For many women, especially those in midlife and beyond, changes in the body can bring new health concerns that feel confusing or even embarrassing to talk about. One of the most common but often unspoken issues is an unusual vaginal odor — particularly when it has a strong or “fishy” smell.

While it can be unsettling, doctors emphasize that a persistent vaginal odor is usually a sign of an imbalance or infection rather than simply poor hygiene. In most cases, it can be treated effectively once the cause is identified.

For older women, being aware of what different odors may signal is especially important. Hormonal changes after menopause, medications, and overall shifts in vaginal health can make infections or imbalances more likely. Understanding the possible causes — and knowing when to seek medical care — can help protect both comfort and long-term health.

Common Causes of a Fishy Vaginal Odor

Doctors note that there are several conditions most often linked to a strong, unpleasant odor. While some are minor and easily corrected, others require professional treatment.

1. Bacterial Vaginosis (BV)

The most frequent cause of a fishy vaginal odor is bacterial vaginosis. BV occurs when the natural balance of good and bad bacteria inside the vagina is disrupted, allowing certain bacteria to overgrow.

Symptoms of BV may include:

• A thin, gray or white discharge
• A strong odor, especially after intercourse
• Mild itching or burning

Bacterial vaginosis is not considered a sexually transmitted infection, but sexual activity can increase the risk. Importantly, BV requires antibiotics to clear up. Home remedies, scented soaps, or over-the-counter treatments will not resolve it.

2. Trichomoniasis

Another possible cause is trichomoniasis, a common sexually transmitted infection caused by a tiny parasite. Unlike BV, this is passed between partners and must be treated with prescription medication.

Trichomoniasis symptoms may include:

• Fishy odor
• Green or yellow discharge
• Vaginal irritation, itching, or burning
• Discomfort during urination or intercourse

Because the symptoms can overlap with other conditions, proper testing from a healthcare provider is essential.

3. Poor Hygiene or Trapped Sweat

Sometimes, an unpleasant odor may not be due to infection at all but to sweat and bacteria trapped in tight clothing. Synthetic fabrics, long hours in non-breathable underwear, or not changing quickly after exercise can create an environment where odor builds up.

While this may not usually produce the classic “fishy” smell, it can cause a musty or unpleasant odor. The solution here is straightforward: gentle washing and switching to cotton underwear or other breathable fabrics can make a big difference.

4. Menstruation or Forgotten Tampons

During menstruation, blood can sometimes alter natural vaginal odor. More concerning, however, is the risk of a forgotten tampon. When left inside, a tampon can cause a very strong, rotten-like smell that some women mistake for fishy odor.

If you suspect this, it’s important to remove the tampon promptly. If you’re unable to, seek immediate medical help, as retained tampons can cause serious infections.

When to See a Doctor

For older women, especially after menopause, it’s important not to dismiss vaginal changes as “just part of aging.” A strong odor may be your body’s way of signaling that something isn’t right.

You should consult a doctor if:

• The odor is persistent, strong, or worsening
• There is unusual discharge (gray, green, or yellow in color)
• You experience itching, burning, or pain
• You suspect a sexually transmitted infection
• You believe you may have left a tampon or menstrual product in place

Seeking help early can prevent complications and bring peace of mind. Most conditions causing vaginal odor are very treatable with the right care.

Preventing Vaginal Odor and Supporting Vaginal Health

Good feminine hygiene practices can go a long way toward maintaining comfort and confidence. Doctors recommend a few simple steps:

Gentle Hygiene

• Wash only the external genital area with warm water and mild, unscented soap.
• Never douche. Douching disrupts the natural balance of bacteria and often makes problems worse.
• Avoid perfumed sprays, wipes, or powders, which can irritate sensitive skin.

Breathable Clothing

• Choose cotton underwear or moisture-wicking fabrics that allow airflow.
• Change out of sweaty or damp clothes promptly after exercise or hot weather.

Safe Sexual Practices

• Use protection to reduce the risk of sexually transmitted infections.
• Ensure both partners are tested regularly if in new or multiple relationships.

Support Vaginal Flora

• Probiotics (with your doctor’s approval) may help support healthy bacteria.
• A balanced diet rich in whole foods and adequate hydration supports overall health, including vaginal wellness.

Post-Menopause Considerations

For women in their 60s and beyond, lower estrogen levels can thin vaginal tissues and alter natural lubrication. This can make infections or imbalances more common. If you notice changes in odor, discharge, or comfort, speak with your healthcare provider. Treatments such as topical estrogen creams or other therapies may help restore balance.

Breaking the Silence Around Vaginal Health

Many women feel embarrassed to bring up issues like vaginal odor, even with their doctor. But these conversations are essential. Vaginal changes can signal infections, imbalances, or even underlying conditions that need attention.

The young teacher in the earlier article ignored signs of liver disease until it was too late. In a similar way, ignoring changes in vaginal health can delay treatment and make matters worse. Listening to your body, even when the symptoms seem small, is one of the best ways to protect long-term health.

For older adults in particular, prioritizing vaginal health is part of overall well-being. The more openly we discuss it, the easier it becomes to take action without shame or delay.

A strong or fishy vaginal odor is never something to ignore. While the cause is often something common like bacterial vaginosis or sweat, it can also signal a treatable infection such as trichomoniasis or, in rare cases, a more serious problem.

The good news is that nearly all causes of unusual vaginal odor can be addressed once they are properly identified. With good hygiene practices, safe sexual habits, and regular checkups, women of all ages — including those over 60 — can maintain confidence and comfort.

If you notice a persistent change in odor, remember: it’s not about hygiene alone. It’s your body asking for attention. And listening to it may be the most empowering step you can take.