Vaginal odor is a normal bodily function, yet it’s a topic many feel uneasy discussing. Understanding your body and what constitutes ‘normal’ for you is crucial in recognizing when a smell might indicate a need for medical attention. This guide will delve into the common causes of vaginal odor, helping you discern between typical scents and those that warrant a visit to the doctor.
The vagina is a self-cleaning organ, maintaining a delicate balance of bacteria known as vaginal flora. This natural ecosystem is essential for vaginal health, and it’s the reason why cervical mucus, naturally present in the vagina, has a scent. Dr. Rosén, a specialist in gynecology and obstetrics, explains, “The vagina has a natural bacterial flora that’s there to keep a good balance… It’s because of this natural bacteria that the cervical mucus in the vagina always has a smell.” This scent can also fluctuate throughout your menstrual cycle due to shifts in vaginal pH balance.
So, what is considered a normal vaginal odor? Typically, it can range from slightly tangy or sour to a metallic scent, especially around or after menstruation. Dr. Rosén reassures, “Generally, if you’re feeling well and your vaginal odour or discharge isn’t unusual for you, there’s no reason to worry.” However, changes in odor, particularly if accompanied by other symptoms, should be noted.
It’s important to differentiate between normal and abnormal vaginal smells. While a mild, musky, or metallic scent is usually nothing to be concerned about, a strong, foul, or fishy smell could indicate an underlying issue. Let’s explore eight common reasons why your coochie might smell and when it’s time to consult a healthcare professional.
8 Common Causes of Vaginal Odor: When to Talk to a Doctor
1. Bacterial Vaginosis (BV)
Vaginal Odor: Fishy
Bacterial vaginosis (BV) stands as one of the most prevalent causes of a smelly vagina, affecting a significant portion of women of reproductive age, ranging from 15% to 50%. Dr. Rosén describes BV as “a condition where there’s an imbalance in the vaginal flora.” The hallmark symptom is often a distinctly fishy odor, which may be accompanied by a frothy, greyish-white or greenish discharge. You might also experience itching and swelling in the vaginal area.
If BV symptoms don’t resolve on their own, various treatment options are available. “A doctor can prescribe you a course of antiseptics or antibiotics,” Dr. Rosén advises. Unfortunately, BV recurrence after antibiotic treatment is common. Some studies suggest that probiotics might be beneficial in preventing recurrence. Dr. Rosén also suggests considering changes in contraception, especially if using an intrauterine device (IUD).
Dr. Rosén also points out the potential role of sexual partners in BV infections. Discussing personal hygiene with your partner and using condoms (internal or external) for a period may be beneficial. In some cases, your partner might also require a course of antibiotics.
“If you’re having these symptoms, you should see a doctor to rule out any underlying conditions that may need treatment,” emphasizes Dr. Rosén. This is particularly crucial for pregnant individuals, as BV can increase the risk of premature labor.
2. Trichomoniasis
Vaginal Odor: Pungent and Fishy, Similar to BV
Trichomoniasis, or “trich,” is recognized as the most common non-viral sexually transmitted infection (STI) globally. Dr. Rosén explains, “It’s a parasitic disease that typically doesn’t cause a lot of symptoms.” However, some individuals may experience subtle symptoms such as a yellowish-green vaginal discharge with an unpleasant, pungent, and fishy smell, similar to BV. The vulva might also become slightly red and itchy. Fortunately, trichomoniasis is usually effectively treated with a course of antibiotics.
3. Toxic Shock Syndrome (TSS)
Vaginal Odor: Very Unpleasant, but Odor is Generally a Minor Symptom
Toxic shock syndrome (TSS) is now a rare but serious illness, historically linked to the use of high-absorbency tampons. Dr. Rosén clarifies, “If this bacteria enters your system, you get very sick very quickly. You’ll get a high fever, blood pressure changes and possibly a rash and diarrhoea or vomiting, and you might feel faint.” While vaginal odor can be very unpleasant in TSS, it’s overshadowed by more severe symptoms.
“If you experience these symptoms, you should go straight to A&E. TSS cases are now very rare, though,” advises Dr. Rosén. Early recognition and treatment are critical for TSS.
4. Forgotten Tampon
Vaginal Odor: Extremely Unpleasant and Offensive
A surprisingly common cause of strong vaginal odor is a forgotten tampon. “There have been instances of people seeking help for a bad vagina smell and finding it’s caused by a tampon that’s been left in for days, sometimes longer,” Dr. Rosén shares.
“If this happens, the smell will get worse quickly and be extremely obvious and offensive – so if you’re experiencing vaginal odour that escalates, it’s always best to check,” she recommends. If you suspect a forgotten tampon, gently check the vaginal canal. Removal of the tampon should quickly resolve the odor.
5. Vaginal Yeast Infection (Thrush)
Vaginal Odor: Yeasty
Vaginal yeast infections, commonly known as thrush, are very frequent and typically cause intense itching, burning, and changes in vaginal discharge. The discharge often becomes thick, white, and clumpy, resembling cottage cheese.
While thrush is primarily known for its discharge and discomfort, it can sometimes be accompanied by a mild, yeasty odor. “If your thrush symptoms are so pronounced that there’s a bad smell, you should see a doctor to rule out any underlying conditions,” Dr. Rosén advises, as a strong odor is less typical of uncomplicated thrush.
6. Hormonal Changes
Vaginal Odor: Varies, Individual
Hormonal fluctuations throughout life can influence vaginal odor. Similar to the cyclical odor changes during the menstrual cycle, other hormonal shifts can affect the scent of cervical mucus. “During menopause and in the post-menopausal years, the smell can change,” Dr. Rosén notes, due to decreased estrogen levels.
Pregnancy also brings about hormonal changes that impact cervical mucus. “You may have more discharge, or sometimes it’s thicker or thinner, but it shouldn’t be smelly,” Dr. Rosén explains. “If you’re pregnant and have a foul-smelling discharge, you should speak to a doctor or midwife,” as this could indicate an infection.
7. Urinary Tract Infections (UTIs) and Urinary Issues
Vaginal Odor: Ammonia-like
An ammonia-like vaginal odor might signal the presence of urine, potentially linked to a urinary tract infection (UTI). “This is more likely if a UTI is left untreated and you might be leaking,” Dr. Rosén clarifies. “An infection that’s left untreated will also cause a fever, and the smell will be quite distinct and sickly.”
Occasionally, an ammonia scent can be a sign of undiagnosed incontinence. “These issues are very common. A doctor or gynaecologist can advise on treatment options,” says Dr. Rosén. Addressing UTIs and incontinence is crucial for overall health and hygiene.
8. Gynecological Cancers
Vaginal Odor: Metallic and Sickly
In rare instances, a foul-smelling discharge can be a symptom of gynecological cancers, such as cervical or uterine cancer. However, it’s important to note that odor and discharge are unlikely to be the sole or initial symptoms.
“You might have experienced bleeding during intercourse, or perhaps occasional spotting that becomes more regular. The smell will be a little metallic,” Dr. Rosén explains. “The smell is very different from the fishy or rotten smells of BV or a forgotten tampon.” Unusual bleeding should always be promptly evaluated by a doctor.
Can STIs Cause Vaginal Odor?
While some STIs like trichomoniasis are associated with odor, others like chlamydia and gonorrhea typically don’t directly cause a significant change in vaginal smell. “STIs like chlamydia and gonorrhoea rarely change the smell of the cervical mucus but can cause other symptoms like pain when peeing,” Dr. Rosén states. “If you notice a smell, it might be that you’ve also got bacterial vaginosis. If in doubt, talk to a doctor for advice,” as co-infections are possible.
How to Address Vaginal Odor
Many people concerned about vaginal odor seek solutions in washing routines and feminine hygiene products. However, maintaining vaginal health is often simpler than we think.
“Like any part of the body that gets sweaty, the area around the vulva can get smelly,” Dr. Rosén acknowledges. However, harsh soaps and douches can disrupt the natural vaginal flora balance and potentially increase the risk of BV. Douching, in particular, is not recommended as it can wash away beneficial bacteria.
The recommended approach to washing the vulva and vaginal area is simply using water. Avoid perfumed soaps, washes, sanitary pads, and vaginal deodorants, as these can be irritating and disrupt the natural vaginal environment.
“If you’re very dry as a result of breastfeeding, vaginal atrophy… or a recent infection, you can use vaginal moisturisers – but nothing with perfume,” suggests Dr. Rosén.
When to Seek Medical Advice for Vaginal Odor
Recognizing what is normal for your body is key. If you notice a significant change in vaginal odor that is unusual for you, or if the odor becomes stronger or foul-smelling, it’s important to pay attention.
Starting with simple lifestyle adjustments like gentle washing with water and avoiding scented products is advisable. While some home remedies for vaginal odor exist, such as pineapple consumption, their effectiveness is not scientifically proven and may vary.
However, if the odor persists, worsens, or is accompanied by other symptoms like unusual discharge, itching, burning, pain, or bleeding, it’s crucial to consult a doctor. Dr. Rosén emphasizes, “But if the smell seems to be getting worse or you have other symptoms too, speak to a doctor.” Prompt medical evaluation can help identify the underlying cause and ensure appropriate treatment, promoting both vaginal health and overall well-being.
This article has been medically approved by Dr. Elisabeth Rosén, a medical doctor at Livi who specializes in gynecology and obstetrics.
