What if antibiotic treatment for pelvic infection does not relieve vaginal odour?

Odour can persist while pelvic or vaginal inflammation settles, but a new, stronger or fishy smell may point to a different or additional vaginal condition. Antibiotics for a pelvic infection do not treat every cause of vaginal odour. Changes in discharge, itching, burning, pain during sex, urinary symptoms or bleeding help distinguish possible causes. Odour can also be affected by blood, semen, retained products or irritation from products used inside or around the vagina.

Tell the prescribing clinician that the odour has not improved and give details about its onset, pattern and any discharge. Say which antibiotic was used, whether doses were missed, and whether symptoms improved before returning. Do not use leftover antibiotics, internal washes or deodorising products. Wash the outer genital area gently with water or a mild unscented cleanser, and keep the area dry. An examination or swab may be needed so treatment matches the cause.

Get urgent help if odour occurs with fever, chills, increasing pelvic pain, vomiting, faintness, heavy bleeding or a sudden feeling of illness. Seek prompt advice if you are pregnant or might be pregnant, or if pain is severe during sex. Do not wait for a routine appointment when symptoms are rapidly worsening.

Ask whether the smell is more consistent with a vaginal cause or ongoing pelvic infection, whether a swab is appropriate, and whether your treatment needs changing. Clarify when sex is safe, whether a partner should be assessed, and which warning signs require same-day care.