You should expect to catch a whiff of something fishy when you go to the beach or hit up your local seafood market for dinner. But if you’re noticing a particularly fishy smell coming from your vagina, that’s usually your body’s way of telling you “hey, BTW, something’s up.”
It’s not like you should expect your vagina to smell like a vanilla-scented candle (in fact, that probably means you used products down there that could be irritating). Vaginas smell like vaginas, and that’s perfectly OK. But a distinctly…sashimi…odor is usually a sign that you should see your doctor.
This is actually a pretty common symptom that’s also typically a solid tip-off that something is off with your vaginal health, Lauren Streicher, M.D., an associate professor of clinical obstetrics and gynecology at Northwestern University Feinberg School of Medicine, tells SELF. Even though a doctor is the only person who can definitively diagnose and treat you, it can still be helpful to have an idea of what may be going on while you wait for your appointment. Here’s what to keep in mind.
The most common reason behind a fishy vaginal odor, hands down, is bacterial vaginosis (BV).
In case you’re not super familiar with it, BV happens when there is too much “harmful” bacteria in your vagina and not enough “good” bacteria to counteract it, the Centers for Disease Control and Prevention (CDC) says. This throws off the pH of your vagina and can lead to an infection that causes a bad, fishy odor (especially after sex), along with itchiness, pain, burning, and a thin gray or white vaginal discharge.
If you have BV, you’re definitely not alone: The CDC says this is the most common vaginal infection in women between the ages of 15 and 44. Known risk factors include being sexually active (especially with a new partner or multiple partners) and douching, the CDC says.
It’s also possible (but less likely) that you could be dealing with trichomoniasis or pelvic inflammatory disease.
Trichomoniasis is a common sexually transmitted infection caused by a parasite, and it can create a foul-smelling vaginal discharge (that can be white, gray, yellow, or green), genital itching, redness, burning, and pain when you pee or have sex, the Mayo Clinic says.
Jessica Shepherd, M.D., a minimally invasive gynecologist at Baylor University Medical Center at Dallas, tells SELF that a fishy odor isn’t required for a trichomoniasis diagnosis, but it’s a possibility. “You can have an odor, but it’s not typical,” Dr. Shepherd says. “But if you do have an odor, it could be fishy.”
Ditto for pelvic inflammatory disease (PID), an infection that usually happens when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes, or ovaries, Christine Greves, M.D., a board-certified ob/gyn at the Winnie Palmer Hospital for Women and Babies, tells SELF. Usually PID causes no signs or symptoms, but sometimes it can lead to pelvic pain, bleeding during or after sex or between your period, a fever, pain when you pee, and even trouble getting pregnant due to scarring of your reproductive organs, the Mayo Clinic says. It can also cause a heavy vaginal discharge with a foul odor, and sometimes that odor is fishy, Dr. Greves says.
Again, if you’re dealing with a fishy scent, it’s highly likely that it’s BV, Dr. Streicher says. But regardless of what’s going on down there, it’s important to rope in your doctor so you can get the right treatment.
There are a few things that you definitely shouldn’t do while you’re waiting to see your doctor, like trying to scorched-earth clean your vagina.
Usually if something stinks, you wash it. But don’t take that tactic with your vagina, says Dr. Greves. Trying to clean out your vagina with a method like douching can just further disrupt your vagina’s natural pH and make you more uncomfortable. Using soap might seem like a more innocent option, but putting soap inside your vagina is basically begging for irritation, Dr. Greves says. Instead of putting any soap up there, remember that your vagina cleans itself with discharge, so you really don’t need to jump in and try to “help.” Letting a mild, gentle soap come into contact with your vulva is fine, but keep your vagina out of it.
You also shouldn’t assume the weird odor is a sign of a yeast infection and try to self-medicate with over-the-counter drugs, which doctors say is common. Yeast infections are completely different than the above issues; they can come with a bread-like scent, Dr. Streicher says, along with chunky white discharge reminiscent of cottage cheese. Using yeast infection cream probably isn’t going to directly make things worse if you have some sort of other vaginal problem, Dr. Streicher says, but you’ll definitely be wasting your money and delaying the time it takes to get treatment for your actual issue.
And, you probably already know this, but it’s worth mentioning given that the doctors say they’ve seen it before: Don’t spray perfume anywhere remotely near your sexual organs. “It’s not going to cover the smell up, and [it may just] irritate your vulvar skin,” Dr. Streicher says.
The good news is that it’s pretty likely that the right treatment will clear up your fishy odor. You just have to see a doctor first.
Your doctor may be able to tell what you’re dealing with just by doing an exam, but they’ll likely also order lab tests on a sample of your vaginal fluid to try to see if BV, trichomoniasis, or PID is the cause of your odor. They can also run other exams, like urine tests, to lock down a diagnosis.
If BV is behind your fishy vaginal odor, antibiotics you take orally or apply vaginally should get rid of it, the Mayo Clinic says. Be sure to follow the drug’s directions. Two common BV drugs (metronidazole and tinidazole) can cause nausea, so avoiding alcohol during treatment and for a day after is recommended, the Mayo Clinic says. One of the vaginal treatments (clindamycin) can weaken latex condoms throughout treatment and for at least three days after you stop applying the cream, too.
Trichomonioasis is also typically treated with metronidazole or tinidazole, two of those drugs often used for bacterial vaginosis.
Antibiotics can also help with PID. There’s a wide range of treatment options because the drugs need to target a broad spectrum of pathogens that could have caused the illness, the CDC says. While these drugs can quell the infection, they can’t reverse any PID-induced scarring in your reproductive system. The earlier you catch PID, the better, which is why it’s always important to see your doctor if you think something is up with your vaginal health (and to protect yourself during sex and get tested at the recommended intervals for you).
No matter what’s causing your fishy vaginal odor, ask your doctor whether or not your partner needs testing and potential treatment, since bacterial vaginosis, trichomoniasis, and pelvic inflammatory disease all have some sort of link to sexual activity.
Ultimately, a fishy odor is a sign that your vagina needs some assistance, and a doctor is the person to do it. Good thing there’s an entire medical field devoted to helping your vagina feel its absolute best!