Vaginal Discharge With Odor: Meanings & Red Flags

Key takeaways:

• The tissues and secretions of the vagina have a natural odor and discharge that can vary throughout your menstrual cycle.
• Some vaginal odor is normal, but when it becomes unpleasant or foul, it can point to infection.
• Bacterial imbalances, dehydration, poor hygiene, high blood sugar, and STIs can all lead to changes in the odor of vaginal discharge.

With the normal processes of your menstrual cycle or the constant influence of hormones during pregnancy, vaginal secretions, and tissue generate a natural odor. At some points, it may be stronger than others. This depends on the stage of your cycle, state of hydration, and whether or not you’re pregnant.

However, it should never be noticeably unpleasant. A foul odor means there is something other than your natural processes at work. Although an odor is often accompanied by a change in the consistency or amount of vaginal discharge, these two warning signals need not come together; either one can be a cause for concern.

Can vaginal discharge have an odor?

Yes. In fact, it’s normal for there to be an odor associated with your vagina. However, you should be suspicious when that odor becomes unpleasant or fish-like. Typically, such a change in the odor occurs with a change in your discharge due to infection.

Normal vs. abnormal vaginal odors that accompany vaginal discharge

A mild, musky scent is normal. Others have described a sharp, fermented, or sour smell. These are normal smells due to a normal bacterial population of lactobacilli. They produce lactic acid, hydrogen peroxide, and other substances that discourage the growth of other bacteria and yeast.

If there is a change in that bacterial balance or an infection, the chemistry of your vagina is altered, and this can produce smells to which you’re not accustomed. Such a change is typically accompanied by a change in your discharge as well. Read our guide on types of vaginal discharge for more.

Odors that can accompany vaginal discharge and their meanings

Your sense of smell plays an important role when it comes to protecting your health. We naturally recoil from foul odors, making us less likely to eat bad or spoiled food, avoid waste products, and take notice of changes in our bodies. Thus, an unusual smell in our own chemistry can alert us to potential health issues.

Fishy odor

Trimethylamine oxide (TMAO) is a chemical metabolized in your intestines from the foods you eat. From there, TMAO ends up in all tissues, including your vagina. The fishy-smell problem arises when there is an excess conversion of TMAO to another chemical, trimethylamine (TMA), by bacteria.

It is this TMA that smells like fish and can become more noticeable with bacterial imbalances, like bacterial vaginosis (BV) or infections. Chlamydia can also generate a fishy odor, but this is not typical. When it does happen, however, it is described as a mild to unpleasant smell that can worsen to foul, musty, or fishy.

Other non-infectious causes of a fishy smell include:

• Dehydration, which can increase in what normally would be a non-smelling, minimal TMA concentration, making the odor more noticeable.
• Sweat, especially combined with dehydration.
• Poor hygiene.
• Sexual activity in which bodily fluids and semen mix with vaginal bacteria. Semen is alkaline, as opposed to the normally acidic vagina. This can cause a bacterial imbalance, leading to BV.

Cheese-like odor

A vaginal yeast infection will usually cause severe burning or itching before any odor becomes a problem. When there is an odor, it is usually mild, sweet, or yeast-like (like beer). Its most common symptom, associated with itching and burning, is its thick, cottage cheese-like discharge.

Mild yeast infections may resolve on their own, but if symptoms continue or worsen, it’s important to seek medical care.

Ammonia-like odor

Urea is a waste product eliminated through our urine. Urea is broken down further into ammonia, which has a distinctive pungent smell. Normally, the water in urine dilutes it to the point where you can’t smell it. However, if the urine is concentrated, e.g., from dehydration, it can cause your urine to have an ammonia smell.

Two causes of an ammonia-like smell in the vagina are:

• Urine residue in the vagina.
• Smelling urine from your urethra, as its opening is near the top of your vagina.

Either way, it’s a result of urine concentration and possibly dehydration.

Metallic or “copper penny” smell

A metallic smell can occur with bleeding due to its iron content. A discharge can change from pink to red to even brown, depending on how much iron has remained in a bloody discharge. This can vary the strength of the metallic smell.

Sweet smell

High blood sugar, such as with poorly controlled diabetes, can cause a vaginal odor that smells sweet. High ketone levels, caused by high blood sugar, cause body secretions like urine, saliva, and vaginal secretions to smell fruity. It must be noted, however, that it takes very high sugar levels to cause such odors, and the vagina is a rare example.

Consistently high blood sugar can lead to a variety of serious health issues, so it’s important to see your doctor if you have concerns.

Foul smell

An offensive, foul smell usually indicates an infection. This can be from STIs like gonorrhea and chlamydia. It can also be from other bacterial infections due to foreign bodies (e.g., a forgotten tampon or condom). Rectal bacteria can also infect the vagina, despite the best of personal hygiene, due to the proximity of the anus. A foul smell can also be from pus, which is the collection of white blood cells attempting to fight infection.

Cancer causes tissue to die and, after that, decompose. Cervical, vaginal, and uterine cancer can result in an unpleasant smell of decay and a brown or bloody discharge.

A smell of feces indicates the presence of feces in the vagina, which can happen with a rectovaginal fistula—an unnatural communication between your rectum and the floor of your vagina. Such a fistula can occur due to severe trauma during childbirth, surgical complications, colon infections, inflammatory bowel disease (like Crohn’s disease or ulcerative colitis), cancer, or radiation therapy.

Causes of odors that accompany vaginal discharge

Aside from the natural smell discharge, there are many reasons vaginal discharge can have an unusual odor. Conditions that cause the various unpleasant odors from the vagina include the following:

Bacterial vaginosis

Bacterial vaginosis has a characteristic fishy odor, and is often associated with a grayish-white discharge.

Trichomoniasis

This common STI, caused by the trichomonas vaginalis parasite, can produce a fishy smell alongside a frothy white, green, or greenish-yellow discharge.

Candidiasis (yeast infection)

This fungal infection causes a yeast-like odor due to the fermentation of lactic acid in the vagina. Because of this relationship with the lactobacilli, a yeasty smell may merely indicate healthy bacterial levels and not necessarily an infection.

Bacterial infection

Any foreign bacteria that takes over the environment of your vagina can cause a discharge that burns or itches and a foul odor, especially if there is pus. STIs like gonorrhea and chlamydia also can do this.

Douching

Douching should be avoided. Your vagina runs on autopilot to maintain its cleanliness and health. Douching does two harmful things:

1. It washes out your normal helpful lactobacilli, which are crucial in maintaining the proper acidity.
2. It leaves a moist environment in a dark place, which can allow yeast to flourish.

When to see a doctor about vaginal discharge and odor

Any discharge to which you’re unaccustomed, in regard to odor, should concern you.

You should see a doctor if:

You experience unusual vaginal discharge that:

• Has an unfamiliar, unpleasant, or offensive odor.
• Comes with additional symptoms, like bleeding, burning, itching, and pain.
• Occurs after sex with a new partner.
• Causes painful urination or pain during intercourse.

You should go to the emergency room if:

You experience any of the above symptoms along with:

• A fever.
• Pelvic or abdominal pain with or without bloating.
• Back pain.
• Nausea or dizziness.
• Bleeding that continues to worsen.

Questions to ask your doctor about vaginal discharge and odor

• How will you diagnose the cause of the odor?
• What is the recommended treatment, and how will I know if it’s working?
• Should I inform my partner of my diagnosis?
• What if I’m pregnant or plan to be?

Frequently asked questions: vaginal discharge and odor

A vaginal discharge that has an unusual odor is usually worrisome, prompting common questions:

What if you have vaginal discharge with an odor while pregnant?

The advice is the same as when you’re not pregnant. An abnormal discharge requires proper medical evaluation to ensure appropriate treatment. Pregnancy merely raises the urgency factor, and symptoms should be addressed immediately.

Can you treat vaginal discharge with an odor at home?

Depending on the cause of the odor, you may be able to address your symptoms at home.

Proper hygiene, hydration, and diet can help maintain vaginal health. For BV and trichomoniasis, antibiotics are often necessary. Yeast infections can usually be managed at home—once you’ve been diagnosed—with the use of over-the-counter antifungal creams and suppositories.

Final thoughts on vaginal discharge with an odor

To protect your health, you should take note of any vaginal discharge different from what you normally expect. Odor can raise the alarm for an infection, especially if it is unpleasant or foul. While your vagina will naturally have a scent, it should never be an offensive odor.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Poushali Bhattacharjee, MD.

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