Many women find that they have an odor emanating from their vagina or their undergarments. Most will not disclose their perception of this odor for fear of embarrassment or social ostracism. However, all women have a typical odor coming from this region. This is due to the presence of apocrine glands (modified sweat glands), which are also present in the armpits and are responsible for body odor. The secretion from these glands, as well as the glands in the vagina, is the source of the distinct odor experienced by every woman. This vaginal odor changes according to levels of physical activity, day of menstrual cycle, and even the consumption of various foods. When the odor becomes particularly foul and increases in intensity, there may be something to worry about.
Does vaginal odor always accompany vaginal discharge?
Usually the distinct odor emanating from the vagina is a result of physiological secretions from vaginal glands. Oversecretion from these glands during physical activity, excitement, or stress can lead to a slightly increased intensity of this smell. Sexual excitement can also be accompanied by a lubricating discharge from the vagina that is completely healthy. It can therefore be assumed that vaginal odor is associated with vaginal discharge, except in physiological circumstances when discharge may not be present.
When considering pathological causes of foul or offensive vaginal odor, accompanying discharge will likely be present. However, many women experience offensive vaginal odor with no evident discharge. The reason for this lies in the quantification of the discharge as well the woman's perception of vaginal discharge. Usually, when questioned carefully, most women agree that when they have noticed an increased intensity of vaginal odor, they have also noticed soaking of the undergarments to some extent. Why is that so? Many conditions that lead to an increased vaginal odor include infections causing a lower quantity of discharge than others. This may be just enough to soak the undergarments, but not enough to be seen actually flowing out of the vagina. Since that is what most women expect to see when asked about vaginal discharge, women may therefore answer 'no' to this question. So it is wise to check your undergarments for soakage and color of the staining (if it is present) when experiencing offensive vaginal odor.
Causes of vaginal odor
Vaginitis. When offensive odor is accompanied by other symptoms such as discharge from the vagina, itching, or redness of the vulva or vagina, it is almost always due to an infection. The frequency and chances of infection increase with the extremes of age, i.e. in pre-pubertal girls and post-menopausal women. The reason for this is that their lack of estrogen results in a higher vaginal pH.
Non-specific or non-infective vaginitis can occur due to sexual trauma to the vagina, use of strong soaps or detergents in cleaning, use of antimicrobial treatment like pessaries, or due to an allergy to deodorants. When suffering from offensive vaginal odor, it is important not to use strong soaps or deodorants, as this may aggravate the situation.
Foreign bodies in the vagina. The presence of this is another reason for developing foul vaginal odor often, women forget a tampon or occasionally a ring pessary inside the vagina. This usually leads to bacterial overgrowth, offensive odor, and discharge. In the 1980s there was an epidemic of a life-threatening condition called Toxic Shock Syndrome due to the colonization of tampons by bacteria called Staphylococcus.
Bacterial Vaginosis, the most common vaginal infection, is caused by an organism called Mobilincus. This is a sexually transmitted disease. Many infected patients will not have any symptoms, as there is no irritation or inflammation of the vagina. However, a characteristic 'fishy' amine odor may be seen with thin greenish vaginal discharge. The diagnosis can be made by a gynecologist from examining the vaginal fluid. Treatment usually involves a course of Metronidazole or local Clindamycin cream application.
Trichomoniasis is another common infection of the vagina, which can be treated with Metronidazole or Clotrimazole. Examination by a gynecologist is required.
Other sexually transmitted infections (STIs) such as gonorrhoea, chlamydia, and candidal infection (thrush) may also lead to foul vaginal odor and discharge. These organisms can cause inflammation of the cervix, so early consultation with a physician is mandatory if any of these conditions are suspected.
Other causes of offensive vaginal odor include Pelvic Inflammatory Disease, cervical or vaginal cancer, and rectovaginal fistula. These diseases will present with additional symptoms, such as irregular bleeding, pain, fever, and extremely foul smelling or purulent vaginal discharge. If a woman suspects that she may be suffering from any of these, immediate medical consultation is recommended.
What can you do?
First and foremost, maintain good hygiene. Poor hygiene allows overgrowth of organisms and may lead to infections causing foul vaginal odors. Regular washing with warm water and mild soap will suffice. Change your undergarments every day. Try and stick to cotton undergarments since synthetic cloth tends to cause excessive dampness. You may even consider wearing loose fitting clothes for a while in order to let the groin dry out. Use of talcum powder may assist in this. Stick to a healthy diet with plenty of fruits and water.
Home remedies such as using vinegar douches, yogurt soaked tampons, deodorants, and hydrogen peroxide have been used by many women to combat this affliction, but none of these methods are proven; some may even be dangerous. It is recommended that you consult your family doctor or gynecologist. Furthermore, there is no reason to be afraid of bringing this to your doctor's attention, as he or she is there to help.