Share the Knowledge 0 Pinterest 0 Reddit 0 Linkedin Print

Fish taco. Crotch mackerel. Cod canal. Tuna town. With these common snipes at the vagina, is it any wonder that women worry about how they smell! Not to mention that every single drugstore across the land houses shelves full of “feminine hygiene” products euphemistically pointing out that a woman’s natural state is being smelly.

Sadly, many women buy into the message that the vagina is dirty and smelly leading to shame and embarrassment. Not to mention the physical consequences of believing your vagina is a wreaking, foul-smelling hellhole. Turns out all those douches, vagina perfumes, deodorants, and wipes can actually cause a host of problems down there.

That’s why we’ve decided to dedicate this blog to some straight talk about vaginal odor. In it we’re going to explain what your vagina is supposed to smell like, including a look at when the smell could signify that there’s a disturbance in the force. In addition, we’re going to talk douching. (Spoiler alert: it’s a terrible idea!)

How is the Vagina Supposed to Smell?

The answer: it depends— on many different factors.

Right out of the shower, the vagina might have no odor, while after a marathon, it’ll have a “strong, musky odor” from all the sweat glands, explains ob/gyn Lissa Rankin in her amazing book, What’s up Down There? Questions you would only ask your Gynecologist if she were your Best Friend.

When menstruating or giving birth, it’ll have the “flinty, iron smell of blood” and if there is a yeast overgrowth, it might smell like “fresh baked bread” or a “good malt beer”. Having intercourse will even change the smell to “faintly bleachlike” as semen has its own special scent.

And as Rankin points out there is a role for hygiene when it comes to vaginal odor: “Just like washing your pits and your feet, cleaning yourself down there is part of being an accepted member of society,” she writes. (More on good housekeeping for the vagina in a bit.)

But what about all that talk of fish? Well, turns out there’s something to it, but before we get into that, let’s first take a look at why the vagina has the odor it does.

For that answer we turned to New York Times science writer and author of Woman: An Intimate Geography, Natalie Angier. Thanks to Angier’s keen ability to boil down biology and make it digestible, here’s what we learned:

To understand the “why” you must first understand the ecosystem of the vagina. When conditions are healthy, the bacteria that live in the vagina are a girl’s best friends. These microbes are lactobacilli, the same bacteria found in yogurt. In fact, a “normal” vagina will have a “slightly sweet, slightly pungent,” odor like the lactic acid smell of yogurt.

On our end, we provide lactobacilli with food and shelter plus the comfortable moisture of our vaginal walls, and on their end they maintain a stable population, which keeps competing bacteria out. Just by living and metabolizing these model tenants generate lactic acid and hydrogen peroxide, which act as disinfectants preventing less congenial microbes from moving in.

For a number of reasons, the balance of the flora within the vagina can be upset causing the lactobacilli to die out. In their place, other less friendly organisms can move in, particularly anaerobic bacteria, which thrive in the absence of oxygen. These bacteria secrete a host of foul-smelling compounds, including trimethylamine, which gives day-old fish its fishy odor and putrescine, a chemical found in putrifying fish.

This good bacteria/bad bacteria shuffle can lead to an infection called “bacterial vaginosis”. Not to mention that the loss of lactobacilli can also cause a yeast infection as their residency in the vagina keeps the amount of yeast in check.

So if a strong fishy odor or the smell of the aforementioned fresh baked bread starts emanating from your lady bits, a trip to the gynecologist may be in order.

Why Douching is Baaad*

Before we get into a discussion of good hygiene habits for the vagina, let’s first talk about a particularly bad one: douching.

When I was growing up in the ‘80s, I remember these hilarious “Do you ever have that ‘not so fresh’ feeling?” commercials. Just saying “that not so fresh feeling” can still make my friends and I laugh. But the potential effects of douching is no laughing matter.

Douching has a long, sordid history. For the first half of the 20th century, Lysol, the same bottle as the kitchen germ killer, was sold as a douche. The ad campaign was designed to convince women their husbands would leave them if they were not fresh and clean.

Just check out this misogynistic jingle from back in the day: “A man marries a woman because he loves her so instead of blaming him if married love begins to cool she should question herself. Is she truly trying to keep her husband and herself eager happy married lovers? One most effective way to safeguard her dainty feminine allure is by practicing complete feminine hygiene as provided by vaginal douches with a scientifically correct preparation like Lysol.”

Thank goodness we’ve come such a long way baby! Well actually, not so much. Today, an estimated 15% of U.S. women douche regularly. And most of them are reaching for the disposable, commercial products. Not only is douching completely unnecessary, it can be downright harmful. Remember those lovely lactobacilli that keep the vagina’s ecosystem in balance? Douching kills some of them, which can upset that balance. The vagina reverts to normal within 72 hours, but before it does the bad microbes can cause a variety of problems.

Don’t just take my word for it; here’s what some of the research shows:

University of Washington researchers correlated douching and chlamydia risk in 1,692 women. Compared with those who never douched, those who did even once in the previous year had double the risk. Among those who douched weekly risk almost quadrupled.

Researchers at Mount Sinai School of Medicine in New York City discovered that monthly douching doubled the risk of pelvic inflammatory disease. And a study at the University of Washington School of Medicine in Seattle showed that weekly douching almost quadrupled it.

University of Pittsburgh researchers surveyed 1,200 women. As douching increased, so did the risk of bacterial vaginosis. Compared with those who did not douche at all, women who douched once a month, were 40 percent more likely to develop BV. In those who douched weekly, risk doubled.

Italian researchers surveyed 931 women about their douching and history of yeast infections. Frequent douching was associated with significantly increased risk.

(And that’s just a tiny snippet of the research. For more, check out the resources below.)

Not only is douching bad for you, it’s completely unnecessary. That’s because the vagina is a self-cleaning organ. In fact, a healthy vagina is the cleanest space in the body.

Plus, the proliferation of the human species depends on the vagina not smelling like a “spring breeze” or “tropical rain” or “island splash” or my personal favorite “sweet romance.” That’s because these douchy scents can cover up the important odor of pheromones—the scent that the glands around the vagina secrete to attract a sexual partner.

(For a laugh: check out SNL’s take on the topic)

Now let’s talk about hygiene. Many ob/gyns say warm water on a soft washcloth is all you need to keep yourself clean. But if you’re going to use soap, do not use an antibacterial soap as it can disrupt the delicate balance of the vagina’s ecosystem and might even be an endocrine disruptor. Find a soap that is free of harsh chemicals, including dyes and fragrances.

Also, go panty free when you can, and when you do wear underwear, choose cotton panties for good ventilation. And avoid pantyhose and tight jeans, both of which can cause more sweating, and more sweating equals more odor. Lastly, (and this is just an FYI because I don’t advocate going without any of these just because they might upset your vaginal bouquet for a bit): things that make your urine smell will also make your vagina smell. Think asparagus, beets, alcohol, broccoli, onions, garlic, and curry.

So that’s the deal. Here’s hoping this blog will wash away any anxiety/embarrassment/discomfort you might harbor about the scent of your vagina.

Questions? Comments? Please leave them below. We want to hear from you!

All my best,

Stephanie

*Note: not all douches are evil. There are cases where the vagina does not self-lubricate. For those that don’t, medically prescribed douches are necessary. But these medical rinses help maintain vaginal health and are marketed and sold on the assumption that vaginas are not dirty.

______________________________________________________________________________________________________________________________________

Are you unable to come see us in person? We offer virtual appointments!

Due to COVID-19, we understand people may prefer to utilize our services from their homes. We also understand that many people do not have access to pelvic floor physical therapy and we are here to help! The Pelvic Health and Rehabilitation Center is a multi-city company of highly trained and specialized pelvic floor physical therapists committed to helping people optimize their pelvic health and eliminate pelvic pain and dysfunction. We are here for you and ready to help, whether it is in-person or online.

Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. The cost for this service is $75.00 per 30 minutes. For more information and to schedule, please visit our digital healthcare page.

In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page.

References:

Angier, Natalie. “Woman: An Intimate Geography,” Houghton Mifflin Harcourt Publishing Company, New York, 1999.

Annang, L. et al. “Vaginal Douching Practices Among Black Women at Risk: Exploring Douching Prevalence, Reasons for It, and Sexually Transmitted Diseases,” Sexually Transmitted Diseases (2006) 33:215.

Brotman, R.M. et al. “A Longitudinal Study of Vaginal Douching and Bacterial Vaginosis: A Marginal Structural Modeling Analysis,” American Journal of Epidemiology (2008) 168:188.

Bruce, F.C. et al. “Is Vaginal Douching Associated with Preterm Delivery?”Epidemiology (2002) 13:328.

Corsello, S. et al. “An Epidemiological Survey of Vulvovaginal Candidiasis in Italy,” European Journal of Obstetrics, Gynecology, and Reproductive Biology (2003) 119:66.

Cottrell, B.H. “Vaginal Douching,” Journal of Obstetrics, Gynecology, and Neonatal Nursing (2003) 32:12.

Fiscella, K. et al. “Risk of Preterm Birth Associated with Vaginal Douching,”American Journal of Obstetrics and Gynecology (2002) 186:1345.

Holtzman, C. et al. “Factors Linked to Bacterial Vaginosis in Nonpregnant Women,” American Journal of Public Health (2001) 91:1664.

Koumans, E.H. “Prevalence of Bacterial Vaginosis in the U.S., 2001-2004: Associations with Symptoms, Sexual Behaviors, and Reproductive Health,”Sexually Transmitted Diseases (2007) 34:864.

Ness, R.B. et al. “Douching, Pelvic Inflammatory Disease, and Incident Gonococcal and Chlamydial Genital Infection in a Cohort of High-Risk Women,” American Journal of Epidemiology (2005) 161:186.

Rankin, Lissa. “What’s up Down There? Questions you would only ask your Gynecologist if she were your Best Friend,” St. Martin’s Griffin, New York, October 2010.

Rothman, K.J. et al. “Randomized Field Trial of Vaginal Douching, Pelvic Inflammatory Disease, and Pregnancy,” Epidemiology (2003) 14:340.

Rupp, R. et al. “Intergenerational Transfer of Douching Information,” Journal of Pediatric and Adolescent Gynecology (2006) 19:69.

Sutton, M. et al. “Prevalence of Trichomonas Vaginalis Among Reproductive-Age Women in the U.S., 2001-2004,” Clinical Infectious Disease (2007) 45:1319.

Thorp, J.M. et al. “Alteration in Vaginal Microflora, Douching Prior to Pregnancy, and Preterm Birth,” Pediatric and Perinatal Epidemiology(2008) 22:530.

Tsai, C.S. et al. “Does Douching Increase Risk for Sexually Transmitted Infections? A Prospective Study in High-Risk Adolescents,” American Journal of Obstetrics and Gynecology. (2009) 200:38.