To get some answers, we spoke with Taraneh Shirazian, MD, assistant professor in the Department of Obstetrics and Gynaecology at the NYU Langone Joan H. Tisch Center for Women’s Health, to determine what makes your period blood smell, and if there's ever a time you need to worry about it. Here's what we learned:
It's totally natural.
"Blood itself has a certain odour," Dr. Shirazian says, adding that, as you probably already know, there's more to your menstrual fluid than just blood. You also expel various substance such as bacteria, vaginal mucus, fluid, and tissue during your period, and that's why your period blood doesn't smell exactly like the blood that comes out of any other part of your body. It's a real mixture rather than just blood. That odour can be more or less intense, depending how long it sits in your uterus before leaving, but Dr. Shirazian says "it’s either bacteria mixed with old blood or it’s bacteria in the vagina that’s coming out with the blood" that plays the lead role in making your period blood odour special and specific to you. As far as what's normal and what isn't, Dr. Shirazian keeps it simple: "A healthy period smell just shouldn’t be fishy."
A change in odour can signal a problem.
Odour can also come from the bacteria that naturally accumulates during your period. "When you’re bleeding, you retain moisture in the vagina," Dr. Shirazian says, which can lead to "secondary vaginal infections like bacterial vaginosis, which has a strong, fishy odour." The thing to remember about bacterial vaginosis (sometimes shortened to BV) is that it occurs when the bacteria that's normally found in your vagina is out of balance, and can either go away on its own or be treated with antibiotics. While BV itself isn't an STI, it is known to increase your risk for catching an STI, so if you are experiencing odour, itching, or painful urination, you should definitely see your doctor for treatment. And, if you notice an out-of-the-ordinary odour when you aren't menstruating, you might want to talk to your doctor. You may have BV, vaginitis, or some other kind of infection that requires treatment.
Keeping things dry down there can help.
While there is nothing wrong with the natural blood smell (and the likelihood that it is noticeable to anyone but you is very small), Dr. Shirazian says keeping the surrounding area as dry as possible can help reduce it if it's bothering you. Change your tampon, pad, or menstrual cup regularly and try to "wear cotton underwear and breathable clothing, not a lot of spandex or tight clothing" during your period to reduce sweating, she says. Although it's not the main cause of period blood odour, sweat can definitely contribute to it. "Many types of bacteria can grow during your period that are due to both blood and sweat," Dr. Shirazian explains.
"Sometimes the issue is very heavy periods or a lot of bleeding. There’s just so much blood that it will allow bacteria to overgrow," she adds. This means that if your flow is naturally heavier, you're probably going to experience more odour than someone with a lighter flow.
If you notice that you're bleeding more than usual, or you're worried that you're bleeding excessively, Dr. Shirazian recommends talking to your doctor. "Heavier bleeding could be a sign of fibroids, polyps, or hormonal changes," she says. Plus, even if it turns out that you just have a naturally heavier flow, there's actually no reason to put up with an annoying period; you can just skip it entirely with the help of a hormonal birth control method.
Don't douche, ever.
The bottom line is that vaginal odour, much like vaginal discharge, is totally normal. As long as you're maintaining healthy period habits — keeping track of any weird changes to your normal cycle (including changes to the smell), changing your period protection regularly while you're bleeding, and most importantly, never, ever douching — you don't need to worry about the normal odour. As self-conscious as any odour may make you feel, there's no reason to go to extremes like douching, which, in fact, has been linked to bringing on the very infections (like BV) that cause even more (and honestly, much grosser) smells.