Menopause can affect the body in many ways, including, for some women, changes in the odor of their vagina and vaginal fluid. It’s also possible for menopause to cause or worsen other conditions that can contribute to changes in vaginal odor.

If you’re noticing changes in how your vagina smells, this article can help you understand why your vaginal odor might be changing and what you can do to prevent or manage unpleasant odors. Then you’ll be able to have better conversations with your obstetrician-gynecologist (OB/GYN) about what’s going on.

How Menopause Can Lead to Vaginal Odor

There are a few ways that menopause can lead to vaginal odor change. Some of these are directly related to menopause, while others are connected to health conditions that menopause raises your risk for.

Hormonal Changes

When your progesterone and estrogen levels lower, the tissue of your genitals changes and becomes thinner and drier. These changes, known as vaginal atrophy, can lead to vulvar and vaginal itching, pain, dryness, soreness, pain during sexual intercourse, and burning. Together, these symptoms are referred to as the genitourinary syndrome of menopause.

The changes in your vulvar and vaginal tissue can also affect how your vaginal fluid smells. If you notice a persistent change in how your genitals smell during menopause, it may simply be another effect of the hormonal changes you’re going through.

Urinary Tract Problems

Vaginal atrophy can also make it more likely that you’ll get urinary tract infections (UTIs) or experience urinary incontinence, where you can’t hold your urine in your bladder.

While these conditions don’t actually make your vagina smell different, urine that has leaked out can make your genital area smell like ammonia. Even though it’s not related to vaginal odor, urinary incontinence might contribute to changes in the odor you smell.

Yeast Infections

During menopause, the pH of your vagina goes up, making it less acidic. This can be problematic, since a slightly acidic vagina keeps your vaginal microbiome healthy. A lower pH prevents microorganisms, such as bacteria or fungi, from growing too much and helps keep a healthy balance in your vagina. When hormone levels change and the pH goes up, certain microorganisms are more likely to thrive and multiply. If a fungus called candida grows too much, it can cause a yeast infection. Yeast infections cause itching, burning, thick white discharge, and unusual odors.

A yeast infection doesn’t usually have a strong odor, but you might notice that your vaginal area smells slightly yeasty, like when someone bakes bread. Most people also have discharge that’s thick, white, and clotted like cottage cheese, alongside intense itching.

Bacterial Vaginosis

Bacterial vaginosis (BV) is an overgrowth of bacteria rather than fungus. It can cause a vaginal infection called vaginitis. BV is more likely to cause a significant shift in your vaginal odor than a yeast infection. Most people describe the smell as fishy. You might notice this fishy odor more after you have penetrative sex. BV may also come with a thin vaginal discharge that looks white or gray, and your vagina may be more irritated than normal.

Diabetes

While menopause doesn’t cause diabetes, it can make diabetes harder to manage. More active diabetes can make it more likely that you’ll end up with a UTI, a vaginal infection, or urinary incontinence. As mentioned above, all of these can lead to a change in your vaginal odor.

Other Causes of Changes in Your Vaginal Odor

If your vaginal smell has changed, it may not be connected to menopause at all. Your healthcare provider can also check for these possible causes:

• A sexually transmitted infection (STI), like trichomoniasis
• A fistula, or tunnel, between your anus and vagina
• Vaginal or cervical cancer (a rare cause)
• A retained tampon

Your gynecologist can test for these conditions and provide the treatment you need if you’re experiencing one of them.

Managing Vaginal Odor in Menopause at Home

The best step you can take if you don’t like your vaginal odor is to talk to a healthcare professional about the issue. If you guess the issue incorrectly and try the wrong treatment, it might worsen the issue. Since some potential causes of unpleasant vaginal odor are serious, identifying and treating the source as soon as possible could help you stay healthy in the long run.

Do’s for Healthy Vaginal Odor

There are several ways you can manage vaginal odor and promote overall vaginal health:

• Bathe regularly, using gentle soap and water to clean your vulvar area.
• Change clothes after exercising. This way, you’re not creating a damp, warm environment where bacteria love to grow.
• Wear cotton underwear or another light fabric that breathes. Clothes that are tight on your vulva may make some vaginal odor worse.
• Protect yourself during sex by using condoms to prevent STIs.

Don’ts for Healthy Vaginal Odor

There are also a few products and practices best avoided for a healthy vagina because they can encourage problems or make vaginal odor worse. These include:

• Douching — Douching can change your vaginal pH and make odor worse. It can also force bacteria deeper inside your body where it can cause additional problems.
• Using flavored or scented lubricants during sex — These products can cause vaginal irritation.
• Using harsh cleansing products — Your vagina is self-cleaning. Any soap or cleanser you use should be fragrance-free and pH balanced.

Treating Problems That May Lead to Unpleasant Vaginal Odors

Your gynecology team will help you figure out what’s causing your vaginal odor. Once any problems are diagnosed, they’ll recommend options to help you stay healthy and hopefully smell more like yourself. Depending on what they find, these recommendations may include:

• Antifungals for yeast infections — You can get antifungals over the counter (OTC) or by prescription. OTC products may not work as well.
• Antibiotics for bacterial infections — Prescription antibiotics can treat BV. However, antibiotics could make a fungal infection worse, so getting the right diagnosis is key.
• Hormone replacement therapy — Raising your hormone levels can help with a number of menopause symptoms, possibly including odor.
• Probiotics — Probiotics help keep a healthy balance of microorganisms. They may also help manage the symptoms of certain infections.

If your doctor suspects that your vaginal odor is caused by something not related to menopause, they may order additional testing to rule out serious conditions that could jeopardize your overall health.