The supermarket shelves are lined with products encouraging us to keep our lady parts clean and pleasant-smelling . Many of us still remember the line “Do you ever get that not-so-fresh feeling?” from a douche commercial years ago that made many a woman begin doubting their vaginal cleanliness at a very young age. The truth is that most women’s natural scent is normal. Your vagina doesn’t need to smell like that field of flowers on the box of feminine deodorant spray.
Why does the vagina smell?
The vagina is a carefully balanced ecosystem of fluid (discharge) and bacteria meant to keep the vaginal PH at a healthy 4.5. This combination of fluid and bacteria that make up the vaginal discharge that can, at times, emit certain odors. Most of these odors are natural and normal, but there are times when excess odor can signal a problem.
So what is a “normal” amount of odor? After performing a very unscientific poll of all the gynecologist I know, we determined that one can smell a normal vagina from 1 foot away. More pungent odor or any associated with pain, burning or itching should prompt a visit to your provider.
Some common causes of vaginal odor include:
Bacterial Vaginosis (BV) – The vagina is normally colonized with healthy bacteria, but if something disturbs the ecosystem, then unhealthy bacteria like BV can take over. BV is most commonly caused by an overgrowth of the bacteria Gardnerella vaginalis. Symptoms include a thin grey, runny discharge and a strong fishy odor. The odor is more pungent when in contact with semen, so often women will first notice this as a strong odor after sex. BV is annoying and can increase your risk of other infections, but is easily treated with antibiotics.
Your Diet – The old adage “You are what eat” is true, all the way down to your lady bits. Garlic, onion, asparagus, and curry are few of the more odoriferous foods known to affect body odor.
Medications/ Supplements - Medications such as antibiotics can affect the bacterial balance of your vagina leading to changes in odor and discharge. Antihistamines can lead to vaginal dryness and decreased vaginal secretions, which can also have an effect. Additionally, herbal therapies and the newly popular essential oils can lead to changes in vaginal odor.
Sweat - Much like your underarms, the skin around your genitals is prone to excessive sweating. Sweat when combined with discharge can escalate the natural musk to a whole new level of stank. This is a natural odor, though sometimes slightly unpleasant. To minimize the smell, change clothes after exercising and wear breathable fabrics.
Hormonal Changes – The amount of discharge varies throughout menstrual cycles. Hormonal therapies, birth control pills and vaginal creams can have an effect the vaginal PH and odor as well. Menopause also leads to major changes as the decreasing estrogen levels can lead to increasing incidence of yeast infection and BV.
A Forgotten Tampon – There is one odor that is so foul, it is unlike anything you have every smelled in your entire life. It’s the one smell that makes even the gynecologist gag: the forgotten tampon. The patients on many occasions have described the odors as ”it smells like something crawled up in there and died.” I would have to agree that this is an honest statement. While the odor is particularly offensive, it does resolve quickly after the tampon is removed. Rarely, the retained tampon can also lead to serious infection, so it is important to see your doctor should this occur (symptoms include a brown discharge and odor).
Douching is never indicated for vaginal odor or any other reason. It only further changes the bacterial content and can spread infection. You do not need to insert anything inside your vagina to clean it: no douche, no essential oils, no soap, no Listerine (yes, these are all things I’ve had patients use to ‘clean themselves’). Simply think of the vagina as a “self-cleaning oven.”
If you’re concerned about your odor, but have no other symptoms, you may first try increasing your water intake and cutting out any odorous foods. You might also take a probiotics to help restore normal bacterial balance. For proper hygiene, clean the external area of your vagina (vulva and labia) with a mild soap. If odor persists despite these measures, then follow up with your provider.