Strong Vaginal Odour

What is abnormal vaginal odour?

Naturally, all vaginas have scents. The odours emitted typically tell more about a person’s lifestyle, daily activities, and general health. These vaginal odours tend to fluctuate during the menstrual cycle, and the discharge smell is more pungent at mid-cycle. In addition, after sexual intercourse or exercise, the scent may become noticeable. However, it’s important to note that everybody’s vaginal scent is unique and totally normal.

On the contrary, an unfamiliar, strong, and foul scent, particularly one that smells like fish and lasts several days, is not normal. This smelly odour may indicate a health issue, particularly if accompanied by symptoms such as itching, greyish-white discharge, and burning.

Possible Causes

What causes vaginal odour?

The pH level or the acidity of the vagina usually influences vaginal odours. The vagina hosts a number of bacteria, making up what is referred to as the vaginal flora. These bacteria live in a delicate harmony to maintain the correct pH or acidity level. A healthy pH protects the vagina against infections causing unpleasant odours. However, an imbalance in the vaginal flora can result in a musty, fishy, or generally foul smell.

Normal vaginal odours

Most vaginal scents signify temporary changes in the pH levels and usually don’t cause any problems. For instance:

• A slightly tangy or sour smell may indicate that the pH level in the vaginal flora is a bit more acidic than usual. This smell is linked to lactobacilli, the good bacteria in the vagina. Sometimes, this odour is described as yeasty, like sourdough bread.
• A somewhat sweet or bittersweet scent, similar to molasses or gingerbread, might also indicate a change in pH levels.
• During menstruation, vaginal discharge might have a metallic smell, similar to copper pennies, because of the iron content in period blood.
• An ammonia-like vaginal smell may signify urine residue on the genitals (vulva) or dehydration.
• A vaginal smell similar to a skunk or body odour could be a sign of stress, causing the sweat glands to work overtime.

Short-term vaginal scent is common and normally resolves alone. These odours might be connected to hormonal variations or sometimes diet. For instance, consuming foods that have strong smells, such as fish or garlic, can alter vaginal odour.

On the other hand, a persistent unpleasant scent may indicate an underlying health problem that necessitates medical care.

Abnormal vaginal odours

When there is an imbalance in the levels of vaginal bacteria, inflammation and infection might occur, a condition known as vaginitis. Common forms of vaginitis producing unpleasant odours also cause symptoms such as abnormal vaginal discharge.

These are the common reasons for foul vaginal odour:

• Bacterial vaginosis (BV): This infection results from an imbalance in the vaginal flora. It is the reason behind a fish-like scent that is mostly linked to unpleasant vaginal odours. The smell can be stronger after having intercourse. Gray or greyish-white vaginal discharge is another prevalent sign to watch out for.
• Trichomoniasis: This sexually transmitted infection (STI) results from a parasite. While it is not always accompanied by symptoms, it can lead to a fishy smell, just like BV, or a musty odour. Greenish-yellow discharge is another common indicator of trichomoniasis.

In rare cases, vaginal odour could be a sign of conditions such as:

• Rectovaginal fistula: In this rare condition, an opening occurs between the vagina and rectum, allowing leakage of faecal matter into the vagina. This leads to an unpleasant-smelling discharge.
• Vaginal cancer: This can result in heavy vaginal discharge accompanied by a strong smell.
• Cervical cancer: This may be associated with a strong, foul-smelling discharge.

In addition, forgetting to remove a tampon can lead to a smell similar to rotten meat. This smell will, however, fade as soon as you or a doctor removes it.

What causes vaginal odour during pregnancy?

The common reason for bad vaginal odours during pregnancy is vaginitis. However, other factors can also contribute to new scents. Most individuals report an increased sense of smell in pregnancy. Moreover, pregnancy cravings might lead one to consume different foods, which can affect the vaginal scent. Shifting pregnancy hormonal levels such as progesterone, oestrogen, and prolactin, along with raised blood supply to the vagina, can also alter pH levels and trigger new smells.

Postpartum vaginal smell is also common. The uterus releases lochia, or pregnancy-related debris that includes blood and mucus, as it reverts to its pre-pregnancy form. Lochia smells like menstrual blood—stale, metallic, musty.

Care and treatment

To prevent foul vaginal odours resulting from infection, adopt habits that maintain balanced bacterial levels in the vagina.

Diagnosis

How is abnormal vaginal odour diagnosed?

To diagnose the cause of vaginitis, the doctor will ask for a sample of the discharge. The prevalent contributing factor of unusual vaginal odor is heightened Gardnerella vaginalis bacteria levels, responsible for the fishy smell linked to BV. The diagnostic process may also include:

• Taking a medical history and asking about your symptoms.
• Performing a vaginal examination.
• Checking the vaginal pH.

Treatment

How is vaginal odour treated?

Abnormal vaginal smell often resolves without any treatment about one-third of the time. But if the odour doesn’t disappear, the doctor may recommend antibiotics to address the underlying problem and eliminate the foul scent. These antibiotics can be administered in the form of pills or creams.

Commonly prescribed antibiotics for treating infections causing bad vaginal smells are:

• Clindamycin
• Tinidazole
• Metronidazole

Prevention

How can vaginal odour be prevented?

Practicing healthy habits can help keep the vulva clean while protecting the vagina from infections. It’s thus important to consider these measures:

• Maintaining good hygiene: Regularly shower and clean the vulva only using mild, unscented soap and warm water. You should also bathe and wear clean clothes immediately after working out to avoid sitting in a hot, sweaty outfit or a damp swimsuit for too long. This is because wet and warm settings promote the growth of dangerous bacteria.
• Avoid douching: Douching can disrupt your vagina’s pH levels, making you more susceptible to infections. For a person who has a vaginal infection, douching can push bacteria further into the body; hence causing serious infections such as pelvic inflammatory disease (PID), which can lead to infertility.
• Wear light, breathable clothing: Do not wear tight clothing, especially around the vulva, such as thongs. Instead, wear cotton underclothes that don’t retain heat and moisture.
• Drink plenty of water: Dehydration can result in a strong ammonia odor in the vagina. The waste material present in urine can be concentrated and have an unpleasant smell if there isn’t enough water in the body. Therefore, water keeps you hydrated and prevents bad scents.
• Protect the vagina and vaginal flora during intercourse: Wearing a condom to minimize the risk of STIs and infections such as BV can upset the vaginal pH levels. Also, it’s important to use only unflavoured and unscented lubricants to avoid vaginal irritation.

When to Call the Doctor

When should I seek treatment for unusual vaginal odour?

If you experience persistent unusual vaginal odour or smell that comes with discharge, itching, and burning, it’s essential to seek medical care. Vaginitis that is left untreated can cause infections that extend to the uterus or fallopian tubes and increase the possibility of getting STIs.

Pregnant individuals with vaginitis or vaginal odour are at a greater risk of complications such as low birth weight, preterm birth, amniotic fluid infection, and others. It is vital to see a doctor if you are expectant.

Additional Common Questions

How do I stop smelling down there?

Getting rid of the vaginal smell starts with identifying the cause. If the odour is fleeting and related to stress levels or menstrual cycle, treatment may not be necessary. Simple lifestyle modifications to maintain the natural pH of the vagina can help if the problem is associated with hygiene. If vaginitis is responsible, the doctor can suggest medicines to clear the infection.

Why do I have a pungent Odour down there?

A strong vaginal odour might indicate vaginitis or is temporarily connected with lifestyle and hygiene. Therefore, it’s essential to take note if there are additional symptoms. When the smell is due to an infection, you will likely notice some changes, such as vaginal itching, discharge, and burning.

What does BV smell like?

BV has a unique fishy odour and is commonly associated with foul vaginal smell.

A Note from MD.co.uk

Most individuals are often self-conscious about their vaginal odour or concerned if it produces any smell. However, a slight scent is normal for all healthy vaginas as this indicates that your vaginal flora is working properly, keeping your vagina free from infections.

On the other hand, if you experience a foul odour along with other symptoms, you should consult a practitioner. Typically, a course of antibiotics can eliminate the unpleasant smell and restore the vagina’s natural scent.