Creamy, Foul-Smelling Vaginal Discharge: Likely Bacterial Vaginosis — See a Doctor

A creamy, "sour milk" odor discharge is classic for bacterial vaginosis (BV)—an overgrowth of anaerobic bacteria (Gardnerella, Prevotella) displacing protective lactobacilli.

BV Symptoms

• Thin, gray-white discharge
• Fishy/sour odor (worse after sex or menses)
• Burning urination, vulvar itch, dyspareunia
• Asymptomatic in ~50% of cases

Risks of Untreated BV

• Increased STI acquisition (HIV, HSV, chlamydia, gonorrhea)
• Increased pelvic inflammatory disease (PID), post-surgical infection
• Pregnancy complications: preterm birth, low birth weight, chorioamnionitis

Treatment

• Metronidazole (oral or vaginal gel) or clindamycin vaginal cream—prescription only
• Partner treatment not routinely recommended
• Recurrence common—boric acid suppositories, lactobacillus probiotics may aid maintenance

Self-Care (Adjunct Only)

Fragrance-free cleanser, cotton underwear, avoid douching/tampons during treatment, stay hydrated.

See a clinician for diagnosis (wet mount, pH, whiff test) and prescription. Do not self-treat with OTC yeast medications—they will not work.