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Women's Health

Ammonia smell

07/15/2008

Question:

I had my daughter 2 years ago, and after I had her I experienced at the end of the pregnancy and from then on a strong ammonia smell from my vaginal area. I could take a shower and still smell it in the morning. My doctor checked for a UTI, I had a small amount of blood in my urine, but not enough to worry she said. They checked for bacteria, and there was none, and I had no discharge. I do have discoloration in my underwear, but no discharge. What could be causing this? Is it my urine, my birth control, (Mirena), infection they cant detect? I am very big in cleanliness and only have one sexual partner, my husband. No STDs. I didnt have this before my daughter, but I have ever since I had her. She was my second pregnancy. My first was my son who is 4 now. Please help? I dont know what else to do.

Answer:

There are two possible common causes for your problem: 1) bacterial vaginosis, or 2) concentrated urine.

Bacterial vaginosis is a common condition in which bacteria that are normally in the vagina overgrow, causing a “fishy” or “ammonia” odor, sometimes accompanied by a thin discharge that will discolor the underwear. Normally a doctor can take a sample of the secretions from the vagina and look under the microscope to make the diagnosis. Sometimes doctors will treat this condition, even if a cause can’t be found, with an antibiotic called metronidazole (Flagyl). More information about bacterial vaginosis can be found at this web site: www.cdc.gov/std/bv/STDFact-Bacterial-Vaginosis.htm.

Sometimes, the urine can cause this smell. Typically, a blood test checking to make sure the liver is normal, and a urine test are helpful. Drinking more fluids may also help.

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Response by:

W. Fred Miser, MD W. Fred Miser, MD
Professor of Family Medicine
Director of Ohio State Medicine Residency Program
College of Medicine
The Ohio State University