Your vulva and vagina are supposed to have a distinct signature aroma, which can vary from woman to woman. This is due to your own rainforest of bacteria and can be influenced by what you eat, your underwear, your hormone levels during your menstrual cycle, and more.
Sometimes the smell can get out of hand and you might need to see a doctor about it. This could be because of an infection or STI, unprotected sex, or medications you’re taking.
Vaginal Bacteria
The bacteria in your vagina normally help keep it healthy and sanitary. But when the flora gets out of balance, you may experience symptoms like bacterial vaginosis (BV). BV is an infection that’s caused by an overgrowth of “bad” bacteria called anaerobes. It’s more common during the reproductive years, when hormone changes can make it easier for certain types of bacteria to grow. It’s also more likely to occur after unprotected sex, and when you use a lubricant that contains scented chemicals.
A sour, fishy smell is the hallmark of BV, which is why people associate it with unpleasant vaginal odors. Other symptoms include watery, white or gray discharge and itchiness.
You can get a diagnosis by having your provider do a pelvic exam or swab your vulva for a sample of discharge. The sample is then analyzed under a microscope for signs of infection, including bacteria and white blood cells. The provider can also check the pH of the sample, which can indicate if you have a high level of acidity in your vagina, a sign of BV.
Another sexually transmitted infection that may cause a foul smell is trichomoniasis (Trich). It’s developed by a parasite, and it’s also associated with yellow-colored, frothy discharge and itchiness. Trich can be treated with antibiotics. Your healthcare provider can diagnose it by performing a pelvic exam or by using a swab to get a sample of a whitish discharge from your vulva.
Hygiene Issues
All vaginas have their own natural scent and it’s a perfectly normal part of being human. Your signature aroma is a combination of your unique rainforest of bacteria, what you’ve eaten for dinner, your sex life, the type of underwear you wear and where you are in your menstrual cycle. All of these factors can affect your signature smell, and a change is a sign that something’s up down there.
A sour or musty odor is common during pregnancy due to changes in hormone levels, including estrogen and progesterone. You may also experience cravings that impact what you eat, which can make your vulva smell different than usual. After pregnancy, a stale or metallic odor can occur as the uterus returns to its pre-pregnancy state, releasing blood, mucus and other debris called lochia. It’s important to talk with your doctor if this odor occurs as it can be a sign of a serious condition like pelvic inflammatory disease (PID).
Don’t use scented soaps or body washes around your vulva as these products may irritate it and cause unwanted odors. Also, avoid douching as it can change the pH of your vulva, making it an ideal breeding ground for bacteria and other infections. Instead, shower daily and use a mild, unscented soap to keep your vulva happy and healthy.
Infections
If you notice a smell that is unusual for you, it could mean your vulva’s natural pH has changed and you have an infection. If you’re not symptomatic, the odor may go away on its own as your body returns to its normal pH. If the odor is constant and severe, you’ll need to talk with your doctor, who can prescribe medications that will help get rid of the infection and restore your vagina’s normal bacterial balance.
A common infection that causes a vaginal odor like onions is a yeast infection, which is when a type of yeast called candida (CAN-duh) grows too much. Candida is normal and occurs in your mouth and intestines, but it should not grow too much in the vagina. When it does, it produces a thick, white discharge with an unpleasant odor, like onions.
Yeast infections can also produce itching and soreness in the vulva. A less common infection that can cause a similar odor is trichomoniasis, which is caused by an infection with the protozoan parasite Trichomonas vaginalis. This condition can lead to pain, itching and a vaginal discharge that smells like onion. Yeast infections and trichomoniasis usually respond to antibiotics, which will eliminate the infection and clear up the smell. Other treatments include avoiding douches and scented products, and practicing good hygiene.
Trichomoniasis
Many things can change how your vulva smells, including the foods you eat. If you notice an unpleasant odor, it could be due to bacteria or an infection, like bacterial vaginosis (BV), which has a fishy, musty odor and can make your genitals feel sore. It can also cause a yellowish-green discharge and itchiness in the vaginal area.
Other causes of bad odors include exercising and sweating, changes in hormone levels during the menstrual cycle or pregnancy, and certain medications. Some of these medications, such as antibiotics and antifungals, can alter the balance of your microflora and cause body odor.
A rectovaginal fistula, a rare condition that can occur when the opening between your rectum and the vagina leaks, can also lead to a strong odor. The odor is similar to that of onions and can be very unpleasant.
If you have an unpleasant odor, it’s important to see your doctor right away, especially if it’s accompanied by symptoms like a painful vulva or a discharge that looks like mud or sand. Your doctor can prescribe you an antibiotic that will help with the infection or an antifungal medication, if needed. They may also suggest you change your feminine hygiene products, wear looser-fitting clothes, stop douching, and start changing your pad or tampon more frequently. They might also recommend a probiotic that can restore the balance of your microflora.
