Dear Dr. Patti:

I am 23 with two young children, and have been in a committed relationship with my children's father for almost seven years. We are comfortable with each other sexually. However, I have this offensive vaginal odor (fishy, "unfresh") that worsens after lovemaking and is around at low levels at other times. My partner says that it attracts him more to me and that it is not offensive. But I feel differently. I have never had a sexually transmitted disease, yeast infection, bladder infection or so on. I am eating less carbohydrates (I heard this may have an effect on body odors) and more fruits and vegetables. But it's still there. Do you have any other ideas as to what it could be? Is it just a natural, woman thing? I am really troubled by it.

E.

Dear E:

My first suggestion to you is to make an appointment immediately with your gynecologist and get a thorough exam and evaluation. Perhaps these odors are a signal that there is an internal cause, such as infection or cysts, and I do not want you to risk your health.

Your question raises an issue about the socially conditioned differences between men and women. Many men report that they enjoy their female lover's musky scent, while the women are repelled by it. Perhaps you are responding to the advertising messages that tell women in our country to keep clean and fresh inside and to smell like a rose, not like a human being. The array of perfumed douches, sprays and other cosmetic products that mask our odors send a damaging note to women (and sometimes their partners) that natural body smells are bad. In truth, these scents can be the greatest aphrodisiacs around.

Your condition may be on the extreme side. Several factors play a role in a woman's genital odors: genetics, age, hormonal status and balance, diet, exercise, hygiene and the menstrual cycle. Obviously, with two children at your young age, you are fertile and vital. Perhaps you wear panty hose or other clothing that blocks the flow of air and causes odor. Always wear undergarments with a cotton crotch to permit proper ventilation. If you are using a vaginal douche with perfumes, it could be irritating your vaginal lining; this irritation, in turn, could cause the odor. On the other hand, you may be "juicy" and emit a strong scent as part of your biological makeup.

I suspect that if you take good care to prevent any unnecessary dampness and avoid going too long without cleaning (even with just a warm washcloth), you may find you can endure this condition by shifting your thinking and feeling about it. Try to be fastidious about bathing regularly, eat foods without spices, avoid sauces such as soy sauce or tamari, and dress for health. You may see a difference right away.