the present study, 52 (30 patients in the azoospermia group and 22 patients in the control group) male patients were involved. When compared to the control group, the azoospermia group had significantly lower scores in smell identification and a lower mean smell score (P=.006 and P=.021, respectively). Statistically significant and mid-level relationship was found between LH and smell identification score in the azoospermia group (r=0.458; P=.016).

Conclusion: The sinonasal functions of the azoospermia group followed up with the diagnosis of infertility were negatively affected. Since there was a statistically significant relationship between LH and sinonasal function and the number of studies carried out on male sex hormones in literature is limited, more comprehensive studies are needed.

Cite this article as: Yıldırım D, Eyigör H, Yıldız M, Selçuk ÖT, Arslan İ, Uysal A. Subtle olfactory impairment in azoospermia: investigating the association with male hormones. B-ENT. 2026;21(3):122-128.