From the nose to the genitals and back again

Recently, the Journal of the Royal Society of Medicine has had some interesting letters on a theory from times past – the nasogenital reflex theory – that says that the nervous system makes a direct link between the erectile tissue in the genitals and the nose.

The nose has tissue which, like the genitals, can become engorged with blood, which is part of the reason we get a stuffy nose. To counter this, most nasal decongestants contain a drug which acts as a vasoconstrictor to reduce blood flow (sometimes this is a type of amphetamine).

The possible link between nose and genital tissue was first proposed by American surgeon John McKenzie in 1883:

Over one hundred years ago, neurological reflexes emanating from the nose — termed the nasal reflex neurosis — were considered to be the cause of many symptoms, including symptoms related to the genitalia. In 1883 McKenzie, an otolaryngologist from Johns Hopkins Hospital, proposed a nasogenital reflex responsible for symptoms such as dysmenorrhea, pelvic pain, etc. and described improvements following nasal treatments.

In other words, he argued that problems with the nose could also results in problems with the genitals and vice versa.

Later, Wilhelm Fleiss, a German ear, nose and throat specialist and a close friend of Freud’s elaborated the theory, and suggested that nasal tissue could be the cause and cure of a number of illnesses in body and mind:

In 1893 Fleiss published his monograph on ‘The Nasal Reflex Neurosis’, in which he claimed that back pain, chest tightness, digestive disturbances, insomnia and ‘anxious dreams’ could all be attributed to nasal pathology. He also claimed that temporary relief of these symptoms was possible with the topical application of cocaine, of which Freud had published the first account of local anaesthetic properties.

Gradually the list of conditions grew to include migraine, vertigo, asthma and then gynaecological conditions such as dysmenorrhoea and repeated miscarriages.

Freud became quite influenced by this theory at one time, and referred a patient to Fleiss for nasal surgery to cure her depression. Sadly, surgical complications nearly cost the patient her life and Freud became disenchanted with the theory.

While it is now clear that the nose isn’t a major cause of other disturbances in the body and mind, and the nervous system has no major pathway that connects the tissues of the nose and the genitals, there are some clues that they might both be affected by similar things.

Reports of ‘viagra nosebleeds‘ and ‘honeymoon rhinitis‘ (a stuffy nose and sneezing after sex) suggest that they may react similarly in some instances.

Link to JRSM letter (not open-access yet).
Link to second JRSM letter (not open-access yet).

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