Along with vaginal dryness, vaginal itch, and vaginal discharge, vaginal odor is one the leading reasons women consult gynecologists. Even in healthy women, normal vaginal secretions can have a slightly "cheesy" or "antiseptic" smell. Contact of the vagina with semen can result in the release of a "fishy" odor. The greatest amount of vaginal discharge occurs at the midpoint of a woman's menstrual cycle, so this odor will naturally be stronger around the time of ovulation, when fertility is greatest.
Vaginal mucus (distinguished from menstrual blood) is released all the time, but the volume of discharge is about twice as great around Day 14 of a woman's period. The actual volume of discharge is normally 2 to 4 ml, about 1/2 a teaspoon to 1 teaspoon a day. Immediately after the menstrual period the mucus is "slippery" and produced in higher volume, and right around ovulation the mucus is "dry" and produced in lower volume.
The relationship of vaginal odor to vaginal infections is not easy to sort out. It is possible to have an infection without odor, and it is possible to have odor without infection. Odor can also result from excessive growth of bacteria that normally inhabit a healthy vagina, such as Gardnerella. Vaginal odor can be caused by yeast or trichomonas, but about a third of women who have issues with vaginal odor do not have infections with any common microorganism.
Vaginal odor can also be a symptom of chlamydia infection or pelvic inflammatory disease (PID). If excessive vaginal odor is an issue, a trip to the doctor is in order to ensure that these two serious conditions do not exist. Looking at the vaginal mucus under the microscope usually reveals the exact source of the odor, but inflammatory processes that have nothing to do with infection can also cause odor problems.
As a general rule, however, itching with no odor is caused by yeast infection while inflammation with a strong "cheese" odor is caused by bacterial infection. Antifungals are prescribed for yeast infection, while antibiotics may be prescribed for bacterial infection-it is important to get the right treatment! Diflucan and fluconazole are more likely to be the right treatment when there is no strong odor, just vaginal itch.
Don't ignore vaginal odor. It is important to get treatment for bacterial infections of the vagina. Untreated infections with the bacterium Gardnerella can result in salpingitis, endometrial infection, pelvic inflammatory disease, and premature labor. Any kind of uterine surgery becomes much more likely to result in infection, and the woman also becomes more at risk for infection with HIV. Women at the highest risk for bacterial infections of the vagina are those who:
· Recently started sexual relations with a new male partner.
· Have lower estrogen levels as a result of perimenopause, the years of a woman's life before full menopause.
· Use douches for vaginal hygiene.
· Recently finished treatment with antibiotics (killing the friendly bacteria that keep odor-causing bacteria in check).
· Wear an IUD (intrauterine device) for contraception.
Finally, vaginal odor sometimes is the only warning sign of herpes infection. It is important to get a medical examination to be sure the cause of the odor is not a serious disease.
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