VAGINAL ODOR: WHAT’S NORMAL AND WHAT’S NOT

Vaginal odor 101

A quick walk down the “feminine hygiene” aisle reveals a dizzying array of pastel-wrapped, floral-scented products, not to mention the buzzy brands on social media that say they'll help you control your body's natural scent. According to experts, this “clean and fresh” messaging is harmful to women both psychologically and physically. A 2021 editorial written by psychologists and an obstetrician/gynecologist that was published in Expert Review of Anti-infective Therapy stated many feminine products promote a cultural message that “women’s bodies are problematic, unclean, [and] inadequate”—and a 2019 survey showed that almost two-thirds of women have felt insecure about their vaginal scent to the point where it's affecting their intimate relationships.

These messages don’t just reinforce a stigma: Research shows they can pose several health risks, too. In particular, some lubricants, vaginal deodorant sprays, and powders—used by about half of American women—increase the risk of urinary tract infections, bacterial vaginosis, sexually transmitted infections, and female reproductive cancers, like ovarian cancer. 

What experts want you to know is that vaginal odor is totally normal, and changes to your normal odor generally have an explanation. But before you go reaching for a lavender meadow-scented spray, board-certified OB/GYN Jennifer Taylor, MD, of Mercy Medical Center in Baltimore, and California-based gynecologist and author Sherry Ross, MD, weigh in on everything you should know about vaginal odor (and when certain odors warrant a trip to the doctor.) 

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What is a normal vaginal odor?

Despite what some soap companies would have you believe, it’s normal, even healthy, for vaginas to have an odor. Think of it this way: Your skin has a distinct aroma, so why wouldn’t your vulva (the external genitalia around your vaginal opening)? The trick, says Dr. Ross, is to know the smell of your “normal.”

Your normal vaginal odor reflects everything from your diet to body chemistry. Some vaginas smell musky. Others smell slightly sweet. Shifting scents are also normal. During menstruation, a vagina might smell metallic, according to Dr. Taylor. After exercise or sex, it might smell of sweat or body odor.

If you’ve noticed a distinct shift in the way your vagina or underwear smells, look for other changes, too. Are you experiencing redness or irritation? Does your vulva itch? Has your discharge changed in color or consistency? A collection of symptoms could suggest a problem. Vaginal odor alone is rarely a concern.

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Common causes of vaginal odor

Vaginal odor is completely normal. Here are a few common causes of changes in pungency or pleasantness, according to Dr. Taylor and Dr. Ross:

If your vagina has a strong foul, fishy smell ...

... you may have bacterial vaginosis (BV).

Bacterial vaginosis is caused by an overgrowth of bacteria in the vagina. If you have BV, you'll likely notice changes beyond the way your vaginal discharge reeks of dead fish. Dr. Ross says other symptoms include redness, irritation, and gray or green discharge.

"Rarely, this same odor can be a sexually transmitted disease called trichomoniasis," Dr. Taylor says. Known colloquially as "trich," this STD has similar symptoms to BV. Trich spreads easily, so avoid sexual activity until you get a diagnosis.

Fortunately, this STD is treatable with prescription medication.

If your vagina smells like ammonia ...

… you might need to drink more water.

Dr. Taylor says the more concentrated your urine is, the more it smells of ammonia. Thus, a strong ammonia smell from your underwear or the skin around your vagina could indicate dehydration.

Although an ammonia odor is probably due to dehydration or sweat, Dr. Ross and Dr. Taylor say it can signify BV. To pinpoint the issue, be extra vigilant about hygiene after peeing or working out. If the ammonia smell persists or is accompanied by pain, burning, or itching, talk to your doctor.

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If your vagina smells earthy or musty ...

... it's probably just body odor (BO).

"Women have sweat glands down there, too," Dr. Taylor says. "Sweat from working out, stress, or anxiety can cause this [smell]."

If genital BO bothers you, Dr. Ross suggests wearing underwear and sportswear made with breathable fabrics. It also helps to remember that it's a completely normal odor.

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If your vagina smells like pennies ...

... it's probably due to menstrual blood.

The iron in blood gives it a metallic smell. An iron-like vaginal odor is most noticeable during your period or after sex, according to Dr. Taylor.

Bleeding after sex is fairly common in women. Causes vary. While a metallic smell or slight spotting is no cause for alarm, you should still tell your doctor about any post-coital bleeding.

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If your vagina smells like rotting meat ...

... check for a forgotten tampon or condom.

"When it comes to a lost tampon, you will know that something is just not right down there," Dr. Ross says. "You may notice a watery-brown discharge with a foul, rotten meat odor."

Dr. Taylor says that, in rare cases, a rotten odor can also be a sign of cervical cancer. In fact, 2017 research published in the medical journal BMC Cancer found that trained scent dogs could detect cervical cancer by sniffing absorbent pads worn by female cancer patients. This link between scent and cancer is so strong that scientists have been working to develop “e-noses,” according to 2022 research published in Integrative Cancer Therapies. 

Still, both doctors say that in most cases, a rotten vaginal smell traces to a tampon soaked in old blood. If you're concerned, the best way to screen for cervical cancer is to get an annual Pap smear (recommended for all women aged 21 and up).

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If your vagina smells tangy or sour ...

… you might have a slight bacterial imbalance.

A tangy smell is no cause for alarm, Dr. Taylor says. Vaginas have a delicately balanced microbiome. An overpopulation of friendly bacteria—Lactobacilli—can lead to a tangy aroma. Lactobacilli are a type of probiotic (“good” bacteria,) so foods containing probiotics, such as fermented foods, can increase these bacteria.

“Fermented foods, including yogurt, bread, and even certain sour beers, can contribute to this normal smell,” Dr. Ross explains.

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If your vagina smells sweet ...

… it’s likely due to something you ate.

Smelling slightly sweet is no cause for concern, according to Dr. Taylor. Dr. Ross adds that consuming fresh fruit (especially pineapple) and fruit juices can sometimes add a sweet smell or taste to the vagina.

That said, sweet-smelling urine can indicate blood sugar problems. With uncontrolled diabetes, your body could expel glucose (sugar) when you pee, according to the US National Library of Medicine. So if you happen to get a whiff of sugar from your underwear, investigate whether the smell came from your vagina or urinary tract.

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When to see a doctor

Fluctuations in vaginal odor are completely normal. But if you notice a pungent, unusual smell that lasts for several days, consider calling your doctor.

“Seeing a health care provider is always a good idea when things seem persistent or different. Trust your instincts,” Dr. Ross says.

Also, pay attention to other signs of a problem, such as itching, swelling, redness, or a rash on the skin around your vagina.

“Almost 50% of vaginal odors are normal and confirmed by culture [sample]. The others are infectious and need to be treated,” Dr. Taylor says.

Fortunately, infections often reveal themselves with additional symptoms beyond vaginal odor. Again, pay careful attention to itching, swelling, redness, or rashes that don’t link to external irritants (such as a new laundry detergent, scented soap, or lube).

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How to prevent unpleasant vaginal odor

First, remember every vagina has a natural odor. Products that claim to eradicate all scents or make your genitals smell like coconut may do you no favors.

“The vagina is especially sensitive to different changes in your daily environment. Anything that affects this delicate balance will affect the smell, type of discharge, and its consistency,” Dr. Ross says.

If you’ve noticed a strong body odor coming from your groin, follow these tips from the experts:

  • Hydrate.
  • Limit consumption of the same foods that lead to strong-smelling urine: Brussels sprouts, asparagus, garlic, blue cheese, fermented foods, etc.
  • Avoid overindulging in nicotine and alcohol, both of which can lead to smells released through sweat glands.
  • Wear breathable underwear and sportswear.
  • Avoid products that can irritate your vulva. These include fragrant soaps and talcum powders, spermicides, and scented lubricants.

There’s no need to shy away from your body’s natural aroma. The more you get familiar with your vaginal odor, the easier it will be to determine if something is amiss. Irritation, rashes, and itching are more likely than vaginal odor to reveal a medical issue.

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Additional writing and reporting by Leslie Finlay.

The post Vaginal Odor: What’s Normal and What’s Not appeared first on The Healthy.

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