Perimenopause and menopause are responsible for a number of changes to the body, but it sometimes can be difficult to determine which are directly tied to menopause-related hormonal changes, and which are simply fluctuations in your body’s natural rhythms.
Some changes may be unexpected and embarrassing, like a change in vaginal odor. It’s important to know, however, that a change in vaginal smell during menopause is not unusual. Several factors can influence this, and it’s good to know why it happens, what’s normal and what’s not, and learn how to manage a change in vaginal smell, if it bothers you.Learn more about a change in vaginal odor during menopause from Bonafide Chief Medical Officer, Dr. Alyssa Dweck, in our quick video, below:
What Causes a Sudden Change in Vaginal Odor During Menopause or Perimenopause?
All vaginas have a scent. Several factors influence this, including sweat gland function, diet, sexual activity, grooming and hygiene habits, and where you are in your menstrual cycle (if you are still experiencing periods). It’s a good idea to be aware of your typical vaginal smell too, so if you notice a change in vaginal odor, you can determine if a medical evaluation is necessary.1
A common cause of a change in vaginal smell during menopause is the inevitable shift in hormone levels, specifically estrogen. As perimenopause begins, estrogen begins to decrease, and as these hormone levels fluctuate, various menopausal symptoms may occur, including a change in vaginal odor.
Some specific causes of vaginal odor experienced during menopause include:2
How a pH Imbalance Could Change Vaginal Smell
The vagina's microbiome is measured in pH values—this scale determines how acidic or basic (alkaline) a substance or environment is. The pH scale ranges from 0-14, where a pH of 7 is neutral, less than 7 is acidic, and higher than 7 is basic (alkaline). The vagina favors an acidic environment, which is helpful for eliminating bad bacteria and potentially preventing infections. If vaginal pH becomes imbalanced, an infection may be the culprit (or even a result). Infections are sometimes accompanied by a change in vaginal odor, atypical to your natural vaginal scent.3
Bacteria and a Sudden Change in Vaginal Odor
Healthy vaginas have an abundance of lactobacilli, or “good” bacteria, that produce anti-microbial compounds to stave off inflammatory-causing bacteria. While some vaginal changes during perimenopause and menopause due to hormonal fluctuations are normal, others may affect this delicate bacterial balance. A lack of lactobacilli, or an abundance of other “bad” bacteria, may result in some distinct vaginal odors.4
How Infections Could Change Vaginal Smell
Vaginal infections can occur in women at any age, but changing hormone levels during menopause may increase risk. Some common infections include yeast infections, bacterial vaginosis (BV), trichomoniasis, and those that are sexually transmitted. Most infections need treatment, so be sure to check with your healthcare provider if you notice a distinct change in vaginal smell, especially if it is accompanied by unusual discharge, itching, burning, or a rash.5
What Types of Vaginal Odors Are Normal?
If you are familiar with your typical vaginal smell, you’ll have a basis for identifying any changes in vaginal odor that might not seem quite right. While some odors may indicate an issue requiring medical attention, some changes don’t necessarily mean anything is wrong.
Below are some of the most common types of vaginal odors:
- Sweet – It’s normal for a vagina to emit a slightly sweet smell, similar to the scent of honey. However, if you notice an exceptionally sweet odor, it could indicate a yeast infection, which will need treatment.6
- Metallic – A metallic scent may indicate blood in the vagina or uterus—this is due to a high presence of iron. Chances are you are on your period if you notice this type of odor, but it can also occur after sex, as sperm raises the pH of the vagina.7
- Sweaty – Because many sweat glands and hair follicles are positioned around the vulva, exercise may cause excess sweating in this area, resulting in a “body odor” scent.8
- Tangy - A sour, slightly yeasty smell can indicate a slightly acidic pH. This may be a sign of beneficial lactobacilli bacteria and is not typically a cause for concern. 9
- Fishy – While some vaginas normally have a mild, fishy odor – a new, more powerful scent of this type may indicate an infection and should be checked out by a healthcare provider. Common infections associated with a fishy vaginal odor include vaginitis, bacterial vaginosis (BV), or trichomoniasis. These infections require a proper diagnosis and typically, an antibiotic treatment.10
How Can I Control Vaginal Odor During Menopause?
If a strong vaginal scent makes you feel uncomfortable, and if you’ve ruled out medical issues for any changes in vaginal odor during menopause, there are a few ways to take control of odors, including:
Practice Good Hygiene to Avoid Changes in Vaginal Smell
The vagina is self-cleaning and does not require internal cleansing with soap(s) or scented washes (i.e., no douching). Washing the vulva—the exterior genital area—is fine; however, non-scented soap is preferable. Some scented cleansing products, like soaps, can disrupt the vagina’s pH balance and cause irritation without the presence of infection, 11 – cleaning with clear, warm water will also work just fine.
Also, you could consider keeping pubic hair short by shaving, trimming, or waxing if you tend to sweat a lot. Hair can trap oil, sweat, and bacteria, and moist, dark spaces are prime for bacterial growth that may result in a noticeable vaginal odor. 12
Change in Vaginal Odor? Check Your Underwear Material
Cotton is a preferred choice for undergarments because its breathable fibers allow air to pass through the material. Cotton also absorbs excess moisture, including sweat and vaginal discharge. Do your best to avoid underwear with synthetic fabric in the crotch, as these fibers can trap sweat and keep the vaginal area moist, providing an ideal environment for bacteria growth. 13
Maintain a Good Diet
Consuming foods with a naturally strong smell may cause a change in vaginal odor, such as certain spices, as well as onions, garlic, broccoli, and asparagus. Some foods can also alter the acidity of micro flora in your vagina, which can affect its scent.14 Hydration matters; a more pungent vaginal scent might be noted with inadequate hydration.
Certain foods can increase the number of lactobacilli present in your vagina, as well. Microorganisms, called probiotics, are present in many types of these foods, including yogurt, pickles, raw sauerkraut, and kefir.15 One 2022 study determined a positive association between the female reproductive health tract and vaginal microbiota, and noted that probiotics are important in maintaining optimal vaginal health by averting gynecology-related diseases, and boosting the overall health of the vagina.16
When Should I Worry About a Change in Vaginal Odor?
Any time you have a concern about your vaginal or reproductive health, it’s important to contact your healthcare provider. And if you notice changes in vaginal smell that are not typical for you, especially when accompanied by itching or unusual discharge or bleeding, a wellness check is in order. Left untreated, infections—especially infections caused by sexually transmitted diseases— can lead to more serious conditions, like pelvic inflammatory disease,17 or fertility concerns.
If you notice a change in your vaginal smell as you approach perimenopause or menopause, remember that not all odors are cause for concern—a change in vaginal smell is not at all unusual. However, identifying potentially problematic vaginal odors, and talking with your healthcare provider about any concerns, can help keep potential issues at bay.