Here are four common reasons for a bad vaginal smell:
1. Bacterial Vaginosis (BV) – The Most Common Cause
Bacterial vaginosis occurs when the balance of healthy bacteria in the vagina is disrupted, allowing certain bacteria to overgrow.
Symptoms:
- Strong “fishy” odor, especially after sex
- Thin white or grey vaginal discharge
- Mild itching or burning (sometimes)
- Some women have no symptoms
Risk factors:
- Douching
- Having a new or multiple sexual partners
- Smoking
- Changes in the vaginal microbiome
Treatment:
- Prescription antibiotics such as metronidazole or clindamycin
- Avoid douching, as it can make BV worse
- Complete the full course of medication
Untreated BV can increase the risk of pelvic infections and certain pregnancy complications.
2. Poor Hygiene or Sweat Build-up
The vulva (the external genital area) contains sweat glands. Sweat, dead skin cells, urine residue, menstrual blood, and tight clothing can contribute to unpleasant odors.
Symptoms:
- Mild body odor
- No unusual discharge
- No itching or pain
Prevention:
- Wash the vulva daily with warm water
- Avoid scented soaps, sprays, or douches
- Wear breathable cotton underwear
- Change out of sweaty clothes promptly
- Change sanitary pads or tampons regularly during menstruation
Remember, the vagina cleans itself naturally. Washing inside the vagina is unnecessary and can disrupt its normal balance.
3. Vaginal Infections or Sexually Transmitted Infections (STIs)
Some infections can cause changes in odor.
Examples include:
- Yeast infection (usually little odor but significant itching and thick white discharge)
- Trichomoniasis (often causes a strong unpleasant smell, frothy yellow-green discharge, and itching)
- Other STIs may also change discharge or odor
Symptoms may include:
- Bad-smelling discharge
- Itching
- Burning during urination
- Pain during sex
- Pelvic discomfort
Treatment:
Treatment depends on the cause and may include antibiotics or antiparasitic medication. Sexual partners may also need treatment for some infections.
4. A Forgotten Tampon or Other Foreign Object
A tampon accidentally left in the vagina for several days can cause a very strong, foul odor.
Symptoms:
- Extremely unpleasant smell
- Brown, yellow, or bloody discharge
- Pelvic discomfort
- Fever (in severe cases)
Why it’s important:
A retained tampon can sometimes lead to serious infections, including Toxic shock syndrome, which requires urgent medical attention.
If you suspect a tampon has been left inside and you cannot remove it, seek medical care promptly.
When should you see a doctor?
Arrange a medical evaluation if you have:
- A strong or persistent fishy or foul odor
- Green, yellow, grey, or frothy discharge
- Vaginal itching or burning
- Pain during urination or sex
- Pelvic or lower abdominal pain
- Fever
- Bleeding that is unrelated to your period
- Symptoms that do not improve within a few days or keep recurring
Tips for maintaining vaginal health
- Wash only the external genital area with warm water or a mild, unscented cleanser.
- Avoid douching, scented sprays, and scented feminine hygiene products.
- Wear cotton underwear and avoid staying in damp clothing for long periods.
- Practice safer sex, including condom use if appropriate.
- Stay hydrated and maintain a balanced diet.
- Attend regular sexual health or gynaecological check-ups if recommended.
Key point
A mild natural vaginal scent is normal. A new, strong, fishy, rotten, or foul smell, especially when accompanied by unusual discharge, itching, pain, or fever, should be assessed by a healthcare professional so the underlying cause can be diagnosed and treated appropriately.