Does Menopause Cause Vaginal Odor?

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There's no way around it: vaginal odor is a sensitive topic that can be hard for many women to talk about. But if you've noticed your usual scent has shifted during or after menopause, you may be wondering what's normal and what isn't – and perhaps what causes vaginal odor.

Here are answers to some of your most common questions about vaginal odor during and after menopause, plus ways to promote overall vaginal health and when to talk about vaginal odor with your healthcare provider.

What Should the Vagina Smell Like?

You may be asking yourself “how can I make my vagina smell better?” But let’s start off discussing how a vagina smells, naturally. The vagina normally has a musky scent. But the truth is, every woman's vaginal odor is unique, and everyone’s scent can shift over time and during certain situations, like after having sex. As long as a woman isn't experiencing discomfort, or signs of an infection (think symptoms such as burning, irritation or copious discharge), there is no "right" or "wrong" way for a vagina to smell. A vaginal odor that’s stronger than normal could be a sign of infection or another issue but will usually be accompanied by one or more of the symptoms listed above.¹ 

What Causes Vaginal Odor During or After Menopause?

So, does menopause cause vaginal odor? In short, no, menopause doesn't directly cause the vagina to have an unpleasant odor. However, hormonal shifts that happen starting in perimenopause, can result in changes to the vagina's normal scent and overall vaginal health.² During this time, declining estrogen levels can lead to changes in the vagina's pH and glucose levels.³ These shifts, which are completely normal, can lead to thinner, drier vaginal tissues and changes in the types of bacteria that populate the vagina. In turn, you may notice several vaginal changes. These can include discomfort, itching, or burning; a change in your typical vaginal discharge, or a slight difference in your vagina's scent.^4,5 Perimenopause and menopause can also put women at higher risk for certain infections, like bacterial vaginosis, that can potentially impact vaginal odor, too.

Hear more from Bonafide Chief Medical Officer, Dr. Alyssa Dweck, on vaginal odor changes in menopause, below: 

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What Are the Other Possible Causes of Vaginal Odor After Menopause?

A number of additional things can potentially cause vaginal odor to shift. Some factors may be more likely to occur during or after menopause, while others have the potential to impact a woman's vaginal scent at any age. These can include:

• Vaginal infections. Bacterial vaginosis – an overgrowth of certain bacteria in the vagina – is the most common cause of vaginal odor changes and is more likely to occur during and after menopause. Sexually transmitted infections like trichomoniasis can affect vaginal odor as well.⁶
• If your vaginal scent seems to change when your nerves are frayed, you're not imagining it. The stress hormone cortisol has been shown to cause changes to the natural balance of bacteria in the vagina⁷, which may result in a shift in menopause vaginal odor.
• Strong-smelling foods like garlic or tuna can temporarily cause the vagina to have a stronger odor.⁸ Some research has also found a link between high-fat diets and an increased risk for odor-causing infections like bacterial vaginosis.⁹ High protein, keto diets may also be linked to a change in vaginal scent.¹⁰
• Just like underarm sweat, sweat in the genital area can have a strong, musky odor. The odor isn't coming from the sweat itself; instead, it's the result of sweat mixing with bacteria that occurs naturally on the skin.¹¹
• Foreign objects. A forgotten tampon, condom, or even a bit of toilet paper that accidentally gets stuck in the vagina can increase discharge and cause a change in vaginal odor.¹²

Are There Treatments for Vaginal Odor?

Many of the habits and remedies that support vaginal health and comfort as a whole during menopause, can also help protect your vagina’s natural scent and reduce the risk for problems that could cause vaginal odor changes. Consider:

• Washing your genital area gently. Wash your vulva with unscented soap and warm water. (Or use warm water alone, especially if you’re experiencing burning or discomfort.)¹³
• Steering clear of scented products. Deodorizing soaps, sprays, perfumes, or lotions can irritate sensitive vaginal tissue and throw off the vagina’s delicate pH balance. This could cause a change in vaginal odor. Consider unscented products instead.¹⁴
• Avoiding douching. In addition to hormonal changes in vaginal pH during menopause, douching can also disrupt the natural balance of bacteria in the vagina, which can increase the risk for odor-causing infections like bacterial vaginosis.¹⁵
• Wearing loose, comfortable clothing. Tight-fitting pants or underwear are more likely to trap bacteria and moisture, which can increase the risk for infection and potentially cause a vaginal odor.¹⁶
• Trying a vaginal moisturizing insert. A hyaluronic acid-based vaginal insert, such as Revaree®, can help maintain vaginal moisture and minimize symptoms of dryness, itching, or irritation when used regularly and as directed.
• Taking an oral probiotic for vaginal health. If you struggle with vaginal infections or irritation, consider talking with your healthcare provider about the possible benefits of using a probiotic targeted at supporting vaginal health. A probiotic geared toward vaginal health may help promote a healthy balance of bacteria in the vagina, and in turn, aid in keeping vaginal pH where it should be, potentially preventing menopause vaginal odor.¹⁷

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When Should I Call My Healthcare Provider About Vaginal Odor After Menopause?

A mild, temporary change to your usual vaginal odor that's not accompanied by other symptoms, such as irritation or new discharge, likely isn't cause for concern.¹⁸ However, you should contact your healthcare provider if you notice an unusual odor that isn't easing up, or one that occurs with burning or soreness, abnormal bleeding, unusual discharge, pain while having sex or urinating, or pain in your abdomen or pelvic region.¹⁹ These could be signs of an infection or another health problem that needs to be addressed.

Resources

1. https://www.mayoclinic.org/symptoms/vaginal-odor/basics/when-to-see-doctor/sym-20050664?p=1
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008313/
3. https://www.webmd.com/healthy-aging/vagina-smell-change-after-50#2
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008313/
5. https://health.clevelandclinic.org/feminine-odor-problems-what-you-should-know-about-douching/
6. https://www.mayoclinic.org/symptoms/vaginal-odor/basics/causes/sym-20050664
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008313/
8. https://health.clevelandclinic.org/feminine-odor-problems-what-you-should-know-about-douching/
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071153/
10. https://www.medicalnewstoday.com/articles/keto-crotch#summary
11. https://my.clevelandclinic.org/health/symptoms/17865-sweating-and-body-odor
12. https://health.clevelandclinic.org/feminine-odor-problems-what-you-should-know-about-douching/
13. https://health.clevelandclinic.org/feminine-odor-problems-what-you-should-know-about-douching/
14. https://medlineplus.gov/ency/article/000897.htm
15. https://health.clevelandclinic.org/feminine-odor-problems-what-you-should-know-about-douching/
16. https://medlineplus.gov/ency/article/000897.htm
17. https://pubmed.ncbi.nlm.nih.gov/31299136/
18. Russo R, Edu A, De Seta F. Arch Gynecol Obstet. 2018; 298(1):139-145.
19. https://www.mayoclinic.org/symptoms/vaginal-odor/basics/causes/sym-20050664
20. https://www.uptodate.com/contents/vaginal-discharge-in-adult-women-beyond-the-basics