Fishy Smell and Other BV Symptoms
Quick answer
Bacterial vaginosis (BV) typically causes a strong fishy smell, often more noticeable after sex, along with thin white or grey discharge. Many people with BV have no symptoms at all, and itching or soreness is less typical than with a yeast infection. A smell like this is worth getting checked, because a clinician can confirm BV and rule out other causes.
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The more of these match, the more it looks like BV. This is not a diagnosis. Only an exam and a test can tell BV apart from other causes.
A new smell down there can be worrying, and it is also very common. Bacterial vaginosis (BV) is the most common cause of vaginal discharge worldwide, and a fishy smell is one of its main signs. This page covers what BV usually smells and looks like, what it usually doesn’t cause, and when to get it checked.
What does bacterial vaginosis smell like?
The usual description is a strong fishy smell. The CDC says the odor is often most noticeable after sex, and NHS says the same. The smell comes with a change in discharge rather than on its own.
Clinicians use the smell as one of several clues. The CDC’s diagnostic criteria for BV include thin discharge, a vaginal pH above 4.5, a fishy odor, and a particular cell type seen under the microscope, and at least three of the four point to BV.
What does BV discharge look like?
BV discharge is typically thin and white or grey, and it can be watery. The CDC describes it as milklike and smoothly coating the vaginal walls. NHS describes it as greyish-white, thin and watery.
If your discharge is thick, white and clumpy instead, that points more toward a yeast infection. Our guide on BV vs yeast infection explains the differences.
What are the other symptoms of BV?
Symptoms vary a lot from person to person. The CDC lists:
- A thin white or grey discharge
- A strong fish-like odor, especially after sex
- Burning when you pee
- Pain, itching or burning in or around the vagina
Itching and soreness are less typical, though. NHS says BV does not usually cause soreness or itching. If itching is your main symptom, see our page on white clumpy discharge and itching.
Can you have BV without symptoms?
Yes. The CDC says that many people with BV have no symptoms, and NHS says about half do not. This is one reason the condition can go unnoticed for a long time. It is also why a smell that comes and goes is still worth mentioning to a clinician.
What does a normal vagina smell like?
Some discharge is normal, and so is a mild natural scent. NHS says discharge is usually nothing to worry about if it is clear or white, thick and sticky or slippery and wet, and does not have a strong or unpleasant smell. Discharge changes across your cycle and can be heavier if you are sexually active, using birth control or pregnant.
It is a change in smell, colour or texture that is worth paying attention to.
What can cause a fishy smell besides BV?
NHS links a fishy smell with BV, but it also lists other causes of discharge changes that can be confused with it:
- Thick white, cottage-cheese-like discharge: usually thrush (a yeast infection).
- Green, yellow or frothy discharge: may be trichomoniasis.
- Discharge with pelvic pain or bleeding: may be chlamydia or gonorrhea.
- Discharge with blisters or sores: may be genital herpes.
NHS also advises against self-diagnosing. A swab and exam are quick, and they can separate these causes. See our page on yellow or green discharge for more.
What makes BV more likely?
Nobody knows the exact cause. The CDC says BV is linked to douching, not using condoms, and new or multiple sex partners. BV is rare in people who have never had sex, but it can happen without sexual activity. NHS also lists having an IUD and using perfumed products in or around the vagina. BV is more common around periods, according to the CDC.
BV isn’t classed as an STI by NHS, but it can be triggered by sex. Having BV makes it more likely that you will catch an STI, which is why an online STD test is worth considering.
Why does it matter to get it checked?
BV is not usually serious, but untreated BV is linked to some risks. The CDC says it raises the chance of catching HIV and other STDs such as chlamydia and gonorrhea, and in pregnancy it raises the chance of an early birth or low birth weight. If you are pregnant and notice a change in discharge or smell, speak to a clinician.
How is BV checked and treated?
A clinician will usually look at the discharge and take a swab of vaginal fluid, which can be tested in the office or sent to a lab. BV is treated with antibiotics prescribed by a clinician, as tablets, gels or creams. Our page on BV treatment and why it comes back goes through what to expect.
Get care today if
- You have a fever or chills along with discharge
- You have pain low in your belly or pelvis
- You have bleeding between periods or after sex
- You are pregnant and your discharge or smell has changed
- You have sores, blisters or warts on your genitals
Call 911 for a medical emergency. Otherwise, urgent care or your doctor can see you today.
When to test
- If you notice a new fishy smell or a change in dischargeSee a doctor or clinician. A short exam and a swab of the discharge can confirm BV.
- If you could have been exposed to an STD, or you have pelvic painOrder an online STD test as well. Some STDs cause discharge and odor that can look like BV.
- If symptoms come back after treatmentGo back to a clinician rather than guessing. BV often returns, and they can check whether it is BV again.
Common questions
What does BV smell like?
BV is described as a strong fish-like odor, especially after sex. Some people notice it more than others, and some have no smell at all.
Can you have BV without any symptoms?
Yes. The CDC notes that many people with BV have no symptoms. NHS says about half of people with BV have none.
Does BV cause itching?
Not usually. NHS says BV does not usually cause soreness or itching, although the CDC lists itching or burning among possible symptoms. Strong itching with thick white discharge points more toward a yeast infection.
Will the smell go away on its own?
Sometimes BV goes away without treatment, according to the CDC. Treatment is still advised if you have symptoms, because BV is linked to a higher chance of catching other STDs and to pregnancy complications.
Can I wash the smell away?
Washing inside the vagina (douching) is not recommended. The CDC says no data support douching for symptom relief, and it may make BV more likely to come back. Gently washing the outside with water and mild, non-perfumed soap is fine.
Sources
This guide is general information written by a patient advocate using public health sources. It is not a diagnosis. Only a clinician who examines you, or a lab test, can tell you what you have. Read how we write and check our guides.