So, your vaginal discharge smells like cheese—this problem is more common than you may realize. Having unusual vaginal discharge with a cheesy (or fishy) smell is a classic symptom of bacterial vaginosis (BV). Often, BV will present with a white or grey vaginal discharge that has one of the aforementioned odors. The primary culprit instigating these symptoms, is a bacteria, known as Gardnerella vaginallis. This bacteria was named after the researcher who discovered it in 1955: Hermann L. Gardner. Gardnerella vaginallis, when it overgrows, can easily cause a vaginal infection. The most common symptom of BV is a malodorous smell from the vagina or discharge. This bad smell can often be worse after sexual intercourse; and, occasionally worse after menstruation. This horrible bacteria can make a woman feel “unclean;” and, even cause her to avoid sex altogether. Fortunately, there are plenty of treatments to clear up this problem. Once you get your vaginal microbiota back in line, the cheese (or fishy) smell will clear up right away!
For healthy women without BV, their vaginal microflora is composed of significant amounts of bacteria in the Lactobacillus genus; and, smaller amounts of other bacteria; and, sometimes, a little yeast. A healthy woman’s vaginal fluid will contain about 95% Lactobacillus genus bacteria; and, in each milliliter of this fluid, there will be about 100 million different microscopic organisms (Anukam, 2006). Women from diverse backgrounds will generally have the same types of bacteria living in their vaginas. Many of the Lactobacillus bacteria secrete lactic acid; which helps to acidify the vagina and keep the pH at a healthy acidic level. These probiotic bacteria can also produce hydrogen peroxide—which helps to keep pathogenic bacteria in check.
When the bacterial environment of the vagina becomes dominated by the wrong anaerobic bacteria, these pathogens can cause an infection. In the case of BV, they also can cause a horrible vaginal smell—usually a strong smell that resembles cheese or fish. To stop the bad smell, you need to establish the right bacterial balance in the vagina.
Bacterial Vaginosis Research
The first study we will look at, positively linked a “high cheese” odor, to BV. The study was published in The Journal of the American Medical Association [291.11 (2004): 1368-1379]. The authors state, that the chances of a woman having BV, increases with a yellow discharge and the presence of a strong cheese smell. But, the presence of yellow vaginal discharge and vaginal redness, made it more likely for a woman to be positive for trichomoniasis. The study also states, that having white vaginal discharge, made it less likely for a woman to be positive for BV. And, having moderate to profuse vaginal discharge, is more indicative of BV than light vaginal discharge.
Another study, published in Nursing Times [83.29 (1987): 44-5], also stated having a cheesy or fishy smelling vagina was a strong indicator of BV. The study stated, that the classic bacteria that causes BV, Gardnerella vaginalis, instigated more symptoms to occur in women who had this bacteria. Also, the presence of Gardnerella vaginalis, was also linked to women having more vaginal discharge. This discharge was described as runny and yellow. 77% of the women, who had the classic BV causing bacteria Gardnerella vaginalis, also had a high cheese or fishy vaginal smell.
Another insightful study on this topic, was published in the Journal of the Royal College of General Practitioners [37.295 (1987): 59-61]. Of the 162 women who participated in the study, 81 were positive for BV. Of the patients participating in the study, 83 of them had the symptoms of a strong cheesy vaginal odor. Of these women with a vaginal cheese smell, 63 (76%) of them were positive for Gardnerella vaginalis; which is a highly significant association. Thus, the odor from your vagina, is a fairly accurate indicator you have BV—if it strongly smells of cheese. Regarding vaginal discharge, 75% of women with profuse vaginal discharge, were positive for BV; and, 70% of women with normal discharge, did not have BV. Women who were positive for Gardnerella vaginallis were significantly more likely to have moderate, to profuse, vaginal discharge. BV positive women also had more of a chance for having yellow, green, or bloodstained vaginal discharge. The following chart was taken from this study and demonstrates this:
Another study addressed the issue of BV induced vaginal odor and discharge. The study was published in the Journal of Obstetric, Gynecologic, and Neonatal Nursing [30.3 (2001): 306-315]. According to the journal publication, women with BV often complain about a foul vaginal smell; this smell is often increased, and more pronounced, after sexual intercourse or during menstruation. A strong indicator that you indeed have BV is the presence of vaginal discharge along with a “fishy” or “cheese” smell. This indicates your vagina may be alkaline, instead of in a healthy acidic pH state; and, that you probably have Gardnerella vaginallis infecting your vagina. The study states BV discharge will be white, grey, thin, homogeneous, and will adhere to the vaginal walls. Also, the study notes that, 50% to 60% of women who are asymptomatic, will also be positive for Gardnerella vaginallis.
Bacterial Vaginosis Recurrence
A study related how common the recurrence of BV was. The study was published in the Journal of Family Practice [53.11 (2004): 890-895]. According to the authors, recurrence of BV is quite common. The authors state, that when using a prescription drug for BV, a longer 10 or 14 day use of an antibiotic may be helpful. Eating yogurt or inserting probiotic vaginal suppositories may also be beneficial to reduce the recurrence of BV. And, even after BV is cleared up, the authors suggest that using intravaginal metronidazole, twice a week, would be a prudent course of action to prevent such recurrences.
Although the prescription drugs, metronidazole or clindamycin, are recommended courses of action to take when treating BV; when you wish to use a prescription drug that is, there are some drawbacks. Yet, despite these drug’s popularity, they are not as good at stopping recurrent infection. According to a study published in Annual Review of Medicine [51.1 (2000): 349-356], 3 day courses of clindamycin or metronidazole are capable of curing BV quickly; but, long term follow ups suggest higher rates of early recurrence. The study states that women who took oral metronidazole, around 30% of them, developed another outbreak of BV within the following 3 months. A quote from the study relates this information:
After therapy with oral metronidazole, 30% of patients who initially responded experience recurrence of symptoms within 3 months. Reasons for recurrence are unclear and include the possibility of reinfection, but recurrence more likely reflects vaginal relapse with failure to eradicate the offending organisms at the same time that the normal protective Lactobacillus-dominant vaginal flora fails to reestablish itself.
Annual Review of Medicine [51.1 (2000): 349-356]
An additional study, published in American Journal of Obstetrics and Gynecology [194.5 (2006): 1283-1289], also related the shockingly high recurrence rates for BV in nonpregnant women. Recurrence rates, amongst nonpregnant women, are reported to be up to 30% within 3 months after treatment; and, up to 80% within 9 months after treatment. When examining recurrence rates among women, who were on preventative suppressive therapy, BV recurred in 25.5% of them. Those women, who were not taking a prescription drug to suppress BV, saw 59.1% recurrence. Also, as you may know, taking strong antibiotic drugs also paves the way for a Candida infection of some kind. The study stated that metronidazole had a propensity for causing a secondary vaginal yeast infection. Besides the obvious vaginal Candidiasis, who knows how many women also developed gut yeast infections due to these prescription antibiotics wiping out probiotic bacteria?
Therefore, natural remedies, that permanently end BV, are much more efficacious than current prescription drug therapies for, perhaps, most women. And, natural remedies can leave the helpful probiotic bacteria in the gut and vagina alone; keeping these areas safe from Candida invasion. Also, natural therapies are likely a lot less expensive, and do not require a time consuming visit to a doctor.
- http://dx.doi.org/10.1097/01.olq.0000175367.15559.c4 - Anukam, Kingsley C., et al. "Lactobacillus vaginal microbiota of women attending a reproductive health care service in Benin city, Nigeria." Sexually transmitted diseases 33.1 (2006): 59-62. PDF Available Here, PubMed
- http://dx.doi.org/10.1016/j.micinf.2006.01.003 — Anukam, Kingsley, et al. "Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial." Microbes and Infection 8.6 (2006): 1450-1454. PDF Available Here, PubMed
- http://dx.doi.org/10.1097/01.EEM.0000307644.29384.1a — Anderson, Matthew R., Kathleen Klink, and Andreas Cohrssen. "Evaluation of vaginal complaints." Jama 291.11 (2004): 1368-1379. PubMed Full Text
- http://www.ncbi.nlm.nih.gov/pubmed/3498151 — Smail, J. "Identifying vaginitis in general practice." Nursing times 83.29 (1987): 44-5.
- http://www.ncbi.nlm.nih.gov/pubmed/15527726 — French, Linda, Jennifer Horton, and Michelle Matousek. "Abnormal vaginal discharge: what does and does not work in treating underlying causes."Journal of family practice 53.11 (2004): 890-895.
- http://dx.doi.org/10.1111/j.1552-6909.2001.tb01549.x — Andrist, Linda C. "Vaginal health and infections." Journal of Obstetric, Gynecologic, & Neonatal Nursing 30.3 (2001): 306-315. PubMed
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1710693/ — O'Dowd, T. C., and R. R. West. "Clinical prediction of Gardnerella vaginalis in general practice." JR Coll Gen Pract 37.295 (1987): 59-61. PubMed PDF
- http://dx.doi.org/10.1146/annurev.med.51.1.349 — Sobel, Jack D. "Bacterial vaginosis." Annual review of medicine 51.1 (2000): 349-356. PubMed
- http://dx.doi.org/10.1016/j.ajog.2005.11.041 — Sobel, Jack D., et al. "Suppressive antibacterial therapy with 0.75% metronidazole vaginal gel to prevent recurrent bacterial vaginosis." American journal of obstetrics and gynecology 194.5 (2006): 1283-1289. PubMed