I have smelly discharge. Could it be bacterial vaginosis?

Oh how we love to joke about the smell of vaginas. Often, crude remarks about the smell are made as throwaway comments, but when they add up they can be damaging. Social opinion of vaginas has been, until recently, that they are unclean, need douching, and should be odourless and pristine. To the men who think everyone should have a Lana Del Rey-inspired cherry cola flavoured vagina: try smelling a sweaty ballsack and get back to me. To women who are concerned about the smell of their vagina: don’t be.

Everyone has their own odour and if you can’t really smell it or it smells fairly neutral that’s fine. Obviously after sport or a busy day of running around it will be a bit sweaty down there but that’s sorted out quickly with a shower. It’s just common sense right? You don’t need to scrub and douche your vagina, it’s entirely self cleansing, and maintains itself at the right pH level for everything to function perfectly. Unless you have an infection, your vagina will smell just right.

Now, that’s not to say that the phrase “fishy fanny” simply sprang up out of nowhere, and, unfortunately, some conditions can cause your vagina and/or vaginal discharge to smell pretty funky. However, these are fairly common, and most are very easily treatable.

What are the symptoms of bacterial vaginosis?

One particular condition of which a strong smell is a hallmark is bacterial vaginosis, or BV. As you can deduce from the name, it is a bacterial infection in the vagina, caused by a bacterial imbalance, ie., when the bad bacteria outgrows the good bacteria. This can occur for a number of reasons, including using vaginal cleansers, which upset the pH balance, allowing unwelcome bacteria to proliferate. BV can also occur after sex (although it is not a sexually transmitted disease), and can even occur due to the changes in your vagina when you’re on your period.

Discharge can become white or grey, or more watery and thin, and is typically described as having a strong, “fishy”, smell, particularly after sex, although this won’t necessarily be the case for everyone.

Commonly reported symptoms include a change in vaginal discharge and a change in odour. However, these symptoms will vary from person to person, so the biggest thing to be aware of is experiencing a discharge or smell that you don’t recognise as normal for you.

Discharge can become white or grey, or more watery and thin, and is typically described as having a strong, “fishy”, smell, particularly after sex, although this won’t necessarily be the case for everyone. You can speak to your pharmacist and get over the counter treatments, although there is no clear proof these work. Instead, you may find you need to go to your GP or a sexual health clinic and get antibiotics.

How do people who have had BV describe their experiences?

It’s easy to read a list of symptoms, but that doesn’t do much to bring it closer to home and won’t necessarily help you understand if this is what you have or not. How do women who have had BV describe their experiences?

“For a few days I noticed this unfamiliar smell when I took my trousers down,” says 28-year-old Leila*. “It was summer and hot so I didn’t know if it was just being sweaty.” But one night the smell got really bad. “I wouldn’t say it was fishy necessarily,” Leila continues, “but it was very strong and kind of cheesy. The main thing I noticed was that it was a new smell.”

Leila could tell it was her discharge smelling and says it made her feel “gross” and “embarrassed” and she was particularly concerned that other people might be able to smell it. She also noticed a change in her discharge. “I just had a bit more of it than normal, and it wasn’t the white sort, it was cloudy and sticky, she says.” Realising something was up, Leila went to the STI clinic where she was very quickly diagnosed with BV and given a simple course of antibiotics lasting five days. “It cleaned it up after like one day,” she says. “As I learned it’s to do with your pH balance now I’m just ultra careful not to get shower gel or anything like that near my vagina.”

“As I learned it’s to do with your pH balance now I’m just ultra careful not to get shower gel or anything like that near my vagina.”

Other people who have had the condition also describe discharge changes as one of the first things they noticed, such as 31-year-old Milly*. “I first noticed that something wasn’t quite right when I became seuxally active at the age of 17,” she says. “By not quite right, I mean I experienced a definite change in my discharge; it was more watery, clear and most significantly, it smelled fishy.”

Milly was so embarrassed she didn’t dare mention her symptoms to anyone and thinks her BV came and went for a couple of years. It was only when she started getting terrible thrush when she was in a new relationship that she went to her doctor about that, told her all her symptoms, and got diagnosed with BV. “This was the first I’d ever heard of it,” she says. “It was such a relief to hear that it had a name and could be treated.” The next time she got it it cleared up immediately with antibiotics.

What’s it like having recurrent BV?

Nonetheless it did keep coming back, so eventually her GP recommended her an over the counter remedy called Balance Activ, a pessary. “Sometimes I would have to take the full dose, one pessary a day for seven consecutive days, but sometimes I was able to use just one pessary and my BV would disappear overnight,” she says. As she got older she started getting BV every time she had a lot of sex or was at the end of her period, so used a precautionary Balance Activ in these situations. For a time her BV stopped, but then when she went back on the contraceptive pill it flared up again, and now comes and goes.

Having recurrent BV knocked both Milly’s body confidence, and her sexual confidence. “I’d read endless articles online about BV, but they rarely gave any solid advice,” she says. “It’s not only a taboo condition, but one that doctors don’t seem to know much about.”

For a condition that not many people have even heard of, BV can impact those who have it quite significantly, both because of the nature of the symptoms and the fact that the condition is so rarely talked about. As both Leila and Milly have shown, the symptoms can manifest differently, but noticing a change in the look and smell of discharge was one of the key indicators in both.

Annoyingly, it is common for BV to recur, usually within about three months, and you may be prescribed treatment for up to six months if you keep getting BV. You will need to speak to your doctor to discuss this, so don’t be ashamed of your symptoms and don’t the stigma put you off seeking help. Untreated infections in the vagina can cause more serious problems further down the line, so any changes in your discharge should warrant a visit to the doctor if they last more than a few days.

*Names have been changed

Page last updated October 2018