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funky fishy smell after period
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jazmine1011 posted:
Hi, this is very new to me. For the past few months, I have been encountering this very fishy smell/discharge after my menstrual period. I've gone thru 3 10-day ointment treatments already. My doctor seems not be able to grasp it as well. Does anybody have any idea what this is?
HELP.
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Jane Harrison Hohner, RN, RNP responded:
Dear jazmine: There are two common vaginal infections that have a fishy smell--bacterial vaginosis (BV) and trichomoniasis ("trich"). Unlike trich where the symptoms stay the same (or worsen), BV symptoms can come and go over the menstrual month.

Bacterial vaginosis (BV) is an overgrowth of anerobic bacteria in the vagina. The reason it smells like dead fish after intercourse or around menses is that the smell is released in an alkaline environment (and ejaculate and menstrual blood are more alkaline). Some women advocate an acidophilus douche treatment . Perhaps this creates a temporary acidic vaginal environment so the smell is not so marked. However, acidophilus does not have the kind of hydrogen peroxide producing lactobacilli needed to rid the vagina of the undesirable anerobic bacteria.

The use of Flagyl/metronidazole or tinidazole, or clindamycin, will kill the anerobes, but they can return unless the hydrogen peroxide producing lactobacilli are there in adequate numbers.

Dr. Sharon Hillier, a well known vaginitis researcher (what a job!) has tested many of the over the counter products for BV and not found any of them very effective. It's best to get a reliable diagnosis and get treated at least once with a Rx treatment for BV to try to eliminate the current anerobic colony.

Alas, BV can be recurrent. If that is your situation the first choice is to try an alternative form of prescriptive therapy. Some MDs will treat the male partners with a one time dose of Flagyl in an attempt to decrease the woman's reoccurrences. But the research studies of male partner treatment have not shown a distinct benefit.

Jazmine, be sure to see your GYN or local family planning clinic when your smell symptoms are the very worst. That can make it easier to identify the culprit.

Yours,
Jane
 
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jazmine1011 replied to Jane Harrison Hohner, RN, RNP's response:
thank you very much. my primary doc has been treating this as BV. i have another appt with her today and hopefully will get some more answers.
 
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jazmine1011 responded:
By the way, how does a person get HPV? my last pap smear test showed that.
 
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Jane Harrison Hohner, RN, RNP replied to jazmine1011's response:
Dear jazmine: There are over 50 subtypes of HPV (human papilloma virus). Some of them cause warts on the fingers, some prefer external genital skin and cause thickened/raised genital warts (eg subtypes 6 & 11). Some subtypes grow on the cervix as flat, almost invisible, cervical warts. These are the subtypes which are linked with abnormal PAP smears and in a few cases (eg types 16 & 18) can lead to cervical cancer.

Often the newer PAP smear technologies can actually test for high risk subtypes like 16 & 18. Both high risk subtypes, and/or severely abnormal PAP smears will require closer follow up.

Genital and cervical warts are spread with sex--thus are very common. One's sexual partner can have the flat warts and not know that they are infected. Fortunately, if you have a good immune system, most genital HPV infections seem to go away, or into a very long term remission.

Yours,
Jane


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