Vulvitis (Vulvar Itching): Causes, Symptoms & Treatment
Why Does My Vagina Smell Like Fish? Experts Explain
© Provided by Romper You are what you eat sometimes, and that also goes for how you smell down there. Ever notice when you eat garlic or asparagus, your pee (and sometimes your discharge or vagina) kinda smells like garlic or asparagus? But what about seafood? If you were recently in a downward facing dog position at yoga class and caught a whiff of a fishy smell coming from down there, you may be wondering, "why does my vagina smell like fish?" it's definitely not because you ate fish, and it is actually something you need to get checked out by a doctor ASAP.
Why does my vagina smell like fish?Your vagina should definitely never ever smell like fish, says Dr. Kameelah Phillips, an OB-GYN. If it does smell like fish, something is wrong. But the good news is that it's treatable. "The most common reason for this is a bacterial infection called bacterial vaginosis (BV)," Phillips says. What exactly is this scary sounding ailment and what causes it? It's an imbalance of vaginal flora, which causes that fishy odor down there, Phillips explains.
Barbara Slocum, board-certified women's health nurse practitioner and certified nurse midwife agrees and explains in an email interview, "BV is triggered by a change in the vaginal pH that allows an overgrowth of a 'bad' bacteria (that normally resides in harmony with the good bacteria) in the vagina."
How do you treat bacterial vaginosis?And just how soon will that fishy smell go away? "This imbalance often requires an antibiotic to treat, but some may notice a spontaneous resolution after a period, with probiotics, or within a short time frame, i.E., your vaginal flora corrected itself. Don't be discouraged if you have a recurrence of the odor. Sometimes multiple treatments are required to correct the imbalance," Phillips says.
© Provided by Romper What should a healthy vagina smell like? I asked Slocum if it wasn't supposed to have an odor at all if it was healthy, and she reminds us that "the vagina does not, nor should it, smell like potpourri. For some reason, women have been told and now believe that their vagina should either be odorless or smell like a field of roses — neither is true. Additionally, many are concerned about vaginal discharge, and I like to remind them that the vagina is self-cleaning, and as long as the discharge is colorless, without odor, and does not cause itching or burning, it is probably totally normal," she explains.
"Most vaginas have some type of odor, especially after a work day, physical exercise, or during a period," Phillips adds. "I tell women your vagina should smell like you and 'you' will vary throughout the month."
She also notes that a "normal odor" is typically hard to describe. "Do not hesitate to smell your underwear — don't cringe, they belong to you," Phillips says. "This will help you get an idea of your normal scent and make it easier for you to detect a change when the scent goes awry."
What is normal when it comes to vaginal discharge?When it comes to your discharge, there can be some changes throughout your cycle. "Discharge varies throughout the month, and may be clear, white, or yellowish. It can be watery or creamy. Looking at your underwear can help you notice a change in your baseline," Phillips says. Different odors to look out for include fishy or yeasty smells, which may indicate you have an infection, according to Phillips.
Both Phillips and Slocum say not to douche or flush your vagina out. "A vagina and the perineal region should be cleaned with a soft cotton washcloth and warm water only. Avoid washing the vagina with soaps, body scrubs, or detergents... Read your soap, it may actually be considered a detergent," Slocum says.
© Provided by Romper "I really believe you should keep soap and other cleaners out of your vagina," Phillips agrees. "Your vagina is self-cleaning so why would any product be necessary? I suggest cleaning the outer labia, hair-bearing areas, including the anus, with a mild wash and keeping the suds out of the vagina."
If a woman is concerned about a vaginal odor, Slocum suggests they should contact their health care provider. Too often I have women using at-home remedies that either cause an increase in symptoms, or do nothing to treat the cause.
Good perineal hygiene includes avoiding all perfumes and sprays in the area, avoid tight-fitting clothes like skinny jeans (especially when symptomatic), getting out of wet and sweaty exercise clothing, steering clear of thongs, and avoiding fabric softeners and using scent-free soap when you're washing your undies, according to Slocum. Additionally, if you're taking antibiotics, it's also a good idea to take a probiotic or eat yogurt to keep the good bacteria and bad bacteria balanced in there.
While not super serious, if you notice a "fishy" smell that is not normal for you, you may want to call your health care provider. Not only because it's unpleasant for you, but you don't want an infection lingering around in your lady bits. Keep clean down there, and steer clear of those advertised feminine hygiene cleansers. Your vagina is good at cleaning itself out, and adding stuff to that balance will throw everything out of whack.
Experts:
Dr. Kameelah Phillips, an OB-GYN
Barbara Slocum, board-certified women's health nurse practitioner
This Helpful Bacterium Can Also Be Responsible For Vaginal Infections
Gardnerella vaginalis is a mouthful to say, but it's important to know.
Gardnerella vaginalis is the scientific name for a bacterium that lives in your body.
In addition to trillions of other microorganisms, Gardnerella vaginalis also helps keep your vaginal flora (the bacteria normally living in and around your genitals) balanced and prevent infections.
A common reproductive health condition called bacterial vaginosis (BV) is caused by Gardnerella going rogue and multiplying too fast.
Premenopausal women are around 30% likely to develop BV at some point, and some are unfortunate enough to contract it repeatedly.
BV doesn't technically qualify as a sexually transmitted infection (STI), but it shares some symptoms and risk factors with STIs (more on that later).
Fortunately, because of its prevalence, BV can be diagnosed and treated fairly easily.
Getting to know Gardnerella
Before we assume that Gardnerella vaginalis is bad for our lady health, let's learn a bit more about what it is.
It is present in the normal vaginal makeup, and in limited quantities, Gardnerella plays a valuable role in maintaining a balanced pH level – that's the measure of acidic versus alkaline in your vaginal tract – that keeps bad bacteria out.
It is possible for Gardnerella vaginalis to disrupt your vaginal pH level and cause vaginal infections such as BV instead of protecting against it when it grows abnormally.
For many years since mid-1950s, researchers believed Gardnerella was the sole cause of BV.
Scientific thinking has changed over the past 70 years.
Now BV is believed to be caused by a wide variety of bacteria, not just one.
Researchers have found that bacteria like Atopobium, Mobiluncus and Prevotella, among others, can also cause BV.
Gardnerella vaginalis used to be commonly referred to as BV.
Nowadays, you will hear Gardnerella vaginalis referred to as one of many bacteria that can cause this infection.
You can treat BV if your vagina is overgrown with bad bacteria.
There is no specific condition called Gardnerella vaginalis, but rather it is a bacteria species that can contribute to the development of this disease.
Gardnerella is already present in small amounts in your body, but when it multiplies, it disrupts your vaginal microbiome.
This can result in symptoms of BV such as pain itching, and abnormal discharge.
Simply put: Gardnerella vaginalis is a bacterium, and BV is a condition that may result from this bacterium.
Symptoms of BV
Around 84% of women are totally asymptomatic when they get infected.
If you do have symptoms of BV, look out for these.
The most common sign of this infection is a thin, grayish vaginal discharge with a strong "fishy" odour.
As well as causing itching and discomfort around the opening of your vulva, BV can also make your vulva smell stronger after sexual activity and after menstruation.
While BV is not officially considered an STI, sexual activity does increase your risk, particularly with a new partner or multiple partners.
Women who have intercourse are more likely to get BV because semen make the vagina more alkaline, raising the pH, which increases their vulnerability to BV.
Experts don't fully understand why some women get BV and others don't.
Men don't show symptoms and don't need treatment, but BV can spread to women.
If you are dating a new or non-monogamous partner, you can reduce your risk of contracting the disease by using condoms.
BV is distinguished from other vaginal conditions such as yeast infections or STIs by its odour, itching, or bloody discharge.
Patients should be evaluated if they have any of these symptoms.
Effective treatment
The treatment for BV involves taking antibiotics for five to seven days, either orally or vaginally.
Two popular antibiotics are metronidazole and clindamycin, available in 150mg, 300mg, or 500mg tablets.
Tinidazole can be used as an alternative to metronidazole or clindamycin.
Recurrent infections can also be treated with boric acid.
A vaginal application, such as a cream or gel applied to the vagina, has fewer side effects than an oral version.
Oral antibiotics may cause upset stomach, diarrhoea, and metallic mouth taste.
Pregnant women aren't advised to take these medications.
Certain blood dyscrasias and central nervous system diseases are also contraindicated.
Douching temporarily removes malodorous secretions, but it does not cure the infection (in fact, it may increase the likelihood of recurrence).
If someone has had at least three documented episodes of BV, you will need to consider a longer and more aggressive treatment plan called suppressive therapy.
The treatment lasts for more than five days – usually seven to 10 days of the medication, followed by one to two nights a week over the next four to six months.
The vaginal flora will be reset so the normal bacteria can take over and prevent BV from recurring in future.
Preventing an infection
Although BV cannot be completely prevented, here are some tips to reduce your risk:
Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician and gynaecologist, and a functional medicine practitioner. For further information, email starhealth@thestar.Com.My. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Common Types Of Vaginal Infections
What Upsets the Normal Vaginal EcosystemA normal, healthy vagina contains bacteria and sometimes yeast without necessarily having an infection. But certain things can change the environment in the vagina, enabling bacterial or yeast overgrowth and causing symptoms. These include:
While not all of these can be avoided, douching is unnecessary and potentially harmful.
RELATED: 8 Rules for a Healthy Vagina
The Most Common Types of Vaginal InfectionsThere are three very common types of vaginal infections, says Cynthia Krause, MD, assistant clinical professor of obstetrics and gynecology at Mount Sinai School of Medicine in New York City: yeast infections, bacterial vaginosis, and trichomoniasis, a sexually transmitted infection.
Yeast InfectionThe most common type of vaginitis, a yeast infection is caused by one of the many types of fungus known as candida. According to Dr. Krause, "There are many species of yeast, or candida — Candida albicans is the most common."
Normally, candida live harmlessly in your body in small numbers, including in the vagina. But under certain conditions, an overgrowth of candida can occur, causing a vaginal infection.
Those conditions might include hormone level changes due to pregnancy, birth control pills, or menstruation. Some other conditions that raise the risk of vaginal yeast infections include having frequent or chronic high blood sugar and having lowered immunity because of a medical condition like HIV or AIDS.
Symptoms of a vaginal yeast infection include a thick, white discharge that some women describe as resembling cottage cheese. Yeast infections also can cause vaginal itching and redness of the vulva (the lips of the external female genital area) and vagina.
Bacterial VaginosisAlong with yeast, "friendly" bacteria called lactobacilli live in the vagina. When the number of lactobacilli gets too low, it can trigger a condition called bacterial vaginosis (BV).
Why bacteria levels change is not known, but the normal lactobacilli can be replaced by other, infection-causing bacteria.
"Gardnerella is the bacteria most often associated with bacterial vaginosis," Krause says. "It is the lack of lactobacilli and overgrowth with these other bacteria that cause the symptoms of infection."
With bacterial vaginosis, a woman may see a thick or whitish discharge or one that is slippery and clear. It is not likely to itch or burn. A fishy odor may be noticeable, especially during intercourse.
Trichomoniasis"Of the three most common vaginal infections, trichomonas vaginitis, also called trichomoniasis, is the only one that is a true sexually transmitted infection," Krause says.
Commonly called "trich," it is caused by a single-celled parasite, Trichomonas vaginalis, and is passed from partner to partner during intercourse.
The symptoms of trichomoniasis are similar to other vaginal infections: burning, irritation, redness, and swelling of the vulva, with a yellow-gray or greenish vaginal discharge, possibly with a fishy odor. Some women also experience pain during urination.
Other Conditions That Affect the VaginaOther common vaginal infections and causes of vaginal itching include:
ChlamydiaChlamydia is a sexually transmitted disease that can cause inflammation of the vagina. Some women will have a discharge with chlamydia and some will not. If the infection spreads beyond the vagina and cervix, women may experience bleeding between periods or after vaginal intercourse, according to Planned Parenthood. But it's important to note that such bleeding can be caused by other factors as well.
"Sexually active women up to age 26 should be tested annually for chlamydia because it so often comes without symptoms and can linger and do a fair amount of damage to fertility," Dr. Moore says.
GonorrheaGonorrhea is another, highly contagious sexually transmitted infection that often doesn't cause any symptoms but can cause vaginal discharge, pain during urination, and pain during vaginal sex.
Women who have gonorrhea often also have chlamydia, so a woman who tests positive for one of these bacterial infections will often also be treated for the other.
Noninfectious VaginitisNoninfectious vaginitis occurs when the vagina becomes sensitive to an irritant, such as scented tampons, perfumed soaps, or fabric softeners. This is not an infection, so the first line of defense is to remove whatever you are having a reaction to, Moore says.
In some cases, that may not be enough, and additional treatment, such as steroids, might be the next step. While it's not always easy to pinpoint the cause, Johns Hopkins Medicine notes that some common offenders include products with dyes or fragrances, such as vaginal sprays and douches, but also soaps, detergents, and fabric softeners.
Another form of noninfectious vaginitis is called atrophic vaginitis, and it typically occurs when female hormone levels decrease around the time of menopause, and the vaginal walls become thinner, drier, and less flexible.
RELATED: 10 Symptoms of Menopause and Perimenopause
Vulvodynia: Persistent Pain of the VulvaIn vulvodynia women have chronic pain or discomfort of the vulva without a known cause. The symptoms are similar to vaginal infections: burning, stinging, rawness, soreness, and swelling. Symptoms may be constant or occasional.
Viral VaginitisViruses also can cause vaginal infections. Most viruses that directly affect the vagina are spread through sexual contact.
"The herpes simplex virus is a common cause of viral vaginosis," Moore says. Symptoms include pain in the genital area from lesions or sores. The sores on the vulva or vagina are usually visible, but if the infection is within the vagina or on the cervix, a pelvic exam by your gynecologist is the best way to confirm the diagnosis, notes Johns Hopkins Medicine.
Treatment for Vaginal InfectionsAll of these conditions can be treated, but it's important to know which type of infection or other condition you have so it can be treated correctly.
"Yeast medication is available over the counter if you are certain that it is a yeast infection," Krause says, but "sometimes women think they have a yeast infection and it is actually something else. If you try over-the-counter medications and they don't work, you should see a doctor."
Additional reporting by Ingrid Strauch.
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