Perimenopause and Yeast Infections: Causes and When To See a Doctor

Medically reviewed by Shelly Beckley, ANP-BC, MSCP · Written by Suzanne Mooney · April 3, 2026

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Key Takeaways

During perimenopause, hormone changes can affect vaginal moisture, acidity, and healthy bacteria, making irritation and infections more likely for some people.

During perimenopause, hormone changes can affect vaginal moisture, acidity, and healthy bacteria. This can make irritation and infections more likely for some women. While hot flashes and irregular periods may be the most well-known symptoms of this life stage, you’re not alone if you start noticing more frequent yeast infections or have your first one ever.

In this article, you’ll learn how perimenopause affects vaginal health and how to recognize, prevent, and treat yeast infections, as well as when it's time to schedule an appointment with your doctor.

How Does Perimenopause Affect Vaginal Health?

Menopause is defined as the point in time when you’ve gone 12 months without a menstrual period. Perimenopause is the transition leading up to this point. Perimenopause can last months or years, and it looks different for everyone.

During perimenopause, fluctuating hormone levels can cause a variety of symptoms, including hot flashes, night sweats, sleep problems, mood changes, brain fog, and irregular periods.

Hormonal changes can also affect vaginal health in several ways:

Vaginal atrophy — Lower estrogen levels can make vaginal walls thinner and vaginal tissue more delicate.
Reduced lubrication — Less natural moisture can cause vaginal dryness, irritation, and discomfort during sex.
Changes in vaginal pH — The vaginal environment can become less acidic, making it harder for good bacteria to thrive.
Changes in the vaginal microbiome — Hormonal shifts can alter the natural balance of bacteria and yeast, creating conditions where a type of yeast called Candida albicans can overgrow.

These changes and other vaginal and urinary symptoms related to declining estrogen levels are grouped under the term “genitourinary syndrome of menopause” (GSM).

What Is a Yeast Infection?

A vaginal yeast infection (vaginal candidiasis) is a fungal infection that affects the vagina and surrounding tissues. It occurs when Candida yeast (the most common type is Candida albicans) grows out of control. Small amounts of Candida yeast normally live on the skin and body, including in the vagina. Candida usually only becomes a problem when there’s too much of it.

Common symptoms of a yeast infection include:

Vaginal itching or burning
Thick, white vaginal discharge
Discoloration and swelling of the vulva and vagina
Pain during sex
Burning with urination
Small cuts or cracks in the skin of the vulva

Some people notice a thick, white vaginal discharge that looks like cottage cheese when they have a yeast infection, while others have mild symptoms or no symptoms at all.

Other Vaginal Health Issues

A yeast overgrowth isn’t the only condition that can cause vaginal itching or discomfort. Other common causes of vaginal symptoms include:

Bacterial vaginosis (BV) — This is a common bacterial infection that may cause a strong “fishy” odor and thin white or gray vaginal discharge.
Sexually transmitted infections (STIs) — Symptoms vary depending on the infection and may include burning, itching, warts, sores, unusual discharge, or bleeding.
Urinary tract infection (UTI) — This is an infection in the urinary system that can cause a strong urge to urinate, burning during urination, pelvic discomfort, or red- or pink-tinged urine.

Because several vaginal health issues can cause similar symptoms, getting an accurate diagnosis is important to ensure you get safe and effective treatment options.

Why Are Yeast Infections Common During Perimenopause?

Yeast infections are common during perimenopause because hormone levels fluctuate during this time. In fact, anything that affects hormone levels can disrupt the natural balance of bacteria and yeast in the vagina. That’s why yeast infections are most common after puberty and before menopause, when hormones are in flux.

Hormonal birth control pills, whether used for contraception or menopause symptom management, can also increase the risk of yeast infections. Other hormone-related vaginal changes, such as thinning of the vaginal tissue, can make yeast infections feel more intense or easier to develop during this life stage.

Beyond hormonal influences, other factors that can increase the risk of yeast infections include:

A weakened immune system — When the immune system is compromised, the body may have a harder time keeping yeast growth in check.
Stress — Physical or emotional stress can affect hormones and immune function.
Antibiotic use — Antibiotics can kill beneficial bacteria in the vagina, allowing yeast to multiply.
Uncontrolled diabetes — High blood sugar levels can promote yeast growth.
Sexual activity — Yeast infections are not considered STIs, but sexual contact can sometimes spread the infection from one partner to another.

While some of these risk factors can’t be avoided, there are steps you can take to try to prevent yeast infections.

Can You Prevent Yeast Infections?

Making a few small changes to your daily routine may help lower your risk of yeast infections. Here are some tips to consider:

Avoid douching, as it can disrupt the natural balance of bacteria and yeast.
Wear cotton underwear and loose-fitting clothing to help keep the vaginal area dry.
Avoid scented soaps, tampons, pads, and other feminine products with fragrances.
Use water-based lubrication during sex to reduce friction and irritation.
Change out of wet bathing suits and sweaty gym clothes as soon as possible.

Some people take probiotics to promote healthy bacteria and restore the natural balance of microorganisms in the vagina. However, research on the effectiveness of probiotics for preventing yeast infections is limited.

If you have recurrent yeast infections or other health conditions, ask your healthcare provider for prevention tips. For people with diabetes, carefully managing blood sugar levels can reduce the risk of yeast infections. For those with a weakened immune system, healthcare providers may recommend preventive antifungal medications.

If you or your partner has a yeast infection, avoid sexual contact until it has fully healed to prevent passing the infection back and forth.

How Are Yeast Infections Treated?

Most yeast infections won’t go away on their own, but effective treatment options are available. With the right care, most yeast infections clear up within a few days to a week.

Prescription Treatments

If you have a yeast infection, your healthcare provider may prescribe an antifungal medication to target the overgrowth of yeast.

Certain antifungal medications are oral, which means they are taken by mouth, while others are topical, such as vaginal creams or suppositories. Fluconazole is a common and effective oral antifungal treatment.

Another option is boric acid vaginal suppositories, which can treat yeast infections. Which treatment your healthcare provider recommends will depend on the severity of your symptoms.

If you’re experiencing thinning vaginal tissue or dryness due to perimenopause, your doctor may recommend vaginal estrogen therapy. Vaginal estrogen can help restore tissue health and support the balance of microorganisms in the vagina. However, research is mixed on whether it directly increases or decreases the risk of yeast infections.

Over-the-Counter Treatments

Over-the-counter (OTC) antifungal treatments are available online and at most drugstores. These products typically come as vaginal creams, suppositories, or tablets and can be effective for mild yeast infections. However, it’s best to check with your healthcare provider first, especially if you have other health conditions, are pregnant, or have never been diagnosed with a yeast infection.

In addition to OTC antifungal treatments, using vaginal moisturizers and maintaining healthy hygiene habits may help reduce irritation and support recovery.

When Should You See a Doctor?

Schedule an appointment with your doctor if you notice new or changing vaginal symptoms during perimenopause. This is especially important with yeast infections, since vaginal itching, discharge, or irritation can overlap with other conditions that may require different treatment.

It’s a good idea to see a doctor if you experience any of the following:

Symptoms that don’t improve after a few days of treatment
Recurrent yeast infections, typically defined as four or more per year
Unusual or severe symptoms, such as pelvic pain, fever, or a strong odor
Discharge or bleeding that is different from your usual pattern
Chronic health concerns that can raise your risk of yeast infections

Your healthcare provider may perform a pelvic exam or lab tests to confirm the cause of your symptoms and recommend the most effective treatment options.

If you don’t already have a doctor who specializes in women’s health, perimenopause is a great time to find one and build that relationship. A healthcare provider who understands the menopause transition can guide you through this time and help you manage your vaginal health.

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