White Vaginal Discharge with Fishy Smell

In: Sexually Transmitted Disease|Women's Health

30 Jun 2011

Bacterial Vaginosis is the most common cause of abnormal vaginal discharge. Normally the vagina is full of good  bacteria called Lactobacilli, but in bacterial vaginosis, this bacteria is replaced with a lot of bad bacteria, which include, Gardnerella vaginalis, bacteroids species, peptostrepto-coccus, mycoplasma hominis, and mobiluncus species. They all  produce volatile amines and this is what causes the characteristic fishy smell.

Who is at high risk?

  • Common in sexually active women but can occur in virgins and lesbians.
  • Common in IUCD users.

Signs and Symptoms

Symptoms often occur after sexual intercourse and menstruation and it is possible that hormonal changes and semen among other factors can change the normal vaginal flora (bacteria)

  • In 50% of cases, bacterial vaginosis has no symptoms, and can go unnoticeable.

Fishy smell- Bacterial vaginosis has a characteristic fishy smell when vaginal secretions are mixed with 10% potassium hydroxide.

Vaginal discharge- there may be white milky vaginal discharge, but itchy vulva is not a feature.


Bacterial vaginosis is knows for certain complications like, pelvic infections after surgery, preterm labor, Chorioamnionitis (placenta infection)  and peurperal pyrexia (fever after child birth)

Gynecological examination

Whats seen by a gynecologist is a thin milky white vaginal discharge, it looks like a cup of milk has been poured into the vagina.

Tests that confirm it?

  • Odor test – fishy smell
  • Ph test- ph less than 4.5 in the vagina
  • Direct microscopic examination from the vaginal discharge in which there are characteristic cells present that are covered with bacteria called clue cells and some of the bacteria can be seen moving


Metronidazole is the drug of choice, treatment of a male partner is usually not needed but a condom should be used while treating a female partner.

Comment Form


General health blog enables you to find useful and interesting facts about many health topics. Written by Dr. Sumaira Khan, this blog is updated regularly and provides reliable information which is made easy to understand for everyone. please feel free to leave any comments or questions.