Dear Doctor: 'The smell of my vagina has changed over the last couple of weeks. Please help!'

Dear Doctor,

Over the past couple of weeks, I've noticed a 'smell'. At first I thought it was something in my environment, but I quickly realised the odour was following me around. I'm feeling pretty embarrassed – I realised the smell is coming from my vagina. Obviously when I realised, I went to the doctor, who has done an STI screen and everything came back normal. But I know something isn’t quite right, because I've never noticed this smell before and it isn't going away.  I shower regularly – even twice a day! – and it's just not changing. Please help!

Sophie, 24.

***

Hi Sophie, 

I often find myself reflecting on just how amazing the vagina is (that isn’t weird, right?). Think about it for a minute. It’s self-cleaning, maintains its own acidity, fights disease. And even births babies! All without expecting any thanks or recognition.

It is also generally pretty good at letting us know if something isn’t quite right down there. The signs it may give us are a change in the consistency, quantity or smell of vaginal discharge, as well as any abnormal vaginal bleeding or any significant pain during sex. 

However, it is important to remember that we do naturally have changes to our odour depending on a few things. For example, in response to altering hormone levels as part of our menstrual cycle. The odour can also change in response to sweating (like after an intense workout), after sex or during our period. 

A more significant change in odour can be distressing for women and is a common reason for presentation to the GP. So, you are definitely not alone in your concerns.

Firstly, a big tick for you for seeing your GP and ruling out STIs. Chlamydia and gonorrhoea don’t always cause symptoms, but are important to rule out with any new vaginal symptom. 

If you were my patient, my next step for you would be to do a thorough examination of the vagina and cervix with a speculum to ensure there are no issues internally, for example, a retained tampon. During this examination, I would collect swabs to assess for bacterial vaginosis and thrush, as well as for rarer causes of STIs such as mycoplasma genitalum.

Bacterial vaginosis is a common reason for a change in smell to the vagina, and is caused by an overgrowth of the normal bacterial flora. Often on examination, we can provide a diagnosis of bacterial vaginosis by observing any discharge or any characteristic 'fishy' odour. A course of antibiotics will be prescribed to assist with your symptoms if bacterial vaginosis is present. 

In my experience, it's not that unusual for all the tests to be normal. If this is the case, you can be reassured that the smell is just your vagina doing its thing by responding to hormones throughout the month. 

Lastly, I strongly advise against over-washing or using vaginal douches to eradicate any odours, as your vagina likes to do its own housekeeping. However, if symptoms persist and remain distressing to you, always let your GP know so they can reassess and do more tests if needed.

Dr Rebecca Goadby is a General Practitioner who is passionate about the health of women through every stage of their lives. Her approach is compassionate and holistic, with a focus on preventative medicine and mental health wellbeing.

Information found in this column is not meant to be a substitute for proper medical advice – please contact your doctor or a health professional to discuss your own medical needs.

Do you have a burning question you'd love Dr Rebecca to answer? Send us an email (submissions@mamamia.com.au) with the subject line 'DEAR DOCTOR' for consideration.

Feature image: Getty. 

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