What should you know about fishy smell and bleeding between periods?

A fishy odour often comes from a change in vaginal bacteria, but smell alone cannot identify the cause. Bleeding between periods can arise from hormonal contraception, irritation of the cervix, infection, polyps or fibroids. Sexually transmitted infections such as chlamydia may cause bleeding or discharge, sometimes with few other symptoms. Cervical dysplasia and cervical cancer, or conditions affecting the womb, are less common explanations but may need consideration when bleeding persists or follows sex.

Arrange a gynaecology or sexual-health assessment, especially if the smell is new or keeps returning. Note the bleeding pattern, discharge colour and texture, pelvic pain, itching, urinary symptoms, recent antibiotics, contraception and new sexual partners. Avoid douching and fragranced washes, and do not use leftover treatment because symptoms can overlap. Consider avoiding sex or using condoms until an infection assessment is complete.

Seek urgent help for heavy bleeding, severe or worsening pelvic pain, fever, vomiting, faintness, or feeling acutely unwell. Prompt assessment is also needed for bleeding after sex that keeps recurring, bleeding after menopause, or discharge with significant pain. A clinician may examine the cervix, collect swabs and decide whether imaging or further testing is needed.

Ask which swabs or tests are suitable, whether your partner needs testing, when results will be available, how to prevent recurrence, and what bleeding changes should trigger a faster review.