- Sweat, changes in vaginal bacteria, and perimenopause can alter the smell of your menstrual blood.
- A new, unpleasant odor could also indicate an infection or, in some rare cases, cervical cancer.
- If good hygiene and timely changing of menstrual products do not help, consult your doctor.
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No doubt your menstrual cycle can produce some pretty unusual odors.
“Menstrual blood contains vaginal mucus and endometrial cells. Combining these with blood can give off a distinctive odor,” says Dr. Yana Markidan, gynecologist in private practice.
But your blood should normally have a similar smell from month to month, whether it smells more metallic, sweet, or something else. If you notice a new odor during your menstrual cycle, it could be a sign that something isn’t quite right, especially since vaginal odors can be a sign of infection.
Here are the seven most common reasons why your period smells stronger than usual and what to do next.
1. Natural vaginal bacteria mixing with blood
Although everyone’s body is different, healthy period blood often smells metallic or sweet due to the iron and copper levels in your blood mixed with vaginal bacteria.
When the mix of bacteria in your vagina (also known as your vaginal microbiome) changes, your period blood may smell different.
Some of the most common culprits that can disrupt your vaginal microbiome include:
- take a shower
- Hormonal changes caused by pregnancy or menopause
- Sexually Transmitted Infections
How to treat it: Practicing good vaginal and vulvar hygiene helps keep your vaginal microbiome healthy and reduces intense odors during your period.
If you’re already noticing a strong odor, try some of the following tips for good vaginal hygiene (and if that doesn’t help, see a doctor):
- Wash your vulva with warm water daily and after sex – remember, you don’t need to wash your vagina.
- Wear breathable cotton underwear.
- Wash new underwear before wearing.
- Avoid showering and scratching down there.
2. Bacterial Vaginosis (BV)
During menstruation, or your period, you lose “good” bacteria called lactobacilli, Markiden says. This increases the risk of infections like bacterial vaginosis (BV).
According to Markiden, bacterial vaginosis is the most common medical cause of vaginal odor. If you have it, you’ll likely notice a fishy odor down there, which can mix with blood during your period to cause a particularly pungent odor.
Other symptoms of BV include:
- Burning, especially when urinating or having sex
- Green, gray, or white discharge
- Severe itching
How to treat it: If you think you have BV, you need to seek medical help. Your doctor may prescribe antibiotics to clear the bacterial infection.
Your doctor may also suggest taking over-the-counter probiotics after the infection has cleared to keep your microbiome balanced and reduce your chances of developing BV again.
3. Menstrual product left in or in for too long
If you’ve left your tampon, pad, or menstrual cup in for too long, you may notice an overwhelming smell of blood.
How often should you change your menstrual products? Well, that may depend on the products you prefer:
How to treat it: Changing your menstrual products on time can reduce unwanted odors and reduce the risk of UTIs, STDs and Toxic Shock Syndrome.
4. Excess sweat
Sweating more than usual is a common symptom of menstruation. And sweating between your legs during your period can leave your vaginal area smelling something like a dirty gym bag.
Intimate sweat glands can increase the odor of your vaginal microbiome and your skin’s natural scent. The combination of salt, fat, and bacteria from perspiration, when mixed with menstrual blood, can create a potent, fragrant concoction.
How to treat it: If sweat is the culprit, then your vulva should be gently washed with warm water and mild soap to get rid of the odor.
“During the menstrual cycle, you should use a gentle, unscented cleanser. Soap can dry out the skin and change the delicate pH of the vulva, predisposing you to infection,” says Markidan.
5. Sexually Transmitted Infections (STIs)
If you notice a foul, pus-like odor accompanied by an unusual discharge, you could have an STI such as trichomoniasis, chlamydia, or gonorrhea.
That means with an STI, the smell lingers after your period ends.
Other symptoms of chlamydia and trichomoniasis include:
- Yellow, green, or other colored discharge that may mix with blood during your menstrual cycle
- Vaginal bleeding when you don’t have your period
- Pain in the lower abdomen that feels similar to menstrual cramps
- Vaginal itching, burning, or pain – especially when urinating or having vaginal sex
Also, keep in mind that STDs don’t always come with an odor — or noticeable symptoms.
How to treat it: A five, seven, or 10 day course of antibiotics can treat both trichomoniasis and chlamydia.
“Avoid douching and vaginal steaming, and clean your sex toys as these can spread STIs,” says Dr. Sophia Yen, CEO of Pandia Health and professor at Stanford Medical School.
6. Cervical Cancer
Cervical cancer can cause a strong, foul odor in your genital area. This smell, which some people say resembles rotting meat, is created when your body sheds dead tissue or cancerous cells, which then leaks out through your vagina.
Cervical cancer can cause increased blood flow or longer menstrual periods, and you may find that the odor becomes more intense during your period.
Cervical cancer is one of the most common cancers worldwide, although it is less common in the United States due to larger annual Pap smears and immunizations. It is most commonly diagnosed before menopause, between the ages of 35 and 44.
Common symptoms are:
- Spotting or bleeding between menstrual periods
- Lower back pain that can feel similar to menstrual cramps
- Pain or bleeding after sex due to tumor growth
- Trouble holding urine
- pain and swelling in the legs
- Unintentional weight loss or decreased appetite
How to treat it: If you notice these symptoms, make an appointment with your gynecologist for a Pap smear. Depending on the results, your treatment team may recommend further testing and a biopsy.
Treatments for cervical cancer include chemotherapy, radiation therapy, surgery, or a combination of these.
Perimenopause causes hormonal changes and vaginal dryness, which can lead to an unusual vaginal odor during your period.
This is because your vaginal pH gradually becomes more alkaline and your estrogen levels fluctuate, leading to heavier and more irregular periods, which can increase vaginal odor.
Other signs of perimenopause include:
How to treat it: Estrogen treatments and vitamins can increase vaginal lubrication and improve odor because vaginal secretions change in response to a combination of hormonal and dietary factors.
If you prefer not to take hormones, a doctor can provide you with more information about other treatment options, including vaginal lubrication.
In most cases, an unusual smell during your period is nothing to worry about. A timely change of menstrual products and gentle cleaning of the vulva with water and a mild detergent can eliminate unwanted odors.
If you notice other symptoms, such as nausea or pain, or just feel like something is wrong, contact your doctor as soon as possible. They can help you identify possible causes and recommend the right treatment to make you feel better.