Firstly, vaginal discharge smells because it’s a bodily fluid, and bodily fluids aren’t designed to be pine fresh.

That being said, your vaginal discharge should smell either pleasant or neutral.

Usually when I mention this in clinic I’m asked to explain what I mean by pleasant.

A vagina is going to smell like a vagina, not a bowl of pot pourri, but the best way I can describe it is to get you thinking about armpit odour.

Yes, really.

We actually secrete substances in our sweat called pheromones. Pheromones are our body’s natural perfume, and these little chemical messengers smell attractive to a potential mate (as a side note, being on the contraceptive pill can change the way women respond to pheromones, causing them to be attracted to the pheromones of men they would not normally be attracted to if they were not on the pill … but more on that another time).

One of the key reasons we have hair on our armpits and genitals is to trap the scent of our pheromones so that it can waft out from us as we wander around. (I just wrote a whole bit here about Pepe Le Pew but then took it out because I’m unsure how many people will get the Looney Tunes reference. Also, upon reflection for those that do remember the cartoon, Pepe Le Pew is probably a perfect character to use to illustrate the concept of consent to children.

“Did the kitty want the skunk to kiss her? No, she didn’t. Did he listen? No, he did not. Is that OK? No, it really isn't.”).

Anyway, we were talking about armpits.

There’s a difference between pheromone armpit odour, and “I just got back from a week camping in the woods” armpit odour. You know what I’m talking about right? One smells like body odour but kinda nice, whereas the other one stinks.

Vaginal discharge is similar. When it’s healthy it smells like a bodily fluid, but it’s not unpleasant. If it smells bad, then there’s something going on.

If that explanation still hasn’t filled in the gaps for you then common words used to describe the smell of healthy vaginal discharge include slightly sweet and musky.

Unpleasant odours on the other hand can include yeasty, rotten and fishy odours.

Also onions. But that one is easily explained. If you’ve ever wondered to yourself “why does my vaginal discharge smell like onions?” (and according to Google a lot of people have) … It’s because you’ve been eating onions.

When vaginal discharge smells like fish, this is usually due to one of two things:

1. Trichomoniasis – a sexually transmitted infection.

2. Bacterial vaginosis – an overgrowth of naturally occurring bacteria.

Trichomoniasis (commonly called trich) is a parasitic infection, is sexually transmitted and in a lot of cases won’t cause any symptoms. If there are symptoms, they can include discharge, pain with urinating, and genital itching (which can be intense, and when I say intense, I mean intense).

The medical textbooks will also tell you that that vulva takes on a “strawberry red appearance” which is a delightfully poetic description of a hellishly inflamed condition.

The discharge associated with trich is typically green and frothy (meaning there are bubbles in it) and has a strong fishy smell.

Bacterial vaginosis (BV) on the other hand is not considered a sexually transmitted infection, although it can be triggered by sexual intercourse, especially with a new partner. It can also be passed back and forth between partners if not treated properly, creating a cycle of recurrent infections.

The vagina has its own bacterial population, known as a microbiome. By now most people have heard of the gut microbiome and know that having lots of different types of bacteria within the gastrointestinal tract is associated with a healthy digestive system.

But in the vagina, we actually need lower bacterial diversity in order to maintain a healthy balance. When it comes to V parts, the lactobacilli strain reign supreme.

When the number of lactobacilli in the vagina drops (which can happen for a variety of reasons) it gives the other types of bacteria the chance to proliferate. These exist naturally in the vaginal environment, just in lower populations. Trouble can start when they begin to dominate.

For many people there are no symptoms. If BV does cause symptoms you may notice mild tingling or prickling of the vaginal tissues, possibly some itchiness. There may also be a tendency for recurrent UTIs.

But the tell-tale signs of BV are a profuse, watery discharge and a fishy odour.

Profuse means gushing. Unlike normal vaginal discharge which is either slippery, sticky or pasty, BV discharge is watery and plentiful, to the point of soaking the underwear. It’s often defined medically as grey … but I’m yet to have anyone come in and tell me they’ve noticed grey discharge.

The fishy odour may be strong or very mild. It may only occur after sexual activity or the day following sexual activity. This is because sex and semen change the pH of the vagina from acidic (healthy range is 3.8 - 4.5) to more alkaline (above 4.5), which is the environment the BV bacteria prefer.

Antibiotics are the conventional medical treatment for trichomoniasis and BV and in a lot of cases a course of antibiotics will clear things up. Left untreated trich can increase the risk of HIV infection and cause a condition called pelvic inflammatory disease, which can ultimately lead to infertility so if you suspect you may have an infection it’s really important to go to the doctor.

BV can be a little more stubborn to treat and some people find themselves stuck in a viscous cycle of getting treatment but then relapsing over and over again. This is because the antibiotics kill the “bad” bacteria by killing all the bacteria – including the good guys.

Without replenishing the right bacteria that help keep order in the vaginal environment you’re only doing half the job.

Unresolved BV is problematic. Aside from leaving sufferers feeling self-conscious, BV increases the risk of contracting STIs and can lead to problems in pregnancy. This includes miscarriage after 12 weeks and preterm labour, increasing the chances that the baby could have complications or even die.

If you notice that your vaginal discharge has a fishy odour it’s important to visit your doctor and get some tests.

No one should have to suffer from recurrent vaginal infections. If you’ve been struggling with them then you might want to consider working with someone who can help you figure out what’s actually causing the problem. That way you can fix the root of the issue instead of just treating the symptoms and finding yourself stuck in a frustrating cycle of repeat infections.

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