29 May 2024 |

Vaginal Odour Treatment and Good Hygiene

The vagina secretes mucus/fluid naturally and occurs normally during daily activities depending on lifestyle and overall health. For example, vaginal odour changes during the menstrual cycle and is noticeably more pronounced mid-cycle and after a workout or sexual intercourse.

A strong unpleasant fishy odour continuing for days is a symptom of a common infection.  It usually presents with itching, burning or a greyish-white or yellow discharge.

What causes vaginal odour?

A collection of live bacteria, which are the normal flora of the vagina, maintain a delicate balance of acidity or pH level in a healthy vagina. The correct pH prevents infections and any unpleasant odour may indicate a problem.  An imbalance in the vaginal flora or pH may be the cause of a musty, unpleasant, or a fishy odour.

Normal vaginal odours

Vaginal odours do change and short-term shifts in the pH level are not a matter of concern.

For example:

• A vaginal odour smelling slightly sour might indicate that the pH level in your vaginal flora is slightly more acidic in nature. This smell is related to good bacteria: lactobacilli, in your vagina. Some people describe the odour as yeastye. similar to sourdough bread.

• A bittersweet smell or slightly sweet like gingerbread or molasses is a sign that your pH levels have changed.

• Your vaginal discharge might smell metallic, like copper pennies, during menstruation as blood cells contain

• A slight smell of ammonia might indicate a urine infection or that you are

• A smell similar to body odour might indicate that you are stressed and your sweat glands are working extra hard.

A temporary vaginal smell is common and generally resolves by itself. Odours are somewhat related to hormonal changes.

Experiencing an unpleasant odour which does not go away may indicate an underlying infection and seeking medical support and help is needed.

Abnormal vaginal smell

When there is an imbalance in the bacterial levels of the vagina, it usually points towards an infection and/or inflammation: a condition known as Vaginitis which causes unpleasant vaginal odours and an unusual vaginal discharge.

The common causes of unpleasant vaginal odour include:

• Bacterial Vaginosis: BV is an infection which occurs due to an imbalance in the vagina’s flora. The bacterial vaginosis is responsible for the fishy smell and becomes stronger after sexual intercourse with a greyish-white or yellow

• Trichomoniasis: It is a sexually transmitted parasitic infection. Trichomoniasis may have little to no symptoms (asymptomatic) but you may, in its earliest stages, experience a musty or fishy odour followed by a greenish-yellow discharge.

• Candida or Thrush: Is common, uncomfortable, and very irritating. Your doctor should be informed if you are pregnant, under 16 or over 60.  Have repeated thrush infections, smelly blood-stained vaginal discharge, blisters or sores in the vaginal area, feel sick, have diarrhoea or a fever and also have a sexually transmitted infection yourself or your partner .

• Chlamydia: If you are infected with chlamydia, it is essential that you start treatment as soon as possible even if you do not have any symptoms. R

The reasons for this include:

1. That the infection may spread and result in serious complications which can be months or years after you were first infected.
2. You can pass the infection to your sexual partner(s) even if you do not have symptoms and after treatment and be reinfected yourself so it is important for you both to receive treatment.

Vaginal odour may be a symptom of,  but rare:

• Rectovaginal fistula: It is a rare condition usually as a result of a surgical procedure to the bowel and an opening between the vagina and the rectum enables faeces to leak into the vagina. This results in a strong smelling

Other vaginal infections include: - eg, candida, trichomoniasis, chlamydia, gonorrhoea and genital herpes simplex and benign causes of vaginal discharge - eg, physiological discharge, chemical irritants, foreign body, pregnancy, cervical ectropion.

• Tumours of the vulva, vagina, cervix, or endometrium

• Cervical cancer: Symptoms include a strong smelling discharge. Around 30% of cervical cancers are detected through cervical screening in the UK. Cervical cancer is more common in younger women. Teenage girls and boys are offered the HPV vaccine to protect against the most common forms of HPV causing cervical and many other forms of cancer.

• Vaginal cancer: Symptoms include a heavy vaginal discharge with a strong odour. Vaginal cancer is very rare - and mostly in women over sixty - but needs treatment as quickly as possible.

The symptoms include:

1. A vaginal discharge that smells or may be bloodstained.
2. Unexpected bleeding - eg, between periods, after menopause or after sex.
3. Vaginal pain during sexual intercourse.
4. A vaginal lump or growth that you or your doctor can feel.
5. A vaginal itch that won't go away and pain when urinating.
6. Persistent pelvic and vaginal pain.

• Postmenopausal vaginal discharge due to atrophic vaginitis.

• Vaginal discharge after gynaecological surgery.

If for any reason you forget or are unable to remove a tampon for longer than normal this may also cause an odour.  Once removed, however, the smell will be gone.

What causes vaginal odour at the time of pregnancy?

During pregnancy your body goes through a host of changes, not all of them are favorable. An imbalance of bacteria in the vagina can cause a common infection: Bacterial Vaginosis. Although not normally dangerous, it has been linked to pregnancy complications.

Postpartum vaginal odour is also common. When the uterus returns to its pre-pregnancy state, it produces mucus, blood and other debris known as lochia for the first 3-4 days. It is similar to your period blood and has a metallic musty odour.

How to diagnose unusual vaginal odour

To help diagnose the cause of vaginitis, a sample of your discharge will be taken for laboratory analysis. The most common causes of unusual vaginal odour are Gardnerella vaginalis, Mycoplasma hominis, Prevotella spp., and Mobiluncus spp. amongst others identified causing a fishy smell. They replace lactobacilli, which are the dominant bacteria present in the normal vagina.

The doctor will carry out certain procedures to assist in a diagnosis.

• Check your vaginal pH
• Check your medical history and ask about your symptoms
• May conduct a vaginal examination
• Send a sample of vaginal fluid to the laboratory for testing

How to treat vaginal odour

Unusual vaginal odour will resolve without treatment most of the time. If, however, the smell and symptoms continue for a week or more and do not improve then a course of antibiotics would be the next course of action to treat an underlying infection and eliminate unwanted vaginal odour. It is usually in the form of a cream or pill depending on the infection. 

The doctor will prescribe the antibiotics relevant to the resulting laboratory tests.  Common antibiotics prescribed for infections in the vagina/cervix are:

• Clindamycin (Cleocin®).
• Metronidazole (Flagyl®).
• Tinidazole (Tindamax®).

However some bacteria have built resistance to these antibiotics therefore it is very important to follow the guidelines given to you by your doctor who may have to prescribe an alternative antibacterial if the strain has become resistant and may warrant two or three trips to the doctor.

How you can prevent vaginal odour

It is important to practice healthy habits: regularly check your vulva for signs and symptoms of an infection, including smelly or thick white-greyish/yellow or thin discharge and practice safe sex.  (Be aware of sexually transmitted infections and their symptoms.  (Some are asymptomatic so regularly get tested if you have multiple partners.) 

• Practice good hygiene habits: If you shower daily use mild or unscented soap with warm water to clean yourself. (Warm and wet environments encourage harmful bacteria to multiply.)
• Wear breathable and light clothing: It is better to avoid clothes that are very tight. Try wearing cotton underwear that is recommended as it does not retain moisture and heat.
• Avoid douching: Douching may unbalance your pH levels in the vagina and make you vulnerable to a number of infections. Douching might even force the bacteria deeper into your body and lead to severe infection: i.e. pelvic inflammatory disease or PID which can result in infertility.
• Protecting your vagina during sexual intercourse: Ask your partner to wear a condom to lessen the risk of sexually transmitted infections or STIs and other infections like BV and unwanted pregnancies. (This might cause a slight disruption to your pH levels of your vagina but nothing too major). If you use a lubricant, choose unflavored/unscented ones to avoid vaginal irritation.
• Drink plenty of water: You might experience a strong vaginal ammonia smell. This may indicate that you are not properly hydrated. Not drinking enough water leads to a concentrated and smelly brown/dark yellow urine with a resulting foul-smell and may be the cause of a vaginal/urine infection. Water helps to allow the smooth movement of waste products from the body and gets rid of unwanted Maintaining adequate hydration is important for your whole body.

When to seek for help from your doctor for abnormal vaginal odour

If you are experiencing an extended unusual vaginal odour and/or discharge, itching and burning, you need to visit a doctor. Untreated vaginal infections can spread to the fallopian tubes and/or uterus. Vaginitis can also increase your risk of contracting an STI (sexually transmitted infection).

It is important to seek medical care if you are pregnant and have an unusual vaginal odour as you may have a vaginal infection.  Pregnant women with vaginitis are at greater risk of low birth weight, amniotic fluid infection, preterm birth and other complications.

How do I stop smelling down there?

Eliminating the smell starts by knowing the exact cause of the odour. This odour might be fleeting, a change in smell related to your menstrual cycle, stress levels, etc. In such cases, you need do nothing or undergo any treatment in others you may need treatment,

Certain changes in your lifestyle are related to maintaining the natural pH of your vagina. It might be somewhat tricky when the problem is related to poor hygiene.

Many women are conscious that their vagina smells bad or worry if it has any scent. But healthy vaginas are meant to have a slight odour. Think of your vaginal scent as an indication that the vaginal flora is functioning as it should by keeping your vagina free from infection.

Unpleasant vaginal odour together with other symptoms may be an indication that  a visit to your doctor is warranted. Taking a course of antibiotics usually solves the issue and all it takes to eliminate the odour and return your vagina to its natural normal state so don’t be unduly worried.