It’s common for pregnant women to notice changes in vaginal discharge, including odor, during the first trimester. An increase in discharge is normal as your body ramps up mucus production to help prevent infections from traveling up the vagina and cervix. Most changes in discharge odor are harmless. But a strong, fishy odor can signal a common infection called bacterial vaginosis.
What causes smelly discharge in early pregnancy?
Here are some common causes of smelly vaginal discharge in the first trimester:
Increased vaginal discharge
More vaginal discharge during pregnancy is normal. Your vagina and cervix make more mucus when you’re pregnant to help stop infections from getting into the uterus. This normal discharge is known as leukorrhea. It’s usually thin, white, milky, and mild smelling.
As discharge increases during pregnancy, you may notice a stronger odor. That’s especially true during the first trimester as your levels of estrogen and progesterone rapidly rise. The smell is often described as earthy or musky. It shouldn’t have a foul odor.
Bacterial vaginosis
Bacterial vaginosis (BV) is a type of vaginal infection caused by an overgrowth of bacteria. Its most common symptom is a fishy odor coming from the vagina. This strong odor is more noticeable after sex but can happen any time.
BV is common during pregnancy, affecting up to 1 in 4 pregnant women. Experts don’t know exactly what causes BV. But pregnancy hormones likely play a role by changing the pH balance in your vagina.
BV poses risks like preterm birth and low birth weight. So it’s important to get treatment as soon as you notice a fishy odor. Your doctor can prescribe antibiotic pills or gel to balance your vaginal bacteria.
Yeast infection
Vaginal yeast infections are also common during pregnancy, especially in the second trimester. They develop when there’s an overgrowth of the fungus Candida.
Symptoms include itching, burning, redness, and thick, white, odorless discharge. Some women describe the yeasty odor as similar to bread or beer.
Pregnancy hormones like estrogen and elevated blood sugar can trigger yeast infections. And yeast love to feed on discharge, so increased discharge raises your risk. Over-the-counter antifungal creams can bring relief.
Trichomoniasis
Trichomoniasis is a sexually transmitted infection caused by a parasite. Symptoms include yellow or green discharge, genital itching, and foul vaginal odor.
Pregnant women are at increased risk for trichomoniasis. Getting treatment is important since the infection raises the risk of preterm labor. Prescription oral antibiotics can cure the infection.
Forgotten tampon
It’s possible to forget a tampon is still lodged in your vagina, especially if your periods are irregular in early pregnancy. A forgotten tampon can lead to increased and foul-smelling vaginal discharge.
If you have a foreign odor and suspect you may have left a tampon in too long, try to locate and remove it. See your doctor if discharge continues despite tampon removal or you have signs of infection like itching, burning, or redness.
When to see a doctor
See your doctor if you notice any of the following symptoms along with smelly vaginal discharge:
- Itching, burning, or redness around your vagina
- Pain or soreness in your vaginal area
- Pain when you pee
- Pain during sex
- Abnormal vaginal bleeding
- Fever, chills, nausea, or vomiting
These could signal a vaginal infection or other condition requires treatment. Don’t wait – get it checked out right away.
How is smelly discharge during pregnancy diagnosed?
Your doctor can usually diagnose the cause of vaginal odor by asking about your symptoms and performing an exam. They may also recommend the following tests:
Pelvic exam
Your doctor visually examines the vulva for signs of infection. Then they insert a speculum to better see the vagina and cervix. Signs of infection include inflammation, unusual discharge, sores, or warts.
Vaginal pH
Your doctor places pH paper against the vaginal walls to measure acidity. A high pH over 4.5 suggests bacterial vaginosis.
Microscopic exam
A sample of discharge is viewed under a microscope. BV shows “clue cells.” For yeast, they look for hyphae fungal strands.
Wet mount
Your doctor mixes a discharge sample with salt solution to look for trichomoniasis parasites moving around.
Vaginal culture
Swabs collect discharge to grow bacteria, yeast, or parasites in a lab to confirm which organisms are causing infection.
What’s the best treatment for smelly vaginal discharge during pregnancy?
Treatment depends on the cause of vaginal odor. Here are some common treatments used in pregnancy:
Antibiotics for BV
For bacterial vaginosis, doctors typically prescribe antibiotic pills like metronidazole or clindamycin. Antibiotic gel or cream may also be used. It’s safe to treat BV during pregnancy.
Antifungal cream for yeast infections
Over-the-counter antifungal creams effectively treat yeast infections in pregnancy. Common active ingredients are miconazole, clotrimazole, or tioconazole. You put the cream on the vulva and inside the vagina.
Oral antibiotics for trichomoniasis
Trichomoniasis is cured with prescription antibiotics like metronidazole or tinidazole. It’s important to treat trichomoniasis to lower the risk of preterm labor. Sex partners should also be treated.
Removing foreign objects
If you have a retained tampon or foreign object in the vagina, removal resolves odor. See your doctor if odor or discharge continues.
Can you prevent smelly vaginal discharge during pregnancy?
You can take steps to help prevent vaginal infections that cause odor discharge:
- Practice good vaginal hygiene by washing external genitalia daily with mild soap and water
- Wipe front to back after using the bathroom
- Avoid scented feminine products
- Change pads and tampons frequently
- Avoid douching, which can disrupt your vaginal pH
- Wear cotton underwear and avoid tight clothes
- Don’t use hot tubs
- Use a condom if you have new sex partners
Eating yogurt with live active cultures may help prevent yeast infections. Ask your doctor before taking probiotics.
When does vaginal discharge return to normal after pregnancy?
It takes a few weeks for your vaginal discharge to return to its pre-pregnancy amount and odor. Here’s a timeline:
Right after delivery: Heavy red bloody discharge called lochia is normal for 2 to 6 weeks.
2 to 3 weeks after: Discharge turns to a whitish color and decreases.
4 to 6 weeks after:By 6 to 8 weeks: Discharge returns to normal non-pregnant amount and appearance.
See your doctor if heavy discharge returns after normal lochia ends or you develop a strong foul odor. This could mean an infection like bacterial vaginosis. Permanent odor changes after pregnancy are unlikely.
Takeaways
– Increased vaginal discharge and mild odor changes are normal early in pregnancy.
– Strong foul odors may signal infections like bacterial vaginosis, trichomoniasis or yeast. See your doctor.
– Preventing vaginal infections can help avoid smelly discharge. Practice good hygiene and avoid irritants.
– Allow at least 6 to 8 weeks postpartum for discharge amount and odor to return to normal.
Conclusion
Smelly vaginal discharge is common in the first trimester as hormones lead to increased mucus production. While some odor is normal, a persistent strong fishy or foul smell can indicate an underlying infection that requires medical treatment. Seek prompt medical attention if smelly discharge is accompanied by itching, burning, pain, or other symptoms. With proper diagnosis and care, vaginal infections can be cured and discharge odor resolved – allowing you to comfortably enjoy the rest of your pregnancy.