Aunt Vadge: I had unprotected rough sex and now my vagina smells fishy – why?

Hi there Aunt Vadge,

I’m almost at the end of my period and had unprotected rough sex. I started to notice a fishy smell down there in the remaining discharge of my menstruation. The discharge is not white, but brownish.

Is this an infection or something serious? When do I need to see a doctor?

Yours,
Concerned
Age: 41
Canada
_____

Dear Concerned,

The fishy smell is almost certainly being caused by some sort of bacteria, but you need to go and be tested immediately to rule out a sexually transmitted infection (STI). If it’s not an STI, you need to get more details on what it is.

There are two main STIs that cause fishy odour: trich and gonorrhoea. It could be others, but those are the two main culprits.

Then, you can have bacterial vaginosis or aerobic vaginitis, which are considered to be microbial imbalances, rather than an infection per se. BV and AV can both be sexually transmitted between partners, both female and male.

Men can carry the microbes (usually without symptoms) on their penises. Unprotected sex is major cause of a fishy vagina, from all causes, because men transmit the microbes unknowingly to sexual partners.

Men are none the wiser, and may have unprotected sex with others, and next thing you know you have a gaggle of bad vag on your hands. It might be worth asking your partner if they have had sexual partners that have had a lot of vulvovaginal infections previously, although this can be an awkward or uncomfortable conversation.

It is a reasonable assumption that this man has given you BV from his penis, that he picked up from other vaginas during unprotected sex. As gross as that feels, it’s important that you talk to him about this, because you can bet he has no idea that it’s him passing this around. Men think it’s a women’s problem, but it’s everyone’s problem. Men need treatment too, so they stop passing these microbes from vagina to vagina, every time they have sex (and whether they ejuclate in the vagina or not).

While the sex has been the trigger for this, there are more ways that you can develop BV or AV. If your vaginal flora is out of balance, pathogens can take over, resulting in odours and unusual discharge, etc., which even sexually inexperienced (i.e. virgins) women can develop.

Semen is slightly alkaline (7-8), while your healthy vaginal flora (lactobacilli) keep the vaginal pH at a healthy 3.2-4.5. Bad bacteria often prefer a more alkaline (or just slightly acidic) environment, so the presence of semen can temporarily allow them to flourish.

Some microbes can do very well in alkaline semen, and the end result is an overgrowth of the wrong bacteria. This doesn’t just happen out of the blue though; there is always a lead-up to this type of BV with your vaginal flora being out of balance for a while before, and not able to regulate itself any more. This is when you start to see symptoms, often triggered by less acidic conditions like during your period or with semen.

Because the sex was at the tail-end of your period, you have already had a spell of higher pH due to menstrual blood. This can lead to a temporary overgrowth of the wrong sorts of bacteria, that the semen just tipped over the edge.

The best thing to do is to go to the doctor quickly to get a test and see what it is. If it’s an STI, then you’ll need to take the standard treatment offered, which will cure it quickly. If it’s not an STI, then you need to determine what it is and then check out your treatment options.

Some key things to remember:

• The doctor will likely do a swab test and prescribe you antibiotics
• You can try to treat this at home without a test, but you may be delaying getting an effective treatment from your doctor, especially for STIs, which need medical treatment
• If you try treatments at home, try some of these: clearing up a non-infected smelly vagina or Killing BV
• If it is an STI, home treatments will not work
• Get some pH strips to keep an eye on your vaginal fluid pH – you need litmus paper that goes from at least 3-8, with a healthy vagina having a pH of between 3.8-4.5
• Don’t use ANY vaginal treatments 48 hours before your vaginal swab at the doctors – you can end up with a false result
• The brownish discharge is likely just the end of your period

Warmest regards,
Aunt Vadge