Introduction

We at LSSN get a lot of questions, such as, “Does vulvar lichen sclerosus cause redness?” or “Can it cause perianal fissures?” Lately, we’ve been getting questions asking, “Does vulvar lichen sclerosus smell”? 

Some vulvovaginal conditions can have a distinct odor; thus, it’s not strange to wonder if vulvar lichen scleorsus (VLS) has a smell. Or perhaps you have a VLS diagnosis and noticed a new odor; you may wonder if this is from VLS or if something else is going on.

If so, we got you! Keep on reading to learn more.

Disclaimers

*This post is evidence-based; I draw on the medical literature to share what you need to know about vulvar lichen sclerosus. Importantly, what I share is my interpretation of the science and data.

**The information contained in this blog post is up-to-date at the time of publication. 

***If this post is helpful to you, we’d love your support so we can continue providing important education like this. Make a donation today, volunteer with us, or share our posts in your support groups.

Let’s Get Right to It: Vulvas, Vaginas, and Odor

It’s not uncommon to be curious about how our vaginas smell, especially when societal narratives and media have vilified the way vaginas smell. Common questions are: “What causes vaginas to smell” and “What is a ‘normal’ smell?”

So, let’s start with why vaginas smell and then discuss normal, healthy odors versus odors that may require medical attention.

The vagina is a muscular tube in the body that connects the uterus (womb) to the outside. It serves as a passageway for menstrual blood to leave the body during periods and allows for sexual intercourse. The vagina can stretch to accommodate various objects, like tampons during menstruation or a baby during childbirth. It is 100% normal for your vagina to smell; all vaginas have an odor, even after washing. The vagina, located inside the body, is a warm, dark place full of lymph nodes (filters for harmful substances) and glands (like tiny factories in your body that produce and release substances like hormones or sweat). It houses its own unique ecosystem with individualized, odor-producing bacteria.

Our diet, clothing choices, overall health, medications, skin bacteria, gland secretions, hormonal fluctuations during the menstrual cycle, and or certain vulvovaginal conditions influence our bodies’ scents. The groin also contains sweat glands, which can produce odor; sometimes, what you smell may be coming from the groin and not the vagina or a combination.

What is a ‘Normal’ Vaginal Smell?

Remember, it is normal for vaginas to smell, and we all have unique smells which can change depending on several lifestyle factors such as what we eat, exercise, sexual activity, etc.

Here are some common odors that are not a cause for concern:

• Tangy, fermented, or sour: Good bacteria in your vagina produce acids that keep it healthy and maintain the right pH balance. This acidity helps prevent infections by stopping bad bacteria from growing too much.
• Metallic: Remember when we stored our pennies, nickels, and dimes in a coin jar at home? If you’ve ever smelled that jar, you know the distinct metallic smell it gives off. Sometimes our vaginas can give off this smell; this is particularly common around the time we menstruate since blood contains iron. Contact with semen can also affect the vagina’s pH, leading to a metallic smell.
• Bittersweet or like molasses: The smell of molasses is often described as rich, sweet, and slightly earthy. It has a deep, caramel-like aroma with hints of sweetness and a touch of bitterness. This is another normal, not a cause for concern smell.
• Bleach-like: This can happen if there is a bit of urine on the vulva. However, it could be a sign of infection if you notice itching and burning along with this smell.

(Morelandobgyn.com, accessed 2024).

Odors that May Indicate a Health Condition

If you notice the following smells, we recommend booking an appointment with your healthcare provider for assessment. 

• Fishy: You may notice a fishy-like odor coming from your vagina. Do not ignore this smell as it may indicate either:
  • Bacterial Vaginosis (BV): learn more about this condition here.
  • Trichomoniasis: a sexually transmitted infection that can cause a fishy odor. In addition to this smell, you may experience symptoms like itching, discharge (typically a frothy, greenish/yellow), painful urination, and pain with sex. This infection is bacterial and requires antibiotics for treatment (Goldstein et al., 2023).
• Rotten (“like bad meat”): this can happen if you forget a tampon in the vagina. It may be accompanied by fever, pain in the pelvis/abdomen, vaginal itching/swelling, and discharge. It is important to see your healthcare provider ASAP if this occurs.

(Morelandobgyn.com, accessed 2024).

Does Vulvar Lichen Sclerosus Smell

After searching through PubMed and Google Scholar (repositories for academic publications), I (Jaclyn) found no paper associating vulvar lichen sclerosus with smell. Similarly, I found no evidence stating that VLS causes a particular odor or smell.

But I was diagnosed with VLS, and then I started noticing a smell; what’s going on?

One thing that may be happening is you are using new topical creams/ointments such as steroids, emollients, balms, salves, hormone creams, etc. These topicals may slightly alter the way you smell. For instance, most emollients have a smell to them–e.g., coconut oil can smell sweet and nutty, and olive oil may smell fresh, fruity, grassy, and/or peppery. Many commercial emollients, balms, and salves include ingredients with an odor. Therefore, adding these products in may slightly change the way you smell. You may try a scent-free or a different product if it’s overpowering.

You may have a secondary condition like an infection that is causing the smell. 

What to do if you notice a New Smell with Vulvar Lichen Sclerosus

If you notice a fishy or rotten smell coming from your vagina, book an appointment with your healthcare provider.

If you suspect the change in odor is due to an emollient, try a different one and see if that helps. Some folks have to cycle through a few to find the emollient that works best for them.

Finally, if you are distressed about how your vagina smells, talk to your healthcare provider about it. It may seem embarrassing, but they are there to help you.

Conclusion On Does Vulvar Lichen Sclerosus Smell

In sum, vulvar lichen sclerosus itself does not typically cause a foul odor. If you notice any unusual or persistent odor in the affected area, it’s essential to consult a healthcare provider to rule out any underlying infections or other conditions that may be causing the smell.

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Whether you are debating booking a support call with me, have a quick question, or want to share something related to my content, I can be reached via:

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References

References

Goldstein, A., Pukall, C., Goldstein, I., & Dr. Jill Krapf. (2023). When Sex Hurts. Hachette Go.

OB-GYN, M. (n.d.). Vaginal Odor: What Is Normal? Www.morelandobgyn.com. Retrieved April 13, 2024, from https://www.morelandobgyn.com/blog/vaginal-odor-what-is-normal#:~:text=Tangy%2C%20fermented%2C%20or%20sour.