Vaginal odor is a topic many find uncomfortable to discuss, yet it’s a common experience for women of all ages. Understanding your body and what’s normal for you is crucial in identifying when a smell is simply a part of your body’s natural processes and when it might signal a need for medical attention. It’s important to remember that a slight vaginal odor is perfectly normal. However, if you’ve noticed a distinct or unpleasant change in how you smell “down there”, you’re likely wondering, “Why Does My Discharge Smell?”.
It’s reassuring to know that the vagina is a self-cleaning organ, maintaining a delicate balance of bacteria to keep healthy. This natural bacterial flora is the reason why vaginal discharge, including cervical mucus, naturally has a scent. Dr. Elisabeth 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.” Furthermore, hormonal fluctuations throughout your menstrual cycle can cause shifts in the vaginal pH balance, which can also influence odor.
But what exactly is considered a “normal” vaginal smell, and when should you be concerned about a change? Let’s delve into the common causes of vaginal odor, helping you understand when that smell is a sign to seek medical advice.
What is Normal Vaginal Odor?
A healthy vagina has a natural scent, and it’s not meant to be odorless. According to Dr. Rosén, normal vaginal odor typically falls within a range of slightly tangy or sour to even a metallic scent, particularly around or after menstruation. This is due to the lactic acid produced by the healthy bacteria in the vagina, similar to the smell of fermented foods like yogurt. The metallic smell, often noticeable during or after your period, is simply due to the presence of blood.
It’s vital to establish what is normal for your body. Pay attention to your baseline scent when you are healthy and symptom-free. If your vaginal odor is generally consistent and you aren’t experiencing any other unusual symptoms, it’s likely within the normal range. “Generally, if you’re feeling well and your vaginal odour or discharge isn’t unusual for you, there’s no reason to worry,” Dr. Rosén reassures.
When is Vaginal Odor a Cause for Concern?
While a mild vaginal odor is normal, a strong, unpleasant, or significantly different smell, especially when accompanied by other symptoms, could indicate an underlying issue. Changes in odor that are concerning often include:
- A strong fishy smell: This is commonly associated with bacterial vaginosis.
- A yeasty or bread-like smell: Though less common, a pronounced yeasty smell alongside other symptoms might suggest a yeast infection.
- A foul or rotten smell: This could be a sign of a forgotten tampon or, in rare cases, a more serious infection.
- An ammonia-like smell: This might point to urinary issues or a urinary tract infection.
- A metallic and sickly smell: In very rare instances, this could be associated with more serious conditions like gynecological cancers.
It’s crucial to consider associated symptoms alongside the odor itself. Symptoms that warrant medical attention along with a change in vaginal odor include:
- Unusual vaginal discharge (change in color, consistency, or amount)
- Itching, burning, or irritation in the vaginal area
- Pain during urination or intercourse
- Pelvic pain or discomfort
- Unexplained bleeding
If you experience a noticeable change in vaginal odor that is concerning to you, or if it’s accompanied by any of these symptoms, it’s always best to consult a healthcare professional to determine the cause and receive appropriate treatment.
Common Causes of Smelly Discharge
Let’s explore some of the most common reasons behind changes in vaginal odor.
1. Bacterial Vaginosis (BV)
Vaginal odor: Fishy
Bacterial vaginosis (BV) is a very common condition and a leading cause of smelly vaginal discharge, affecting a significant portion of women of reproductive age. Dr. Rosén describes BV as “a condition where there’s an imbalance in the vaginal flora.” In a healthy vagina, lactobacilli bacteria are dominant, maintaining an acidic environment that prevents the overgrowth of other bacteria. BV occurs when there’s an overgrowth of other types of bacteria, disrupting this balance.
The hallmark symptom of BV is a distinct fishy vaginal odor. This odor may be more noticeable after intercourse or menstruation. Other symptoms can include an abnormal vaginal discharge that is often described as thin, frothy, and greyish-white or greenish. Itching and vaginal irritation can also occur.
If you suspect you have BV, it’s important to see a doctor. While sometimes BV can clear up on its own, often treatment is needed to restore the vaginal bacterial balance. Treatment options include antibiotics, usually in the form of vaginal creams or oral pills. Recurrence of BV is unfortunately common. Some research suggests that probiotics might be helpful in preventing recurrence. Dr. Rosén also suggests considering your contraceptive method, particularly if you use an intrauterine device (IUD), as it may play a role in recurrent BV for some individuals.
It’s also worth noting that sexual partners can sometimes contribute to BV recurrence. While BV is not considered an STI, discussing hygiene practices with your partner and using condoms (internal or external) might be beneficial. In some cases, male partners may also require antibiotic treatment if they are contributing to recurrent infections. If you are pregnant and experience symptoms of BV, seeking medical attention is especially important due to the increased risk of premature labor associated with untreated BV.
2. Trichomoniasis
Vaginal odor: Pungent and Fishy, Similar to BV
Trichomoniasis, often called “trich,” is a sexually transmitted infection (STI) caused by a parasite. It is the most common non-viral STI worldwide. Dr. Rosén points out that trichomoniasis “typically doesn’t cause a lot of symptoms” in many people. However, when symptoms do occur, smelly vaginal discharge is a common one.
The vaginal odor associated with trichomoniasis is often described as pungent and fishy, similar to BV, but it can also be foul-smelling. The discharge is typically frothy and can be yellow-green in color. Other symptoms may include vaginal itching, redness, and irritation, as well as pain during urination or intercourse.
Trichomoniasis is easily treated with antibiotics. It’s crucial to get tested and treated if you suspect you have trichomoniasis, and it’s also important to inform your sexual partner(s) so they can get tested and treated to prevent reinfection and further spread of the STI.
3. Toxic Shock Syndrome (TSS)
Vaginal odor: Very Unpleasant, but Odor is Generally a Minor Symptom
Toxic Shock Syndrome (TSS) is a rare but serious condition caused by toxins produced by bacteria, often Staphylococcus aureus. While historically linked to high-absorbency tampons, TSS can occur in anyone and is not solely related to tampon use.
While a very unpleasant vaginal odor may be present in TSS, it’s usually a minor symptom compared to the more severe systemic effects. Dr. Rosén explains the rapid onset and severity of TSS: “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.”
TSS is a medical emergency. If you experience these symptoms, especially in conjunction with tampon use or after surgery or skin wounds, seek immediate medical attention at the nearest emergency room. Prompt treatment with antibiotics and supportive care is crucial. While TSS is rare today due to changes in tampon manufacturing and increased awareness, it’s still important to be aware of the symptoms.
4. A Tampon You’ve Forgotten to Remove
Vaginal odor: Very Unpleasant
Perhaps surprisingly common, a forgotten tampon is a frequent cause of a sudden and very unpleasant vaginal odor. Dr. Rosén shares, “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.”
When a tampon is left in the vagina for too long, it can become a breeding ground for bacteria, leading to a strong, foul, and often rotten-smelling odor. The odor will typically worsen rapidly and become very noticeable. Besides the smell, you might also experience vaginal discharge, irritation, or even spotting.
If you suspect you might have forgotten a tampon, gently check inside your vagina. If you can feel it, try to remove it yourself. If you have difficulty removing it, or if you are concerned about infection, see a doctor. Once removed, the odor should gradually disappear. It’s important to be mindful of tampon usage and change them regularly, typically every 4-8 hours, and always remove the last tampon at the end of your period.
5. Vaginal Thrush (Yeast Infection)
Vaginal odor: Yeasty
Vaginal yeast infections, also known as thrush or candidiasis, are very common fungal infections. They are usually caused by an overgrowth of Candida yeast, which is naturally present in the vagina. While the primary symptoms of thrush are intense vaginal itching and burning, changes in vaginal discharge are also typical.
The discharge associated with thrush is often described as thick, white, and curd-like, resembling cottage cheese. While thrush is more known for its itching and discharge, it can sometimes cause a mild odor. This odor is often described as yeasty, similar to the smell of bread or beer. However, the odor from thrush is typically not very strong or offensive.
Dr. Rosén advises, “If your thrush symptoms are so pronounced that there’s a bad smell, you should see a doctor to rule out any underlying conditions.” A strong or foul odor is not typical of thrush alone and might indicate a mixed infection or another condition. Over-the-counter antifungal creams or suppositories are usually effective in treating uncomplicated yeast infections. However, if you are unsure if you have thrush, or if your symptoms are severe or don’t improve with over-the-counter treatment, it’s best to consult a doctor.
6. Hormonal Changes
Vaginal odor: Individual
Hormonal fluctuations throughout a woman’s life can impact vaginal discharge and odor. Just as the menstrual cycle influences vaginal scent, other hormonal shifts, such as those during menopause and pregnancy, can also lead to changes.
During perimenopause and post-menopause, declining estrogen levels can lead to vaginal dryness and changes in the vaginal flora, which can alter vaginal odor. Similarly, pregnancy brings about significant hormonal changes that can affect cervical mucus. Dr. Rosén explains, “Pregnancy changes the cervical mucus, too. ‘You may have more discharge, or sometimes it’s thicker or thinner, but it shouldn’t be smelly.” While pregnancy can increase the amount of discharge, it should not typically cause a foul odor.
If you are pregnant and experience a foul-smelling discharge, it’s important to contact your doctor or midwife promptly, as it could indicate an infection that needs treatment to protect both your health and the pregnancy.
7. UTIs and Other Urinary Issues
Vaginal odor: Ammonia
If you notice an ammonia-like vaginal odor, it’s possible that urine is involved. This can occur with urinary tract infections (UTIs). Dr. Rosén explains, “This is more likely if a UTI is left untreated and you might be leaking… An infection that’s left untreated will also cause a fever, and the smell will be quite distinct and sickly.” In a UTI, bacteria can contaminate the urine, and if there’s any leakage, it can cause an ammonia-like smell in the vaginal area. Other UTI symptoms include burning during urination, frequent urination, and pelvic pain.
Sometimes, an ammonia smell can also indicate urinary incontinence, even if you’re not aware of leaking urine. Dr. Rosén states, “Occasionally, an ammonia-like smell can be a sign of an existing incontinence issue that you’re unaware of… These issues are very common.” Urinary incontinence is more common than many realize, and a doctor or gynecologist can provide advice and treatment options to manage incontinence and related odors.
8. Gynecological Cancers
Vaginal odor: Metallic and Sickly
In very rare cases, a foul-smelling vaginal discharge can be a symptom of gynecological cancers, such as cervical or uterine cancer. However, it’s crucial to emphasize that vaginal odor and discharge are unlikely to be the only or first symptoms of these cancers.
Dr. Rosén describes the odor in these rare cases as “a little metallic” and “sickly,” and different from the fishy or rotten smells of infections or forgotten tampons. More commonly, women with gynecological cancers might experience abnormal vaginal bleeding, such as bleeding after intercourse or between periods. Spotting that becomes more regular is also a warning sign.
It is vital to remember that unusual vaginal bleeding should always be evaluated by a doctor. While smelly discharge alone is rarely indicative of cancer, if it is accompanied by abnormal bleeding, pelvic pain, or unexplained weight loss, it’s essential to seek prompt medical attention to rule out any serious conditions.
Can STIs Cause Vaginal Odor?
While some STIs like trichomoniasis are known to cause vaginal odor, other common STIs such as chlamydia and gonorrhea typically do not directly cause a significant change in vaginal odor. Dr. Rosén clarifies, “STIs like chlamydia and gonorrhoea rarely change the smell of the cervical mucus but can cause other symptoms like pain when peeing.”
However, it’s important to note that having an STI can sometimes increase your risk of developing bacterial vaginosis. So, if you notice a new vaginal odor and are concerned about STIs, it’s always best to get tested to rule out any infections and receive appropriate treatment. “If in doubt, talk to a doctor for advice,” Dr. Rosén recommends.
How to Manage Vaginal Odor
Many women concerned about vaginal odor wonder about the best hygiene practices. While it’s natural to want to feel clean and fresh, harsh soaps and douches can actually disrupt the natural vaginal balance and potentially worsen odor problems.
Dr. Rosén advises against using soaps internally or douching. “Like any part of the body that gets sweaty, the area around the vulva can get smelly… But soaps can disturb the natural balance of the vaginal bacterial flora and possibly increase the risk of bacterial vaginosis. Douching – a method of washing out or rinsing the vagina – can do the same.”
The recommended approach to vaginal hygiene is gentle cleansing of the vulva (the external genital area) with plain water during your daily shower or bath. Avoid using perfumed soaps, washes, wipes, or feminine hygiene sprays in or around the vagina, as these can be irritating and disrupt the natural flora. Similarly, opt for unscented sanitary pads and tampons.
For vaginal dryness, especially due to breastfeeding, menopause, or after infections, vaginal moisturizers can be helpful. However, choose unscented, water-based moisturizers and avoid products with perfumes or added chemicals.
Home remedies for vaginal odor, such as dietary changes like eating pineapple or drinking pineapple juice, are often suggested online. However, there is limited scientific evidence to support their effectiveness, and they are unlikely to address the underlying cause of abnormal vaginal odor.
When Should I Speak to a Doctor About Vaginal Odor?
Recognizing when vaginal odor is abnormal for you is key. If you notice a significant change in odor that is persistent, strong, or unpleasant, or if it is accompanied by other symptoms like unusual discharge, itching, burning, or pain, it’s important to seek medical advice.
Starting with gentle hygiene practices, like washing with water only and avoiding perfumed products, is a good first step. However, if the odor persists or worsens, or if you have any concerning symptoms, don’t hesitate to speak to a doctor.
A healthcare professional can properly diagnose the cause of your smelly discharge and recommend the appropriate treatment. Early diagnosis and treatment are essential for managing conditions like BV, trichomoniasis, UTIs, and other potential causes of abnormal vaginal odor, ensuring your vaginal health and overall well-being.
This article has been medically approved by Dr. Elisabeth Rosén, a medical doctor at Livi specializing in gynecology and obstetrics.
