Types of Vaginal Odor After Menopause

It’s no secret that menopause causes a variety of changes throughout the body, including within the vagina. If you’ve gone through menopause, you may have noticed some noteworthy vaginal changes such as dryness, burning, itching and even potentially pain with sex.

You may have also noticed changes to your vagina’s natural scent.

Variations in vaginal odor after menopause are not particularly uncommon and can have a variety of causes. In this article, we’ll explain why vaginal odor in older women may differ from that of premenopausal women, as well as talk through some specific vaginal odors that might signal the need for a healthcare provider’s input.

Vaginal Odor and the Connection to Menopause  

Estrogen, a female sex hormone, fluctuates significantly during perimenopause and declines during menopause. This often affects the delicate pH balance of the vaginal microbiome, which can influence the way the vagina smells.¹

To provide a clearer sense of how vaginal pH works, let’s briefly talk through different pH values. The pH scale measures acidity levels from 0-14, with 7 in the middle, as neutral. The lower the number on this scale, the more acidic the value is. The higher the number, the more alkaline, or basic, the value is.²

Like your gut, your vaginal microbiome contains helpful microbial species, like lactobacilli, and other fermentable bacteria. In the vagina, these “good” bacteria combine with vaginal skin cells to produce lactic acid and hydrogen peroxide.^3,4 In reproductive-aged women, this supports a moderately acidic vaginal pH of 3.8-4.5.⁵ This acidic environment is hostile to the overgrowth of “bad” bacteria. It’s also beneficial for reducing yeast buildup. In this acidic pH range, it’s not uncommon for a vaginal scent to be more tangy or to have a slightly fermented smell.⁶

As estrogen levels decline with menopause, so does the number of helpful bacteria within the vagina. The result is less lactic acid production, and a shift to a more alkaline vaginal environment, with a pH of 5.3 or higher.⁷ At this pH level, the vagina may smell slightly sweeter than what you were used to toward the beginning of your reproductive years. You may also notice an absence of a coppery scent that typically accompanies menstrual blood. In some instances, the vagina may now even have a bittersweet smell.

Vaginal secretions which contain bacteria that produce lactic acid are also reduced during menopause.⁸ This can change the scent of your vaginal discharge from acidic, to slightly bready or yeast-like.

Hear more from Bonafide Chief Medical Officer, Dr. Alyssa Dweck on why vaginal odor may change and some common scents to be aware of, below:

Types of Vaginal Odor Changes During and After Menopause  

There is no such thing as a scentless vagina, so don’t put pressure on yourself to achieve that unrealistic goal – it’s natural for all vaginas to have a scent. No matter what your age or menopausal status, your vagina will emit different types of smells that are influenced by a variety of factors. These can include what you eat, your level of hydration, your hygiene habits, and how much you sweat.

Some different types of vaginal odor experienced after menopause can include:

Fishy Vaginal Odor

A fishy vaginal odor is not considered normal and is commonly associated with an infection called bacterial vaginosis – more on that later. It can also be caused by dehydration, sweat, or even sex with a new partner.⁹ It’s important to note that douching, or using feminine “hygiene” products can increase your levels of “bad” vaginal bacteria, causing a fishy smell to occur during or after use – this often has to do with a shift in vaginal pH.¹⁰

But sometimes, a fishy vaginal odor can signal an infection that needs treatment.

As we mentioned, low levels of vaginal lactobacillus and a pH level of 5 or higher are not uncommon in postmenopausal women. These changes to the vaginal microbiome can make you more susceptible to an infection known as bacterial vaginosis (BV). This specific infection causes a strong, fish-like vaginal odor, especially after having sex.¹¹ It can also cause itching, burning, and a thick, gray or white discharge.

A strong, fishy vaginal odor may also be a symptom of trichomoniasis, a sexually transmitted infection (STI). Itching, burning, vaginal redness, and excessive discharge are additional symptoms of this infection.¹²

If you have any other accompanying symptoms along with a fishy vaginal odor, or the smell is strong, it’s time to check-in with your healthcare provider. BV and trichomoniasis are both treatable with prescription antibiotics.

Yeasty or Bread-like Vaginal Odors

If your vaginal pH is fluctuating due to menopause, you may notice a sweeter vaginal scent, like gingerbread, or molasses.¹³

If you notice a scent that is somewhat yeasty, like sourdough bread, it may indicate an acidic pH that’s falling within a healthy range.¹⁴ But, since lactic acid production in the vagina decreases during menopause, a bread-like or beer-like vaginal smell may also indicate that you may have a yeast infection.¹⁵ If the smell is accompanied by clumpy, white vaginal discharge and/or intense itching, let your healthcare provider know. They can help to diagnose any infection, and provide a prescription for antifungal medication, if needed.

Ammonia or Bleach-Like Vaginal Smells

Urinary incontinence may occur during the menopause transition. If there’s urine residue in your genital area, you may notice a temporary ammonia, chlorine-like, or bleach-like smell that often dissipates with washing.¹⁶

Dehydration and sweating can also cause these types of vaginal odors temporarily. If you’ve exercised or sweated profusely and haven’t had a chance to wash or change your clothes, your sweat may have had time to combine with vaginal bacteria. This will exacerbate the vaginal odor, causing a more pungent smell.¹⁷ 

Rancid or Rotting Vaginal Odor

If you notice a rancid or rotting type of vaginal odor and are still menstruating, this often points to a forgotten tampon. This is more common than you may think. In the chance this occurs, you may need to visit your gynecologist to assist with removal. As always, be sure to check with your healthcare provider if you have any questions or concerns.¹⁸

Remember, All Vagina’s Have a Scent

Many women are hyper-aware of the way their bodies smell. The vagina is an amazingly complex organ and yes, it does produce a variety of scents and odors.

Vigorous scrubbing, cleansing, and douching are not recommended, ever, for eliminating or reducing vaginal odor. In fact, these practices may even worsen it.

Simple hygiene basics like washing daily with a mild soap and water are typically all that’s required to keep you fresh and clean. If you notice a stronger vaginal odor, one that’s different than your norm, or one that’s accompanied by other symptoms, put embarrassment aside and talk with your healthcare provider. They can help uncover what may be going on and help to put your mind at ease.

Resources

1. https://pubmed.ncbi.nlm.nih.gov/30848142/#:~:text=Results%3A%20The%20vaginal%20microbiome%20is,is%20under%20control%20of%20estrogens
2. https://www.usgs.gov/media/images/ph-scale-0#:~:text=pH%20is%20a%20measure%20of,hydroxyl%20ions%20in%20the%20water.
3. https://pubmed.ncbi.nlm.nih.gov/30848142/#:~:text=Results%3A%20The%20vaginal%20microbiome%20is,is%20under%20control%20of%20estrogens
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10215881/#:~:text=Female%20reproductive%20health%20is%20strongly,(H2O2)
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8618584/#:~:text=The%20normal%20vaginal%20pH%20value,and%20postmenopausal%20women%20%5B12%5D.
6. https://my.clevelandclinic.org/health/symptoms/17905-vaginal-odor
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955044/
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9705842/#:~:text=In%20addition%2C%20we%20confirmed%20through,fluid%20of%20women%20after%20menopause.
9. https://www.healthline.com/health/vaginal-health/what-you-need-to-know-if-your-vagina-has-a-fishy-odor#causes
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291839/
11. https://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm
12. https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/trichomonas-infection/#:~:text=Symptoms%20of%20trichomonas&text=a%20yellow%20or%20green%20discharge,infection%20of%20the%20prostate%20gland
13. https://my.clevelandclinic.org/health/symptoms/17905-vaginal-odor
14. https://my.clevelandclinic.org/health/symptoms/17905-vaginal-odor
15. https://health.unl.edu/vaginal-odor-what%E2%80%99s-normal-and-what%E2%80%99s-not#:~:text=A%20yeast%20infection%20may%20be,and%20rawness%20or%20skin%20breakdown.
16. https://my.clevelandclinic.org/health/symptoms/17905-vaginal-odor
17. https://www.verywellhealth.com/vaginal-odor-6362565
18. https://www.healthline.com/health/womens-health/vagina-smells#7.-Rotten-like-a-decaying-organism