Why Chronic BV Smells Fishy and How To Stop It for Good

You know that awkward moment when you’re suddenly hyper-aware of your own scent — and not in a “just-left-the-spa” kind of way? Yeah, I’ve been there too. That lingering, fishy smell that keeps coming back even after antibiotics — that’s often what people mean when they talk about chronic BV. And it’s way more common than most of us think. If you’re here wondering, what does chronic BV smell like, you’re definitely not alone. Let’s unpack this in real talk, with insights that blend medical understanding with a bit of personal experience.

What Chronic BV Really Smells Like

The hallmark of chronic bacterial vaginosis is its signature odor — commonly described as “fishy.” But let me be straight with you: it’s not always just fishy. Some describe it as metallic, sour, or even bleach-like, depending on factors like hormones, diet, and time of the month.

For me, it started subtly. I thought maybe it was just a sweaty day. But when that scent kept showing up even after showers, different soaps, and “down there” care, I knew something was off. Chronic BV has a sneaky way of hanging around like an uninvited guest — especially when your vaginal pH is out of whack.

Why Does BV Smell That Way?

BV odor isn’t just about poor hygiene — let’s bust that myth right now. It’s all about balance. A healthy vagina is dominated by Lactobacillus bacteria, which help keep things acidic and odor-free. When BV strikes, anaerobic bacteria take over, releasing compounds like amines that give off that classic fishy smell.

These smells are especially noticeable:

• After sex (especially unprotected sex)
• Right before or after your period
• When using certain soaps or scented products

How Long Can the Odor Last?

If you’re constantly wondering why that scent comes back every month like clockwork, there’s a reason for that. Chronic BV is often tied to recurring imbalances. Even if antibiotics clear it for a while, many women (including myself) find it reappears due to triggers like stress, sex, diet, or even hormonal fluctuations.

In fact, according to PubMed, recurrence rates for BV after treatment are as high as 50% within 6 months. It’s not about treatment failure—it’s about underlying imbalances not being addressed. That’s why managing chronic BV is more than just a one-and-done antibiotic course.

Clues That It’s Chronic

You might be dealing with chronic BV if:

1. The fishy smell returns within a few weeks of treatment
2. You’ve had 3 or more infections in the past year
3. Discharge looks thin, grayish, or watery
4. You’ve tried everything — and it still comes back

If any of that hits close to home, it might be time to explore why BV keeps coming back and what long-term strategies could help.

How to Tell It’s Not Something Else

I get this question all the time: “What if it’s not BV?” Because yeah, other conditions like yeast infections or STIs can cause odor too — but their signature smells differ. Yeast often smells like bread or beer (yes, really), and trichomoniasis tends to produce a stronger, almost musty scent.

If you’re confused, this breakdown helps:

• BV: Thin, gray discharge with fishy smell
• Yeast: Thick, white discharge with little or no odor
• Trich: Yellow-green discharge, often frothy, with foul smell

For a deeper look at how to tell the difference, check out this full comparison of BV and yeast infections.

What Makes Chronic BV Smell Worse?

I noticed that after a night of poor sleep and one too many sugary snacks, my symptoms got worse. Turns out, sugar can feed the bad bacteria that contribute to BV. Stress, tight synthetic underwear, and hormonal birth control were also big triggers for me.

Other things that can make the smell more pronounced:

• Douching (don’t do it — ever)
• Skipping probiotics
• Frequent sex without condoms
• Using overly alkaline soaps

Addressing these can be a game-changer. I personally saw improvement after I switched to cotton underwear, started using pH-balanced feminine wash, and introduced vaginal probiotics daily.

When It’s Time to See a Doctor

BV is one of those things you shouldn’t try to ignore for too long. That odor isn’t just annoying — it’s your body signaling that something’s off. Chronic BV has been linked to an increased risk of pelvic inflammatory disease and even complications in pregnancy.

If you’ve been self-treating for months with no long-term relief, get professional help. You might need a different class of antibiotics or a long-term treatment plan. Learn more about how it’s diagnosed in this guide.

For a broader understanding of BV, symptoms, causes, and prevention tips, you’ll find this comprehensive article very helpful. And of course, the main guide at healthusias.com’s BV page is a fantastic go-to for everything related to the condition.

What Actually Helps Get Rid of the Smell (for Good)

Let’s get honest: most of us just want that smell gone. Like, yesterday. I’ve tried more treatments than I care to admit — prescription meds, over-the-counter stuff, all the DIY hacks TikTok has ever offered. Some worked temporarily, others made it worse. But here’s what genuinely made a difference for me and many others dealing with chronic BV odor.

Prescription Options

The go-to meds are usually metronidazole or clindamycin, and they work — but they don’t always stick. What I didn’t know at first is that you can request a longer treatment course or a combination (oral + vaginal) to lower recurrence.

And if you’re pregnant or sensitive to antibiotics, there are safer options too.

Boric Acid Suppositories

Boric acid was a game changer for me. It doesn’t “cure” BV, but it helps restore vaginal pH and keep bad bacteria in check. You can find more info here on how to use it safely, especially after finishing antibiotics.

Pro tip: Always check that the boric acid you’re using is pharmaceutical grade. Don’t just grab any powder off Amazon.

Natural Remedies That Help (and the Ones That Don’t)

Okay, so not every “natural” trick works — but some are legit when used alongside medical treatment. These ones actually helped reduce the smell and kept things in balance for me:

• Probiotics (vaginal and oral): Look for strains like L. crispatus or L. reuteri
• Apple cider vinegar soaks (diluted, short duration)
• Unsweetened yogurt applied vaginally
• Tea tree oil suppositories — but be careful, it’s potent

I tried garlic once because the internet said it was a miracle. Bad idea. Burned like hell. Don’t be me. Stick with things backed by science — or at least common sense.

Daily Habits That Help Prevent the Return of the Smell

Once you manage to get rid of the fishy smell, the real challenge is keeping it gone. Chronic BV loves to sneak back, and often the trigger is something minor you wouldn’t even suspect. Here’s what I changed that helped big time:

1. Switched to cotton underwear
2. Stopped wearing pantyliners daily (let things breathe!)
3. Used a pH-balanced wash, no fragrance
4. Started using probiotics consistently — even during my cycle
5. Cut back on sugar and started eating for vaginal health

And yes, I ditched douching completely. If you’re still doing it, please read this myth-busting post — it explains why that’s the fastest way to throw off your pH.

What to Do If the Smell Still Comes Back

If you’re treating the symptoms, changing your lifestyle, and the odor still keeps returning, you’re not alone — and you’re not doing anything wrong. Chronic BV might be tied to deeper factors like your immune response, gut health, or even your partner’s microbiome.

Some important areas to explore:

• Sexual health and partner treatment
• Dietary imbalances
• Microbiome disruptions from past antibiotics
• Hormonal shifts, especially during your period or perimenopause

What finally worked for me? A combo approach — antibiotics + boric acid + ongoing probiotics + sugar reduction. It wasn’t overnight, but now when I get a whiff of anything off, I can course-correct before it becomes full-blown BV again.

Start With Education and Long-Term Management

Learning what triggers the smell and how to respond is half the battle. Once you stop seeing BV as a one-time infection and more as a condition that needs ongoing care, things get easier. And not just symptom-wise — it also helped me feel less frustrated, less embarrassed, and more in control.

If you haven’t yet, dive into this comprehensive guide on recurring BV causes and prevention. It’s honestly one of the best breakdowns I’ve found that covers both medical treatment and daily living changes.

And for a big-picture view, the full bacterial vaginosis overview at Healthusias has everything in one place — including causes, diagnosis, diet, and treatments.

Gwenna Aazee

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.