7 Reasons You May Smell Bad Despite Good Hygiene

Everyone has an occasional case of bad body odor or foul-smelling breath. But what does it mean if the odor persists even though you're on top of your personal hygiene? Many body odors are normal, but some body odors signal a health problem or change in the body.

“Diseases change the balance of chemicals in the body,” explains William Hanson, MD, a professor of anesthesiology and critical care at the University of Pennsylvania Health System in Philadelphia. Those chemicals can trigger changes in the scent of breath, urine, and other body fluids.

Here’s what several different odors mean, how to identify them, and what to do about them.

1. A Forgotten Tampon in Your Vagina

Natasha Johnson, MD, the director of the Vulvovaginal Center at Brigham and Women’s Hospital in Boston, describes the smell of a forgotten tampon as “an overpowering, foul odor, like rotting garbage.”

“Occasionally, a woman just forgets she already has a tampon in,” says Miriam Greene, MD, an associate professor of obstetrics and gynecology at NYU Langone Medical Center in New York City, and a cohost of the show Sexual Health on Sirius/XM Channel 81, Doctor Radio.

If that’s the cause, within 24 to 48 hours, you’ll notice a “very pungent smell that develops when vaginal bacteria multiply,” she says. According to Dr. Greene, “You may also have a feeling of pressure or general discomfort, but for many women, the powerful odor is the only symptom.”

• Vaginal discharge unrelated to the period
• Pain in the pelvis
• Fever

The first step is simply checking for and removing the tampon. Then follow up with a doctor. If it’s been there a long time, bacteria may have grown and caused an infection. “I always like to treat with an antibiotic cream just in case the overgrowth of bacteria leads to an infection,” Greene says.

• A sunburn-like rash or red dots
• Nausea
• Vomiting
• Dizziness
• Lightheadedness
• Fainting
• Aches and pains in the muscles
• Skin peeling on the hands and feet

2. Vaginal Yeast Infection

• A burning sensation while peeing or having sex
• A red, swollen vulva
• Rashes, pain, and soreness in the vagina
• Watery discharge

Yeast infections can also become painful. “Your tissues will develop inflammation and may eventually crack, which can cause a lot of pain,” Greene adds.

She recommends trying an over-the-counter (OTC) antifungal remedy for three days. If symptoms worsen or don’t improve, see your doctor. She suggests that you may need a stronger prescription cream or even an oral antifungal medicine, such as fluconazole.

Dr. Johnson says the odor may also have another cause, such as a bacterial infection. “When they have a discharge, most of my patients assume it’s a yeast infection,” she says. “Often, that’s not the case, so I prefer to see them to confirm the diagnosis.”

3. Bacterial Vaginosis

Johnson says the odor is often most noticeable after sex, during menstruation, or just after your period. That’s because semen and menstrual blood have a high pH, meaning they're alkaline and can disrupt the normal acidic environment of the vagina. She explains that this causes the bacteria to release amines, which are organic compounds that cause foul smells.

• Itching
• Irritation
• A burning feeling while peeing

4. Urinary Tract Infection

Johnson suggests that other factors like vitamins, medication, and foods can also change your urine’s scent. For example, “Asparagus can change the odor of your urine, but that usually lasts through only one or two voids of your bladder,” Johnson says. She advises that if you take vitamins or medications daily, the effects can last longer.

Other symptoms usually occur alongside the smell when it’s from an infection, including:

• A burning feeling
• An urgent need to pee
• Leaking urine
• Pain
• Cloudy or bloody urine

• Drink plenty of fluids.
• Pee regularly, which can improve how quickly a UTI heals.
• Place a heated pad on the back or belly to relieve UTI pain.

5. Diabetes

This one is not a bad body odor, but it does spell bad news. Sometimes, urine may have a sweet, fruity smell. “If you notice this, it may be because you’re getting rid of too much sugar in your urine,” Greene says. “This can be a sign of diabetes.” The Institute of Biomedical Science confirms that throughout history, ancient practitioners used to taste and smell pee to diagnose diabetes, identifying its trademark sweet taste and aroma.

Diabetes may cause extremely mild symptoms until a later stage. People with diabetes experience excessive thirst and frequent urges to pee. They also may have frequent infections, including urinary tract and yeast infections, which might cause their own odors along the sweet-smelling pee.

Other symptoms include:

• Numbness in feet and hands
• Constant feelings of hunger
• Wounds that don’t heal
• Blurred vision
• Weight loss that occurs unexpectedly without explanation
• Fatigue

Before starting treatment, you’ll first need to determine with your doctor whether or not you’re having difficulties controlling blood glucose. Several blood tests can diagnose diabetes, including:

• A hemoglobin A1C test
• Fasting plasma glucose test (FPG), in which the doctor measures blood glucose after eight hours of fasting
• Oral glucose tolerance test (OGTT), in which the doctor measures your blood glucose level two hours after drinking a fluid containing glucose
• Random plasma glucose test, a simple test of the glucose in your blood

While diabetes is a lifelong condition, you can manage it through diet, physical activity, and medication.

6. Sinusitis

This type of infection can make your breath smell bad because infected mucus from your sinuses drains into the back of your throat, explains Michael Perskin, MD, the director of faculty group practice at NYU Langone Medical Center in New York City.

• Intense nasal congestion and pressure
• A decreased sense of smell
• Postnasal drip
• Cough
• Thick green or yellow discharge from the nose
• Pressure in the ear, tooth, or face
• Fever
• Headache
• Fatigue

• Fever over 103 degrees Fahrenheit
• Mental changes, such as confusion
• Altered vision, including eye pain and swelling
• Neck stiffness
• Seizures

These might suggest a severe infection.

But people can manage sinusitis through over-the-counter (OTC) and prescription medications, such as decongestants, steroid nasal sprays, cold and allergy medications, or leukotriene antagonists. Surgery may be necessary to remove nasal polyps or treat fungal infections.

7. Foot Infection

“The sweat on your feet doesn’t smell on its own,” says Mark Kosinski, DPM, a podiatrist and a professor at the New York College of Podiatric Medicine in New York City. “The sweat creates a moist environment which, in your warm shoes, is a perfect setting for growth of bacteria and fungi. The odor is a metabolic by-product of the bacteria and fungi living on your feet.”

Itching in specific locations on the feet, as well as red skin, can suggest a fungal foot infection. “Itching that starts between the webs of toes and spreads is a sign of fungal infection,” says Zeina Tannous, MD, an assistant professor of dermatology at Harvard Medical School in Boston. “Other signs are redness and flaking or scaling skin.”

Dr. Kosinski suggests treating the condition with OTC products. To stop the sweat, use a deodorizing foot powder or even a regular underarm spray antiperspirant.

Stay away from cornstarch, though, Kosinski advises. Cornstarch actually provides food for the bacteria and fungi on your feet. His other tips for dealing with embarrassing foot odor include:

• Spray both shoes and feet with an athlete’s foot spray powder.
• Try activated charcoal insoles to combat the smell in your shoes.
• Avoid wearing the same shoes every day, and let them dry and air out between wearings.
• Wear shoes with breathable uppers made of leather or canvas.
• Wear cotton socks when possible, as they allow feet to breathe better than synthetic fabrics.

The Takeaway

While foul odors can cause embarrassment, it’s vital to identify the health problems at their root, as they may be causing other symptoms that affect quality of life, such as pain, illness, or skin issues. Infections of the genitals and urinary tract can lead to distinctive foul odors, while diabetes, sinusitis, and excess sweating might contribute to other unwelcome odors.

Speak to a doctor about odors that persist despite good hygiene, or those that occur alongside other uncomfortable symptoms. Many of the causes have direct treatments or medications that manage the underlying health issue.