Q: Over the last 4 months, I have had this strong odour coming from my vagina. I often wonder if others can smell it. I have not had sex in over a year. What can you recommend?

A normal vagina is not odourless. Within a healthy vagina, billions of good bacteria thrive. The bacterial balance can change from moment to moment. Such changes directly impact the odour emanating from the vagina at any given time. The prevailing odour is most noticeable after penetrative vaginal intercourse.

Normal odours from vaginas have been described as:

• Mildly fishy
• Sweet/ Molasses like
• Tangy
• Metallic/ Coppery
• Chemical – e.g. ammonia or bleach
• Musty, sweaty, smoky, herbal, and earthy.

Abnormal odours from the vagina:

• Although yeast infections are not usually associated with an odour, some report a beer-smelling scent.
• A very strong fishy smell is associated with trichomoniasis or bacterial vaginosis.
• Rotten smell is often associated with a retained tampon, and cancer – cervical and vaginal.

Factors influencing the normal vagina’s odour include:

• Diet
• Activity/ Exercise
• Hormonal fluctuations and changes – including pregnancy and menopause
• Menstruation
• Prevailing vaginal bacterial flora
• Sweating.

The more common causes of abnormal vaginal odours include:

• Sperm – The alkaline sperm alters the acidic pH of the vagina and can impact the bacterial makeup.
• Bacterial vaginosis – This occurs when there is an overgrowth of the bacteria normally found in the vagina.
• Trichomoniasis – an STD
• Yeast infection
• Suboptimal vaginal hygiene
• Allergy to condoms
• Douching
• Type of underwear worn
• A retained tampon.

The less common causes of abnormal vaginal odours include:

• Cancer – Cervical, vaginal.
• A fistula connecting the rectum and the vagina.

A woman should see a doctor for a vaginal odour if:

• Odour is persistent- Up to ⅓ go away without treatment.
• Itching, burning, irritation, rash, or pain (especially during sex) is/ are also present.
• Swelling of the vaginal lips or lymph nodes in the groin observed.
• Sores or blisters are noted in the vaginal area.
• Lower abdominal/ pelvic pain felt.
• There is burning on urination.
• Pregnant.
• Abnormal vaginal bleeding seen.
• Abnormal vaginal discharge noticed.
• PAP smear has been abnormal in the past.
• No PAP smear has been done in the previous 2-3 years.
• One suspects that their partner has another sexual partner.
• Diagnosing the cause of an abnormal vaginal odour

Your healthcare provider will:

• Take a relevant history.
• Perform a vaginal examination.
• May take a swab and send it to the lab for further analysis.
• Preventing abnormal vaginal odours

In order to reduce the chances of abnormal vaginal odours it is recommended that women:

• Bathe a minimum of once per day. The vulva (external area) should be washed with a mild soap that has a neutral pH.
• The vagina is a self-cleaning organ. Washing within, even with water, can drastically disrupt its pH, predisposing to the development of bacterial vaginosis.
• Cotton underwear should be worn. Avoid wearing pantyhose.
• Stay well hydrated.
• Eat a healthy and balanced diet.
• Avoid douching.
• Avoid using perfumed products or antibacterial soaps in the area.
• Change out of wet swimsuits and sweaty gym clothes or underwear ASAP.

Author’s Contact Information: Dr. C. Malcolm Grant, Family Care Clinic, Arnos Vale, clinic@familycaresvg.com, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp)
Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnosis, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided