When does male genital odor signal illness?

Mild, transient male genital odor after a day of physical activity is normal, but strong, persistent odor, or odor accompanied by itching and burning, may indicate a medical condition requiring a doctor's visit.

Dr. Tra Anh Duy, a specialist physician at Men's Health Center, states that the penis and scrotum regions have numerous apocrine sweat glands, sebaceous glands, and skin folds. In individuals with a long or tight foreskin, the moist environment easily allows bacteria to thrive, producing odor. Normally, the odor is faint and not bothersome. When smegma accumulates or an infection is present, the odor becomes pungent, fishy, or foul—a sign that requires attention. Many men, due to embarrassment, ignore these symptoms, which can affect reproductive health and sexual life.

Some causes of genital odor that are not medical conditions include:

Excessive sweating: This occurs especially during physical activity, when wearing tight underwear, or in hot weather.

Consuming strong-smelling foods: Such as garlic, onions, asparagus, or alcohol, which can alter body odor.

Improper hygiene: This includes not retracting and cleaning the foreskin (in uncircumcised individuals) or using overly strong antibacterial soaps that disrupt microbial balance. Many believe that daily showering is sufficient, but without proper cleaning of the foreskin area, particularly if uncircumcised, the risk of infection and foul odor remains high.

Unhygienic masturbation or unprotected sexual intercourse: These practices can leave behind semen or secretions that cause odor.

These causes often improve with lifestyle adjustments. However, if the odor persists, especially when accompanied by itching, burning, rash, or discharge, a medical condition should be suspected.

Medical conditions to note

Some medical conditions that can cause unpleasant genital odor include:

Balanitis and balanoposthitis: Commonly seen in individuals with a long or tight foreskin, caused by fungi (Candida), bacteria, or viruses. Candida-related balanoposthitis produces an unusual sour or sweet odor and often recurs if not thoroughly treated.

Urethritis: Caused by sexually transmitted bacteria like Chlamydia trachomatis or Neisseria gonorrhoeae, leading to a fishy odor, accompanied by painful urination and pus in the urine.

Sexually transmitted infections: Conditions like genital herpes, syphilis, or genital warts can cause odor due to ulcers and discharge.

Hidradenitis suppurativa: This causes abscesses, painful swelling, and a very strong odor.

Penile cancer: Although rare, late stages can cause ulcers, pus, and a very unpleasant odor.

When is genital odor a sign of abnormality?

A distinct fishy or foul odor that does not disappear after showering.

Accompanied by white, cloudy, yellow discharge, or pus.

Presence of ulcers, redness, itching, or burning, especially in the coronal sulcus or urethral opening.

Painful or frequent urination, or pain during sexual intercourse.

Unusually moist genitals, even without physical activity.

A doctor may order a urethral discharge test, PCR for sexually transmitted pathogens, a fresh smear of smegma, or urine and blood tests to identify the cause and determine treatment.