Unusual Menstrual Odors After Childbirth: Causes and Concerns

Odor

Doctor, after giving birth in July this year, my menstrual flow has changed.
On the first day, there is almost no flow, but by the second day, it becomes so heavy that I need to use overnight sanitary pads, and there is a strong odor, which I can only describe as a fishy smell.
Why is this happening? Before pregnancy, my menstrual flow lasted an average of 4-7 days and did not have such a strong odor.
I have a 4 cm adenomyosis, and after giving birth, the doctor said it is now 3 cm.
Previously, I experienced very severe menstrual pain that required pain relief injections, but now the pain is within a tolerable range.
I would like to know if the menstrual pain will return to the severity it was before.

judy, 20~29 year old female. Ask Date: 2004/10/26

Dr. Zhou Dali reply Obstetrics and Gynecology

Menstrual odor may indicate that menstrual blood has been retained for a longer period, leading to changes due to vaginal bacteria.
A fishy smell may not be a significant concern, but if there is a foul odor or a change in color, it could suggest a bacterial infection, and further evaluation in a clinic is necessary.
Additionally, postpartum menstrual pain can be alleviated due to cervical dilation, which facilitates the flow of menstrual blood.
Therefore, abdominal pain may improve.

Reply Date: 2004/10/26

More Info

After childbirth, many women experience changes in their menstrual cycles, including variations in flow, duration, and odor. Your concerns regarding the unusual odor and increased flow during your menstrual period are valid and warrant further exploration.

Causes of Unusual Menstrual Odors After Childbirth
1. Hormonal Changes: After giving birth, your body undergoes significant hormonal fluctuations as it returns to its pre-pregnancy state. These hormonal changes can affect the menstrual cycle, leading to variations in flow and odor. The presence of hormones such as estrogen and progesterone can influence the vaginal flora, which may contribute to changes in odor.

2. Infection: A strong, fishy, or foul odor can sometimes indicate an infection, such as bacterial vaginosis or a sexually transmitted infection (STI). After childbirth, the risk of infections can increase due to changes in the vaginal environment and the potential for retained products of conception. If you notice any accompanying symptoms such as itching, burning, or unusual discharge, it is crucial to consult a healthcare provider.

3. Retained Products of Conception: If any placental tissue remains in the uterus after delivery, it can lead to abnormal bleeding and odor. This condition can cause infections and should be evaluated by a healthcare professional.

4. Uterine Conditions: You mentioned having adenomyosis (uterine adenomyosis), which can cause heavy menstrual bleeding and pain. While the size of your adenomyosis has decreased, it is possible that it could still influence your menstrual symptoms. Adenomyosis can lead to increased menstrual pain and heavy bleeding, and it may take some time for your body to adjust after childbirth.

Concerns Regarding Menstrual Pain
Regarding your concern about the return of severe menstrual pain, it is difficult to predict how your menstrual symptoms will evolve. Some women find that their menstrual pain improves after childbirth, while others may experience a return to pre-pregnancy symptoms. Factors that can influence this include:
- Changes in Uterine Structure: After childbirth, the uterus undergoes changes that may alter the way it contracts during menstruation.

- Hormonal Levels: Fluctuations in hormone levels can also affect the severity of menstrual cramps.

- Overall Health: Your general health, stress levels, and lifestyle choices can impact menstrual symptoms.

Recommendations
1. Consult a Healthcare Provider: Given the changes in your menstrual cycle and the presence of a strong odor, it is advisable to consult your healthcare provider. They may perform a pelvic examination, order laboratory tests, or conduct imaging studies to rule out any underlying issues such as infections or retained products.

2. Monitor Symptoms: Keep track of your menstrual cycle, including flow, duration, and any accompanying symptoms (e.g., pain, odor, discharge). This information can be helpful for your healthcare provider in determining the cause of your symptoms.

3. Maintain Hygiene: Good hygiene practices can help manage odors. Regular bathing and wearing breathable cotton underwear can help maintain a healthy vaginal environment.

4. Consider Dietary Factors: Sometimes, dietary choices can influence body odor. Staying hydrated and maintaining a balanced diet may help.

5. Follow-Up on Adenomyosis: Since you have a history of adenomyosis, it may be beneficial to have regular follow-ups with your gynecologist to monitor your condition and discuss any changes in your symptoms.

In conclusion, while changes in menstrual flow and odor can be common after childbirth, it is essential to pay attention to any significant changes or concerning symptoms. Consulting with a healthcare provider will provide you with the best guidance and care tailored to your specific situation.

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