Strong fishy vaginal odour

A fishy smell may occur when the balance of vaginal bacteria changes. It can be more noticeable after sex or during a period and may come with thin, greyish or unusual discharge. Itching is not always present. Thrush more often causes intense itching and thick discharge, so symptoms alone cannot identify the cause. A retained tampon, a sexually transmitted infection, or irritation from scented products can also change odour.

Pelvic pain, pain during sex, bleeding after sex, fever, or feeling unwell raises concern for an infection that should be assessed rather than masked with deodorants or washes.

Wash the external vulval area gently with water or a mild unscented cleanser, then pat dry. Avoid douching, vaginal deodorants, scented pads, and self-treating with leftover antibiotics. Arrange a sexual-health or gynaecology appointment for an examination and swabs if the odour persists, returns, or follows unprotected sex. Use condoms until an infection has been excluded when relevant.

Seek prompt care for lower abdominal or pelvic pain, fever, vomiting, pain when urinating, bleeding after sex, pregnancy, or rapidly worsening symptoms. Urgent assessment is needed if severe pain, faintness, or heavy bleeding occurs. Antibiotic treatment for pelvic infection may be needed when a clinician confirms or strongly suspects that diagnosis.

Could this be bacterial vaginosis, an STI, irritation, or a retained tampon? Do I need a pelvic examination or swabs? Should my partner be tested or treated?