Unusual Menstrual Odors: Causes and When to Seek Help

Abnormal menstrual odor?

Hello, doctor.
My menstrual cycle is regular (about 29-30 days), the flow is normal, and the duration is also normal (5-7 days).
I experience mild premenstrual syndrome, but it does not interfere with my daily life.
However, for the past year, I have been troubled by a specific issue: the first 1-2 days of my period are normal, but around days 3 to 5, the menstrual blood has a particularly strong odor, somewhat resembling the smell of spoiled ink.
This odor occurs immediately whenever there is menstrual flow, even after I take a shower (it is not due to infrequent changing of sanitary pads).
I would like to know what might be causing this and if any tests are necessary.
Thank you for your help!

Xiao Tao, 30~39 year old female. Ask Date: 2017/08/01

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the amount of vaginal discharge typically varies based on individual physiology, and its quantity and characteristics can change throughout the menstrual cycle.
For instance, immediately after menstruation, the discharge is usually minimal and gradually increases.
During ovulation, the discharge becomes more abundant, appearing clear, stretchy, and elastic, with no odor.
After ovulation, the discharge decreases again but becomes thicker.
Just before menstruation, the discharge increases once more, and it may appear slightly yellow or blood-tinged, possibly with a faint fishy odor.
Based on your symptoms, it is advisable to consult a physician if the symptoms persist or worsen, as they can determine the appropriate course of treatment.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2017/08/01

More Info

Understanding unusual menstrual odors can be a source of concern for many individuals, and it is important to recognize that while some variations in odor can be normal, significant changes may indicate an underlying issue that requires attention.
In your case, you have described a situation where your menstrual flow has a notably strong odor, particularly around the third to fifth day of your period. This odor, which you liken to "the smell of spoiled ink," is something that persists even after bathing, suggesting that it is not merely a hygiene issue.
Firstly, it is essential to understand that menstrual blood can have a distinct odor due to several factors. The menstrual cycle involves the shedding of the uterine lining, which includes blood, tissue, and mucus. The presence of blood can lead to a metallic or iron-like smell, which is generally considered normal. However, if the odor becomes particularly strong or unpleasant, it may indicate the presence of bacteria or an infection.

One potential cause of a strong odor during menstruation is bacterial vaginosis (BV), a condition caused by an imbalance of bacteria in the vagina. BV can lead to a fishy odor, especially after menstruation. Another possibility is a yeast infection, which can also alter the odor and is often accompanied by other symptoms such as itching or unusual discharge.
Additionally, the presence of retained menstrual products, such as tampons, can lead to a foul odor due to the growth of bacteria. It is crucial to ensure that menstrual products are changed regularly to prevent this issue.
In some cases, the odor may be associated with more serious conditions, such as pelvic inflammatory disease (PID) or sexually transmitted infections (STIs). These conditions can cause inflammation and infection in the reproductive organs, leading to changes in odor and other symptoms such as pain, fever, or abnormal discharge.

Given that your menstrual cycle is otherwise regular and you do not experience significant discomfort, it may not be an immediate cause for alarm. However, it is advisable to consult with a healthcare provider to discuss your symptoms in detail. They may recommend a pelvic examination and possibly laboratory tests to check for infections or other underlying conditions.
In summary, while some odor during menstruation can be normal, a strong or unusual odor, especially if it persists, warrants further investigation. It is always best to err on the side of caution and seek medical advice to ensure that there are no underlying health issues that need to be addressed. Regular gynecological check-ups can also help monitor your reproductive health and catch any potential issues early on.

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