What to do when your period smells like death

Having period blood that smells like something died inside your vagina can be terrifying and gross, but there are reasons why this happens and things you can do about it. The first element is to understand the problem so you can treat yourself correctly.

Why your vagina and period blood smells like death

The reason your vagina smells like death is that there is an overgrowth of the wrong sort of bacteria. Maybe you put a tampon in and forgot about it, or you may also have bacterial vaginosis or a sexually transmitted infection like trich or gonorrhoea.

How do you know which one it is? You need to get a test.

There is an imbalance of vaginal microbes, where protective bacteria (usually lactobacilli) have been overrun by bacteria that don’t create a healthy environment, and ultimately, cause bad smells.

The bad smell comes from the same process that occurs when meat rots. If something smells, it’s usually caused by bacteria – think of off milk, meat, an infected wound. Just like we produce ‘stuff’ as part of our life cycle (gas, poos, carbon dioxide from our breath), so do bacteria. This stuff (metabolites) interacts with the fluids in your vagina and chemistry happens, creating odours. It’s very sciency.

What can be incredibly confusing is why me, why now.

How to treat a vagina that smells like death

It’s important to know what you are dealing with before diving into treatments, so the first thing you need to do is get a test. See your doctor.

A comprehensive microbiome test is very useful, but not all sexually transmitted infections can be tested for using this method, so visit your doctor to have an examination and a swab.

Having a clear diagnosis means you can then use a targeted treatment and clear up the problem sooner rather than later.

There are a few questions you might like to consider:

1. Have you lost something inside your vagina? (Condoms, tampons, tissues, etc.)
2. Have you had unprotected sex with a new partner recently?
3. Are you prone to vaginal issues and perhaps need a more comprehensive solution?
4. Are you entering perimenopause or are menopausal and things are changing?
5. Are more things going wrong with your health at the same time?

A vagina problem may be the symptom of another problem in the rest of your body, so if you have recurrent problems, it can pay to book in to see a practitioner who can help you work it out.

Understanding bacterial imbalances or infections

When the wrong bacteria colonise your vagina, they change the way your vagina smells and behaves for the worse. This is usually called bacterial vaginosis (BV) or aerobic vaginitis (AV), but can be caused by STIs or other more (rarer) serious problems with the reproductive organs.

In BV, AV and STIs, the normal protective bacteria that live in your vagina, typically the various species of lactobacilli, become displaced by unfriendly bacteria, leaving your vagina in an unhappy state that it is struggling to recover from.

You may experience bad smells, unusual discharge, itch, soreness, redness or inflammation. You may not notice that something is wrong until you get your period, and the environment changes.

Why does period blood change the way my vagina smells?

Your period changes your vaginal ecosystem temporarily. If you have an overabundance of unfriendly bacteria living there already, they can thrive in your period blood for a few reasons: hormonal changes, pH changes and iron in the blood.

How hormones change your bugs

The low levels of oestrogen during your period mean there is less food (glycogen) in your vaginal cells for your healthy lactobacilli species, so their numbers naturally decrease during this time. You can’t change this. Oestrogen is always low during your period, and is one of the reasons you even get your period.

Why pH matters

Then, the menstrual blood has a less acidic pH than usual, which pathogens prefer. You can’t alter the pH of menstrual blood. Usually lactobacilli species keep the vagina acidic, because they produce lactic acid. When there are fewer of them, there is less lactic acid. Less lactic acid means less defences against pathogens, who do not like lactic acid.

Iron as a food source

The iron in your menstrual blood feeds all bacteria, so this shift can mean you start to smell the problem when it gets too much. You can’t change the iron levels, so don’t think eating less iron will help! It won’t – it will lower your immunity and make the problem worse.

The perfect storm

Sometimes after your period, the ‘bloom’ of bad bacteria will shrink, your healthy flora increase with an increase in oestrogen levels, and your vagina will go back to normal. Consider this a warning shot, however, that your vagina has lurkers and malingerers, and next period they are likely to come back out again.

What to do about a vagina that smells like death

The goal, therefore, is to increase the numbers of healthy flora so when the environment changes, you don’t experience such a sharp shift to the negative.

You first need to establish the cause, and that is going to mean going to get a test to see what is growing in your vagina, and then looking at your treatment options.

You are likely to be prescribed antibiotics by your doctor, which may work very well. If it’s BV or AV, you may find that the antibiotics do not work for very long. If that’s the case, see Killing BV for some different treatment options.

• See suggestions for managing a bad-smelling vagina. 
• Tools and tips for clearing up a non-infected smelly vagina

If you have ongoing issues and nothing is working, please make an appointment with a practitioner who specialises in vaginal infections.