I smell down there, what can I do?

Dear doctor,

 I smell down there. What can I do?

Dear reader,

For the males, the most common cause of a bad smell from the testicles is accumulation of dirt and sweat within the folds of the scrotum, and this should resolve with good hygiene. Other factors that may cause the smell include wearing tight clothing, wearing non-breathable fabrics, eating junk food or foods with strong smell. The smell may also be from an infection in the skin covering the scrotum, the nearby organs or the perineum; or from an infection in the urinary/reproductive tract.

It is advisable to see a doctor for a urine test and examination of any substance coming from the urethra. Other tests may be done depending on the findings. Treatment may include antibiotics, if there is an infection present. If there is an infection in the scrotal skin that is extensive (fournier’s gangrene), sometimes surgery may be done to remove dead and dying skin. Also, maintain hygiene, wear loose fitting cotton clothing and use boxers instead of briefs. Some people benefit from using powder to keep the perineum dry.

For females, the vagina has a normal musty smell, which changes due to hormonal changes at different times of the monthly cycle, or due to pregnancy, menopause, or use of hormonal medications. The odor may also be different after intercourse due to mixing with semen and/or a lubricant. Some women experience a metallic smell during the periods due to the iron in the blood. A change in the odor can also happen due to sweating a lot, or due to taking foods or drinks that have strong smells like garlic, onions, caffeine and some fruits. These changes do not require treatment.

If, in addition to the odour you have itching, or an abnormal discharge, or low abdominal pain, then most likely you have an infection, and it would be advisable to see a doctor so that you can have tests done to get an accurate diagnosis and you will be put on the appropriate treatment.

Dear Doc

Even prior to the pandemic I experienced a gradual loss to my sense of smell and sense of taste. Are there any medications or Dos/Don'ts that can help rejuvenate the two senses?

Jonah

Dear Jonah,

Partial or complete loss of smell is called anosmia, and it may be temporary or permanent. Irritation of the lining of the nose due to colds or allergies may cause temporary loss of smell. It can also occur if there is something obstructing the nasal passage or if there is nerve damage. Anosmia can also contribute to the altered sense of taste, and you can only notice a few flavours.

When you see a doctor, the examination conducted will depend on what is found or suspected. For instance, if a nasal blockage is suspected, you may have scans or nasal endoscopy done. Management follows the underlying cause such as removing the blockage. For anosmia that develops due to a cold, the sense of smell usually normalises on its own after a few weeks. Medication that may help to reduce the irritation of the nasal mucosa include antihistamines, decongestants or nasal sprays. In the meantime, you can add flavouring agents to food to make it taste better to you.

My anus always itches. What can be the problem? Especially when it's cold and when I sweat. How can I treat this?

Dear reader,

Itching around the anus, also called pruritus ani, can be due to poor hygiene, heat and sweating, skin tags, constipation, fungal infection, skin diseases like eczema or psoriasis, worm infection, hemorrhoids (veins that bulge or prolapse in the lower part of the rectum and anus), and allergy/irritation caused by tissues, wipes, soaps or antiseptics.

It is good to be examined by a doctor, and if necessary, have stool tests done to get a proper diagnosis. Treatment depends on the cause. There are ointments and suppositories that can help relieve the itching. Also, avoid scratching yourself, take lots of fluids and roughage to keep your stool soft, clean up with water and wipe gently after opening bowels, wear loose cotton underwear and avoid underwear when sleeping. If you have noticed that some foods worsen the itch, such as pepper, avoid them.

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