Why Does My Vagina Have an Extremely Foul Odor?

Family Medicine, Primary Care Roots Community Health Center, Hippo Education, Kameda Medical Center

Supervised by Kenji Taylor, MD

An extremely foul vaginal odor can be a sign that the normal balance of bacteria has been disturbed, often seen with infections like bacterial vaginosis or in rare cases, health issues like fish odor syndrome.

Explanation

Your vagina normally has a mix of good bacteria that keep it clean and maintain a gentle natural smell. When this balance is upset, it can lead to the release of chemicals such as trimethylamine. In bacterial vaginosis, for example, the healthy bacteria called lactobacilli decrease while other bacteria proliferate, producing trimethylamine that gives off a strong, foul, fishy odor. In some rare cases, a condition known as fish odor syndrome (trimethylaminuria) may cause a very strong foul odor because the body cannot break down trimethylamine properly. Research shows that even factors like changes in the vaginal lining or infections, including HPV, might alter the natural defenses in the vagina and contribute to odor. If you experience an extremely foul odor that is unusual for your body, it is important to talk to a healthcare provider. They can do tests, check for infections, and determine if any treatment is needed to restore a healthy balance and help you feel comfortable.

(References)

Wolrath H, Borén H, Hallén A, Forsum U. Trimethylamine content in vaginal secretion and its relation to bacterial vaginosis. APMIS. 2002 Nov;110(11):819-24. doi: 10.1034/j.1600-0463.2002.1101108.x. PMID: 12588422.
Li M, Al-Sarraf A, Sinclair G, Frohlich J. Fish odour syndrome. CMAJ. 2011 May 17;183(8):929-31. doi: 10.1503/cmaj.100642. Epub 2011 Mar 21. PMID: 21422137; PMCID: PMC3091902.
Lebeau A, Bruyere D, Roncarati P, Peixoto P, Hervouet E, Cobraiville G, Taminiau B, Masson M, Gallego C, Mazzucchelli G, Smargiasso N, Fleron M, Baiwir D, Hendrick E, Pilard C, Lerho T, Reynders C, Ancion M, Greimers R, Twizere JC, Daube G, Schlecht-Louf G, Bachelerie F, Combes JD, Melin P, Fillet M, Delvenne P, Hubert P, Herfs M. HPV infection alters vaginal microbiome through down-regulating host mucosal innate peptides used by Lactobacilli as amino acid sources. Nat Commun. 2022 Feb 28;13(1):1076. doi: 10.1038/s41467-022-28724-8. PMID: 35228537; PMCID: PMC8885657.

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