A foul smelling vaginal odor affects many women and may occur with or without any discharge. Often associated with overgrown pubic hair and poor hygiene, a smelly odor from the vagina may be indicative of a medical disorder that requires treatment in order to be corrected. In these cases, vaginal douching, removing the pubic hair and even good personal hygiene will have a limited effect in reducing the smell.

Vaginal odor is often associated with a “fishy” odor. However a range of other odors may also be present, like a “chemical” odor associated with high concentrations of ammonia, as well as  damp and musty odors. It is important to identify if the odor is emanating internally, often carried to the outside by vaginal discharge, or if it is only present on the outside, from the vulva or surrounding areas.

The vagina is a hollow tube that leads to the uterus and is separated from the external environment by the vulva. The micro-environment within the vagina is balanced to ensure a constant pH (acidity or alkalinity), moisture and the existence of naturally occurring bacteria. Any upset of these three factors can allow for the vaginal environment to be compromised, allowing invading bacteria or fungi to affect the tissue.

Vaginal Infections

Infections, particularly from bacteria and fungi, are the most common causes of a vaginal infection. In most cases, the naturally occurring bacteria or yeasts within the vagina may multiply uncontrollably, thereby causing an overgrowth resulting in an infection. At other times, external microbes may be deposited through the use of tampons, vaginal douches, intra-uterine device (IUD), bathing water or sexual contact.

Bacterial Vaginosis

Bacterial vaginosis is an infection caused by an overgrowth of naturally occurring bacteria or foreign pathogens. Some signs and symptoms include :

  • Yellow to brown discharge, usually foul smelling, (“fishy”)  and may have streaks of blood.
  • Pain in the pelvic area.
  • Fever may or may not be present.

Chlamydia Infection

Chlamydia is a bacterial infection caused by the bacterium Chlamydia trachomatis. It is primarily spread through sexual contact and may affect both men and women. Typical symptoms include :

  • Lower abdominal pain.
  • Vaginal discharge.
  • Burning and/or pain during urination/sexual intercourse.

Urinary Tract Infections (UTI’s)

A UTI will affect most women multiple times in their life. The short urethra (tube leading from the bladder to the outside) in women means that microoragnisms, particularly bacteria, can easily infect the bladder (cystitis). Some signs and symptoms include :

  • Vaginal discharge may or may not be present.
  • Frequent urination.
  • Constant urge to urinate.
  • Incontinence or dribbling.
  • Burning and/or pain when urinating.
  • Dark yellow to orange-red color of urine, or bleeding noticed upon wiping.

Thrush

Vaginal thrush or candidiasis is an yeast infection of the vagina, most often caused by the fungus Candida albicans. Yeast may be a normal part of the microbe population in the vagina, however, like the bacteria, its population size is controlled by internal factors. If any opportunity arises whereby the conditions change in the favor of the microbe, it will take the opportunity to multiply aggressively. Symptoms of thrush include :

  • Vaginal itching.
  • Burning and/or pain in the vagina.
  • Vulva may be swollen and painful.
  • Smelly vaginal odor.
  • Vaginal discharge may be thick and creamy-white (like cottage cheese) or thin and watery.

Sexually transmitted diseases

A host of sexually transmitted diseases (STD’s) can result in vaginal odor. This may include gonorrhea, genital herpes, and even syphilis. Lymphogranuloma venereum (LGV) is a form of chlamydia infection that causes sores on the gentialia and may also contribute to vaginal odor. The presence of a sexually transmitted disease should always raise concerns about unprotected sex and the possibility of HIV infection. In terms of HIV/AIDS, the body’s natural defenses (immune system) are weakened, thereby making cavities, such as the vagina, prone to opportunisitic infections.

Pelvic Inflammatory Disease

This condition occurs as a result of an infection spreading up towards the uterus, fallopian tubes and ovaries. It is often the result of an untreated infection, particularly those transmitted by sexual contact, like chlamydia or gonorrhea. Pelvic inflammatory disease (PID) should be treated immediately as the infection could spread further up into the abdominal cavity or damage the reproductive organs thereby impairing future fertility. PID symptoms include :

  • Fever.
  • Foul smelling vaginal discharge.
  • Changes in menstruation.
  • Bleeding, not associated with menses.
  • Pelvic pain as well as lower abdominal pain.
  • Pain when urinating, during sexual intercourse and even when moving.

Vaginitis

Vaginitis is a broad term for inflammation of the vagina. It may be caused by trauma, may be the result of an infection or could be linked to an allergic reaction. Vaginitis should always be a cause for concern if it occurs in young children, as it could be associated with sexual abuse. Typically, with the inflammation associated with vaginitis, there should be other signs or symptoms of inflammation, including pain and swelling. The use of vaginal douches is one of the most common cause of vaginitis and douches affect the normal pH and moisture of the vagina, often allowing vaginal infections to set in. All these factors may contribute towards a foul smelling vaginal odor.

Allergic reactions in the vagina may occur as a result of irritation caused by tampons, some brands of condoms or lubricants used during sexual intercourse. This will cause swelling of the vaginal wall, with severe itching, and excessive moisture, usually thin and watery. The vaginal odor in an allergic reaction is not usually foul smelling but will have a distinctly different smell to regular discharge.

Personal Hygiene

Hygiene plays an important part in body odor, not only in vaginal odor. Regular bathing and change of clothing and underwear will limit the extent of any odor. However, conditions like hyperhidrosis (excessive sweating) and bromhidrosis (sweating with an offensive odor) may cause a foul smelling vaginal odor, often with a musty smell emanating from outside, rather than from internally like in the conditions above. The presence of pubic hair, especially if untrimmed, contained within a warm, damp and dark environment will also increase any musty odor. It also creates the perfect environment for a skin fungal infection on and around the vagina.

Cancer

Both vaginal or cervical cancer may cause a smelly vaginal discharge. However a discharge may be absent at times, so routine testing for cervical cancer is important, rather than waiting for the appearance of symptoms like discharge. Vaginal cancer is rare when compared to cervical cancer and ideally it should be identified during routine gynecological testing, rather than waiting for symptoms to appear.

Treatment of Smelly Vaginal Odor

Before considering any medical treatment, start by attending to personal hygiene issues. Regular bathing, trimming pubic hair, changing from tampons to pads and using light clothing is the first step. Should the vaginal odor persist, then consult with your gynecologist about other possible causes of vaginal odor. However, if you are ever experiencing a foul smelling discharge, bleeding or pain with a fever, you need to consult with a doctor immediately.