The Biggest Causes of Vaginal Odor (& How to Address Them)

Vaginal odor can be embarrassing and burdensome for women, but it is normal under some circumstances. The major causes of vaginal odor are menstruation, stress, dietary changes, arousal, medications, and pregnancy.

Thankfully, it is easily treatable once the odor’s cause is found. (Learn More)

If your vaginal odor is abnormal, there are a variety of infections and other issues that may be triggering it. (Learn MoreIt’s always best to consult a doctor to pinpoint the cause. (Learn More)

A doctor can answer your questions, provide an accurate diagnosis, and recommend treatments, including medication. (Learn More)

Major Causes of Vaginal Odor

It is normal for your vaginal odor to change under certain circumstances. The vagina is self-cleaning. It contains good bacteria that promotes an environment that is high in acidity.

This process may result in discharge that can change in odor sometimes. Vaginal odor may change due to:

  • Your menstrual cycle.
  • Stress.
  • Recent dietary changes.
  • Sexual arousal.
  • Medications.
  • Pregnancy.

Causes of Abnormal Vaginal Odor

Healthline explains that vaginal odor that is not caused by hormones, pregnancy, or other normal reactions to stress may be caused by some of these conditions:

  • Trichomoniasis: While this infection can result from sharing a towel or bathing suit with someone else, the main source of the single-celled organism that causes it is sexual contact. You may experience inflammation, pain, and itching, but some patients may not experience any symptoms. Your vaginal discharge may have a strong odor and be green or yellow.
  • Bacterial vaginosis: This is a common infection. Having multiple partners and receiving oral sex puts you at risk of developing bacterial vaginosis. Not everyone will feel symptoms, but take note if you secrete more discharge that smells fishy.
    Women who are pregnant should deal with bacterial vaginosis to prevent premature birth or weight that is below normal.
  • Yeast infections: These infections are also common, and they are caused by a fungus. Yeast is naturally present in the vagina, but infections mean this fungus is growing at a faster or higher rate than normal.
    Common symptoms of yeast infections are a feeling of itching or burning in the vaginal area, as well as discharge that resembles cottage cheese.
  • Pelvic inflammatory disease (PID): Spread through sexual contact, PID begins in the vagina and can travel to other organs. A strong foul odor is often a main symptom.
  • Sexually transmitted infections (STIs): These include gonorrhea and chlamydia. They can cause a change in vaginal odor as well as green or yellow discharge.
  • Cervical cancer or human papillomavirus (HPV): Spread through sexual contact, HPV can eventually lead to cervical cancer. Discharge resulting from cervical cancer may be bloody, brown, or thinner in consistency. It can have a foul odor.
  • A forgotten tampon: Forgetting to remove a tampon can lead to vaginal odor, unpleasant discharge, and irritation. You may be able to remove a forgotten tampon on your own, but your gynecologist can do it for you if it has traveled past the cervix.

When to See a Doctor

A fishy odor, heavier discharge, or pain resembling cramps can be a sign of something more serious. You should see a doctor if you experience:

  • Increased cramps or rashes.
  • Blisters near the vagina or on the labia.
  • Any sign that your labia or vagina may have an infection.
  • Pain or cramping during or after intercourse.
  • Lethargy or extreme fatigue.
  • Discharge that is green, gray, or yellow in color.
  • Fever.

The symptoms of yeast infections are similar to the symptoms of an STI. It is best if your doctor rules this out as a cause for vaginal odor, as complications can be serious.

Medications

Thankfully, many of the conditions that cause vaginal odor are treatable.

  • Bacterial vaginosis: Treatment medications include:
    • Clindamycin. This cream is inserted into the vagina. If you are sexually active, be aware that the medication can thin or weaken condoms for up to 72 hours after stopping use.
    • Tinidazole. This oral medication fights the bacteria causing the infection, but it may cause you to have an upset stomach. Abstaining from alcohol during treatment can lessen the potential for an upset stomach.
    • Metronidazole. This medication is available as an oral medication or gel. If taken orally, it is best not to drink alcohol, as it could increase the risk of an upset stomach.
  • Trichomoniasis: Mayo Clinic says that as with bacterial vaginosis, tinidazole or metronidazole can treat this infection. Both medications are usually taken in one large dose, even for patients who are pregnant. Doctors can also divide the treatment into two doses taken for one week.
    Avoid alcohol during treatment to prevent nausea or other stomach upset symptoms.
    Your doctor will follow up with you within a few weeks to ensure the infection is gone. This infection can stay in the body for months or years if not treated. Your partner needs to be treated as well to prevent reinfection.
  • Yeast infections: These infections are treated differently depending on severity and frequency.
    • Infrequent or mild infections may be treated with topical antifungal medication for three to seven days. Some of these may be over-the-counter options, while others are only available via prescription. Topical treatments are available as ointments, creams, and gels.
      If topical medications do not work, you might get a prescription for Diflucan (fluconazole). This oral medication is meant to be taken only once, but your doctor may divide the dose into two.
    • Frequent or severe yeast infections may require other treatment methods, such as:
      • Boric acid. Inserted into the vagina, this capsule attacks the fungus that causes yeast infections. It is only given when other treatments do not work.
        Boric acid may worsen symptoms of burning. When taken orally, this medication is deadly.
      • Long-term vaginal therapy. This means you will take an oral antifungal for about a week or two. After this, you will take it once weekly for the next six months or so.
      • Oral antifungal medication in multiple doses. It is best for pregnant women to avoid this option. This is an alternative to long-term vaginal therapy. NHS says antifungals come with side effects, such as stomach pain, redness, rash, or diarrhea.
    • Genital warts are treated with prescription medication or other procedures from your doctor.
    • HPV-related cancers can be treated if they are caught in time.
    • Cervical pre-cancers can be treated if they are found early enough.
  • Pelvic Inflammatory Disease (PID): Several treatment options exist for PID, including:
    • Antibiotics. It is hard to know which bacteria is the cause of your PID, so you may have to take two antibiotics to successfully treat it. The medication may cause your stomach to hurt or feel upset.
    • Hospitalization. This may be necessary for patients who are pregnant, sick, develop an abscess, or cannot swallow pills.
    • Surgery. This may only be necessary if you have an abscess that ruptures or that runs the risk of doing so. It is also a last resort for patients whose PID does not respond to less invasive treatment.
  • Sexually transmitted infections (STIs): Gonorrhea and chlamydia are two STIs known to cause vaginal odor.
    • Gonorrhea is treated with antibiotics that are taken orally. Antibiotic-resistant gonorrhea may require a longer course of treatment, including a seven-day regimen, or the use of two antibiotics. As with other antibiotics, you should avoid alcohol while taking them. You are likely to get an upset stomach, and you may develop diarrhea.
    • Chlamydia is caused by a bacteria. It is commonly treated with antibiotics, but some alternative treatments may be able to help you with it too. If not treated, chlamydia can lead to PID.

Lifestyle Changes

If you do not have any of the above conditions but still have vaginal odor, some lifestyle changes may help you deal with it.

  • Change clothes after you exercise.
  • Wear cotton underwear, and avoid tight clothing.
  • Avoid vaginal cleansing products such as sprays and douches.

Frequently Asked Questions

What are some major causes of vaginal odor?

Vaginal odor is caused by natural changes in your hormones and stress. It is also the result of the vagina’s self-cleaning methods.

A fishy or strong smell could indicate other problems, such as an STI, pelvic inflammatory disease, HPV (human papillomavirus), a yeast infection, or a bacterial infection.

Lifestyle problems, such as using a douche or external vaginal products, may also cause an odor because they irritate the vagina.

How do I find out what exactly is causing the problem?

It is best to visit the doctor every year for a pap smear. Vaginal odor can come from several causes, and your doctor can run tests to rule out certain problems.

When should I see a doctor?

You should see a doctor if you experience vaginal odor along with pain or cramps in the lower abdomen, a fever, or fatigue.

What medications can I use to prevent or treat vaginal odor?

This will depend on the cause.

Bacterial infections, such as the STIs gonorrhea and chlamydia, can be treated with antibiotics. Yeast infections can be treated with antifungal ointments.

No medications can manage HPV at the moment. Treatment is only currently available for some of its effects, such as genital warts.

Lifestyle changes, such as changing clothes promptly after exercise and staying away from vaginal sprays and other vaginal cleaning products, can reduce vaginal odor.

References

Vaginal Odor. (March 2018). Mayo Clinic.

Vaginal Odor: Causes and Remedies. (June 2015). Berkeley Wellness.

Everything You Need to Know About Vaginal Discharge. (July 2018). Healthline.

Bacterial Vaginosis. (May 2019). Mayo Clinic.

When to See a Doctor About Vaginal Discharge. (January 2019). Verywell Health.

Pelvic Inflammatory Disease (PID). (April 2019). Healthline.

Trichomoniasis. (May 2018). Mayo Clinic.

Yeast Infection (Vaginal). (July 2019). Mayo Clinic.

HPV Treatment. (December 2016). Centers for Disease Control and Prevention.

Antifungal Medicines. (August 2017). NHS.

Gonorrhea. (June 2016). Healthline.

Everything You Need to Know About Chlamydia Infection. (May 2019). Healthline.

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