If you want to know the possible causes of a change in the odour of your vagina, especially if it is strong and unfamiliar or if you suspect vaginal infections, read on.

Causes of vaginal odour

The most common causes are ^{(1, 2, 3)}:

• Bacterial vaginosis. May be caused by an imbalance of vaginal flora.
• Vaginal trichomoniasis. This is a sexually transmitted infection caused by a parasite.
• Rectovaginal fistula. This is an unusual condition in which the rectum and vagina communicate through a canal.
• Vaginal or cervical cancer.
• Changes in vaginal pH.
• Insufficient intimate higiene.
• Menstruation.
• Hormonal changes, such as those that occur during menopause and pregnancy.
• Sexual intercourse.

Hormonal changes during the menopause

During perimenopause, your vagina has an acidic pH; however, it becomes alkaline when you enter menopause, so you may experience vaginal odour. This is mainly due to a decrease in oestrogen, which makes you susceptible to vaginitis and urinary tract infections ⁽⁴⁾.

Odours considered normal

Among the individualities of each woman are odours that are considered normal, as they are present in healthy vaginas, such as⁽⁵⁾:

• Fermented odour. A sour or acidic vaginal odour, similar to that of fermented foods such as yoghurt or beer. The main reasons are the pH of a healthy vagina in a person of reproductive age.
• Metallic or coppery odour, similar to that of coins. Common during menstruation and usually not a cause for concern. Occasionally, it may appear after sexual intercourse, especially during menopause when vaginal dryness occurs.

Vaginal odour

Let us now examine what we interpret as vaginal odour. These odours are associated with infections and abnormal processes, besides being strong and unpleasant. The most common ones are ^(1,5):

• Sweet like molasses:

Robust and earthy, usually caused by bacteria; although it does not always mean they are bad.

• Chemical, such as bleach or ammonia:

Can sometimes be caused by urine in underwear or bacterial vaginosis, in which case it might be accompanied by a fishy smell, with grey or white discharge, vaginal itching, burning during urination and pelvic pain.

• Herbs or cannabis:

Likely secondary to secretions from sweat glands in the groin, which are similar to those in the armpits and can cause such an odour.

• Fish:

But specifically, fish that is decomposing. Bacterial vaginosis and trichomoniasis are the most common. Especially the latter has a very strong odour and increases after sexual intercourse. Both are accompanied by burning during urination, white, grey, greenish or foamy discharge, pain, itching or burning in the vagina and itching of the vulva.

• Rotting, like decaying material:

The most common reasons are objects inside your vagina, such as forgotten tampons or gauze.

• Fermented:

May also be abnormal if accompanied by white or grey lumpy discharge, itching and swelling at the vulva. It is usually caused by yeast infections.

• Metallic:

When this persists for a long time after menstrual bleeding.

When to see a doctor for vaginal odour?

The first thing you should know is that if the odour produced by your vagina causes you discomfort or displeasure; the ideal thing to do is to see your doctor. Perfumes, shampoo or vaginal douching are not recommended as they can make the problem worse.

Here are some signs and symptoms that may indicate that you need to see a professional ⁽²⁾:

• Foul-smelling vaginal odour.
• Fever.
• Itching, burning, redness, rash, or swelling around the vagina or vulva.
• Thick, white, green or yellowish discharge of unusual consistency.
• Pain when urinating.
• Discomfort during intercourse.
• Bleeding that is different from your period.

Such manifestations often require further examination, usually including a physical examination, pelvic ultrasound and vaginal cytology ⁽²⁾.

Remember that all vaginas produce a characteristic odour and there is no vagina that does not. However, if it is becoming a problem, don't hesitate to see a professional. Keep in mind that during menopause you are more susceptible to infections in this area, so don't forget to use condoms for HPV prevention and other sexually transmitted diseases. Remember that your vagina is an important part of you, so don't wait any longer to take care of it!

Bibliographical references.

1. Cleveland Clinic. Vaginal Odor: Types, Causes, Diagnosis & Treatment - . 2022 . Available from: https://my.clevelandclinic.org/health/symptoms/17905-vaginal-odor

2. Very Well Health. Is Vaginal Odor Normal? . 2023 . Available from: https://www.verywellhealth.com/vaginal-odor-6362565

3. NHS Choices. Bacterial vaginosis . 2023 . Available from: https://www.nhs.uk/conditions/bacterial-vaginosis/

4. WebMD Editorial Contributors. What to Know About Changing Vaginal Smell After 50 . 2023 . Available from: https://www.webmd.com/healthy-aging/vagina-smell-change-after-50

5. Wojcik G. Molasses to Pennies: All the Smells a Healthy Vagina Can Be . Healthline Media; 2023 . Available from: https://www.healthline.com/health/womens-health/vagina-smells#When-you-should-see-a-doctor

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