Strong Fishy Smell from BV? What It Means and How to Fix It
If you’ve ever noticed an unusual vaginal odor that smells like fish, especially after sex or at the end of your menstrual cycle, you’re not alone—and it might be something more common than you think. I remember the first time it happened to me: I panicked, searched the internet for hours, and immediately jumped to worst-case scenarios. Turns out, what I was experiencing had a name—bacterial vaginosis, or BV—and it affects millions of women, whether they talk about it or not.
Understanding the Link Between BV and That Strong Fishy Odor
So, can bacterial vaginosis cause a strong fishy smell? Absolutely—it’s one of the most defining signs. That unmistakable odor comes from chemical compounds called amines that are produced when the natural balance of bacteria in the vagina shifts. And yes, it can be incredibly strong, almost pungent, and worsens after intercourse.
The vagina has its own ecosystem, dominated by good bacteria (mainly lactobacilli). When this balance gets disrupted—whether due to antibiotics, sex, or even stress—the overgrowth of anaerobic bacteria releases amines like putrescine and cadaverine. Not exactly what you want to be smelling down there, right?
According to NIH and CDC, BV is the most common vaginal condition among women of reproductive age. It’s not technically an STI, but it is sexually associated and extremely common—just not often talked about.
When Does the Odor Appear the Most?
- After unprotected sex (semen is alkaline and can mess with your pH)
- Right before or after your period
- Post-workout or excessive sweating
Honestly, I used to think it was just poor hygiene—so I overdid it with scented washes. Huge mistake. It made everything worse. That’s because BV isn’t about being dirty; it’s about imbalances that even good intentions can cause.
What BV Discharge Smells and Looks Like
Besides the smell, BV usually comes with a thin, grayish-white discharge. It’s not chunky (like yeast infections), and it spreads easily. One thing I noticed? It coats underwear in a way that’s hard to miss. Sometimes there’s a bit of itchiness or irritation, but not always pain. You might want to check this detailed explanation about BV discharge color and texture.
Is There Always a Smell?
Nope. Not every case of BV comes with odor. That’s what makes it tricky—and why some women never even realize they have it until it recurs or causes complications. But when the fishy smell is there, it’s very telling.
I had one doctor once describe it as “the hallmark scent” of BV, and she wasn’t wrong. If you’ve ever smelled it, you know exactly what I mean.
How BV Smell Differs From Other Infections
A lot of people confuse BV with yeast infections—but they’re totally different animals. Yeast infections come with a thick, cottage-cheese-like discharge and intense itching, but not typically a strong odor. In contrast, BV is all about the smell and thin discharge, with little to no itching.
Another one that gets confused? Trichomoniasis, an actual STI. It can also cause a bad smell, but it’s usually paired with frothy discharge and discomfort. For an in-depth breakdown, here’s a really helpful page on how to tell which infection you have.
When Should You See a Doctor?
If the odor persists beyond a few days, or if it worsens after sex, don’t wait. A quick swab at the clinic can give you clarity fast. I learned the hard way that ignoring it just led to recurrence. And if you’re pregnant, it’s even more important to treat BV early—more on that in this guide about BV treatment during pregnancy.
Why It Keeps Coming Back (and What I Did About It)
This was honestly the most frustrating part for me: even after treatment, the smell returned. Turns out, BV has a nasty tendency to recur—especially if you don’t address the underlying triggers. That’s where I had to make some lifestyle changes. Wearing breathable underwear, avoiding douches (seriously, toss them!), and taking daily probiotics helped keep things balanced long-term.
It also helped me to understand the deeper causes—stress, diet, even post-period pH shifts can lead to flare-ups. It’s not just about killing off bacteria with antibiotics; it’s about maintaining the right environment.
Probiotics, Diet, and Smell Control
If you’re not already incorporating probiotics, you’re missing out. Certain strains like Lactobacillus crispatus can help restore the vaginal flora and reduce odor. I personally started adding yogurt, kimchi, and even probiotic capsules—and yep, it made a difference. Here’s a science-backed guide to probiotics for BV.
What to Do If You Think You Have BV
Step one? Don’t freak out. You’re not dirty. You’re not alone. And BV is treatable. The key is knowing what you’re dealing with. If you’re unsure, you can start by reading the full guide on BV symptoms and how they show up in different people.
For more complete info on why this imbalance happens in the first place, check out the full BV causes and risk factors pillar article as well as the main BV overview here that ties everything together.
Why the Fishy Smell Often Gets Worse After Sex
Here’s something I didn’t realize until my OB-GYN explained it: semen is alkaline, and your vaginal environment is naturally acidic. When those two mix, it can trigger or worsen the overgrowth of bad bacteria in BV. That’s exactly why the fishy smell intensifies after intercourse. It’s not just in your head—it’s basic chemistry.
And yes, it also explains why the odor might seem stronger with a new partner. Everyone has a different microbiome, and yours might just not vibe well with theirs. I once experienced an awful flare-up with someone new, only to discover it was linked to this exact issue.
Even oral sex can affect the pH and microbiome. It’s not about assigning blame—it’s about understanding what your body needs to stay balanced. Here’s a practical post on safe sex tips to avoid BV that I found helpful when trying to manage flare-ups.
The Emotional Toll No One Talks About
Let’s be real—the smell doesn’t just mess with your body. It messes with your confidence. I remember constantly checking myself, avoiding intimacy, over-washing out of paranoia. At one point, I thought something was seriously wrong with me, and I felt embarrassed bringing it up at appointments.
The thing is, BV is common. Like, really common. And yet we act like it’s taboo. One of the best decisions I made was talking to a friend about it—she admitted she’d been dealing with the same thing for years. We compared notes, swapped what worked, and finally ditched the shame.
Now I know odor isn’t something to hide—it’s a signal. Your body’s trying to tell you it needs a reset.
Mental Health Impacts Are Real
There’s not much discussion on how recurring BV affects self-esteem and anxiety, but it should be part of the conversation. I’ve had days where I canceled plans just because I felt “off.” If that’s you, trust me—you’re not alone.
Is There a Cure for the Smell or Just Temporary Relief?
Short answer: yes, you can get rid of the smell. But long-term relief takes more than one prescription. I went through multiple rounds of Metronidazole and Clindamycin, only to have the odor creep back weeks later.
Eventually, I combined meds with probiotic therapy, dietary changes, and smarter hygiene. One thing that surprised me? Boric acid suppositories. My doctor recommended them as a maintenance option, and they worked wonders for me.
- Finish your full antibiotic course—don’t stop early, even if symptoms improve.
- Introduce probiotics immediately after to help restore balance.
- Avoid triggers like douching, scented soaps, and tight synthetic underwear.
How Long Until the Smell Goes Away?
It varies. In my case, once I started treatment, the smell was gone in 48–72 hours. But if I ignored underlying causes, it came back. If your odor persists after treatment, it’s time to explore recurrence triggers and possibly see a specialist.
Here’s an excellent guide that helped me understand what causes BV to come back after antibiotics. It’s not just bad luck—it’s usually something in your routine that needs a tweak.
Smart Prevention Tips That Actually Work
If I could go back and tell my younger self one thing, it would be: prevention is a lifestyle, not a product. Forget all the “feminine washes” promising freshness. Most of them do more harm than good.
- Use fragrance-free soap—on the outside only.
- Switch to cotton underwear and avoid wearing tight leggings for long hours.
- Always pee after sex and rinse with plain warm water.
- Incorporate fermented foods like kefir and sauerkraut in your diet.
I also changed my approach to stress. That might sound unrelated, but it’s not—stress weakens immunity and disrupts your natural flora. For me, yoga, better sleep, and time offline helped just as much as meds.
What Your Doctor May Not Tell You
Don’t be afraid to ask about non-antibiotic maintenance options. Most doctors focus on treatment, not prevention. You can also ask for a vaginal microbiome test—yep, that’s a thing now—and it helped me identify exactly what my body was lacking.
If you’re stuck in a cycle of BV-smell-treat-repeat, this post about long-term solutions for BV will give you a roadmap. It’s not a one-size-fits-all fix, but understanding the root of your imbalance makes all the difference.
For a deeper look at all your treatment options, including holistic ones, check out this full guide on BV treatment. And if you haven’t yet, bookmark the foundational resource that ties all this together: our main BV resource page.
Dr. Gwenna Aazee is a board-certified Internal Medicine Physician with a special focus on hypertension management, chronic disease prevention, and patient education. With years of experience in both clinical practice and medical writing, she’s passionate about turning evidence-based medicine into accessible, actionable advice. Through her work at Healthusias.com, Dr. Aazee empowers readers to take charge of their health with confidence and clarity. Off the clock, she enjoys deep dives into nutrition research, long walks with her rescue pup, and simplifying medical jargon one article at a time.
