Navigating the changes of perimenopause can bring about unexpected shifts, including vaginal odor. This phase is a natural part of aging, but it can sometimes feel confusing and even frustrating.
Many women experience new and unfamiliar scents, which can lead to discomfort and concern. It's important to remember that these changes are common and manageable.
Hormonal fluctuations impact your vagina, often leading to shifts in the natural balance of your bacteria. This can result in an often noticeable difference in vaginal odor. While it might feel unsettling, there are simple ways to manage and reduce these symptoms.
Taking proactive measures to maintain your vaginal health and comfort during perimenopause can make a big difference, but it all starts with being informed.
Your Vaginal Odor 101
Most women have dealt with vaginal odor for one reason or another in their lifetime—it's completely normal to experience shifts, whether they're caused by changes in your cycle or even a short-lived infection.
However, you may notice more ongoing changes in vaginal smell that occur during the transitional years before menopause.
This natural phase typically begins in your 40s but can start earlier or later for some women. During this time, fluctuating estrogen levels create a cascade of changes throughout your body, including in your vaginal environment. These shifts can feel sudden and unexpected, leaving many women wondering if what they're experiencing is normal.
The good news? Most changes in vaginal smell during this time are completely natural responses to the hormonal fluctuations, and are usually nothing to be concerned about.
How Perimenopause Can Change Your Vaginal Odor
Your vagina is a finely balanced environment. When estrogen levels begin to drop during perimenopause, that balance shifts—and so can vaginal odor.
Estrogen helps maintain the thickness of the vaginal walls, supports natural lubrication, and keeps the vaginal pH in an acidic range. That acidity is important: it helps beneficial bacteria, like lactobacilli, thrive while keeping odor-causing bacteria in check.
As estrogen declines:
- The vaginal lining becomes thinner and drier.
- Vaginal pH becomes less acidic.
- Protective bacteria may decrease in number.
This shift in your vaginal microbiota can allow other types of bacteria to grow more easily, which can lead to a noticeable change in scent. It’s not necessarily a bad smell—just different. Many women describe it as stronger, muskier, or unfamiliar compared to what they were used to before perimenopause.
What's Normal and What's Not?
Some change in vaginal odor is expected during perimenopause, especially as hormone levels fluctuate. A mild musky scent or a slightly stronger smell than usual can fall within the range of normal.
But there are times when a change in odor signals something more:
Signs that may indicate an infection or imbalance:
- A strong fishy odor, especially after sex (often linked to bacterial vaginosis or BV).
- A foul or rotten smell, especially if accompanied by unusual discharge or irritation (can be caused by BV or some sexually transmitted infections)
- A sweet or “yeasty” scent, along with thick white discharge and itching (commonly seen in yeast infections).
If you notice any of these symptoms, it’s best to be evaluated by your healthcare provider. If you’re not sure what’s going on, it’s always safe to be evaluated and tested to rule out any infections. Infections can usually be treated easily, and addressing them promptly can help prevent discomfort or complications.
The Shifts That Cause Changes
Changes in vaginal odor during perimenopause are common—and often linked to hormonal shifts, changes in vaginal pH, and disruptions in the balance of bacteria. Understanding these causes can help you take simple, effective steps to manage what you’re experiencing.
Estrogen Decline and Changes to the Vaginal Wall
As estrogen levels fall during perimenopause, the structure and function of the vaginal wall change.
- The tissue becomes thinner, less elastic, and produces less natural moisture—a condition known as vaginal atrophy.
- These changes can lead to small irritations or micro-tears, which may increase your risk of infection or inflammation, both of which can affect odor.
Lower estrogen also reduces the amount of glycogen in vaginal cells. Glycogen fuels lactobacilli, the healthy bacteria that help maintain a low, protective pH. Without enough glycogen:
- Acid-producing bacteria decline.
- pH levels rise from the usual acidic range (3.8–4.5) to more neutral levels (above 5.0).
- Other bacteria that produce stronger or different-smelling byproducts may begin to grow more easily.
Vaginal Dryness
Vaginal dryness is more than a comfort issue—it affects the self-cleaning mechanisms of the vagina.
- Less moisture means dead cells and bacteria aren’t flushed out as efficiently, which can lead to a stronger or unfamiliar odor.
- Dryness also makes the vaginal tissue more prone to irritation, which can contribute to inflammation-related odors or raise the risk of infection.
Vaginal Flora and pH
Your vaginal pH plays a central role in odor. A low pH helps healthy bacteria thrive and prevents overgrowth of odor-causing organisms. During perimenopause:
- Lactobacilli populations (that produce lactic acid) decline as estrogen and glycogen levels drop.
- Other bacteria, which don’t produce protective acids, can increase in number.
- These shifts can change the overall scent, even in the absence of infection.
Some women find that gentle, pH-balanced washes help maintain balance during this time. Just avoid anything heavily fragranced or harsh, which can make things worse.
Bacterial Vaginosis and Other Vaginal Infections
As the vaginal environment changes, the risk of certain infections increases.
Bacterial vaginosis (BV):
- Occurs when harmful bacteria outnumber lactobacilli.
- Often causes a strong, fishy smell, especially after sex.
- May include thin, gray discharge and a burning sensation during urination.
Yeast infections:
- Common in perimenopause due to hormonal shifts.
- Typically causes a sweet or bread-like smell, thick white discharge, and itching.
If you’re experiencing a persistent or unusual smell, especially alongside other symptoms, it’s best to see your healthcare provider. Most vaginal infections are easily treatable once diagnosed.
Sexually Transmitted Infection (STI) Risks
A fishy vaginal odor can sometimes signal more than BV. Certain STIs may cause similar symptoms like a strong, unpleasant odor, as well as vaginal discharge and irritation.
- Thinner vaginal walls during perimenopause may increase the risk of transmission during intercourse.
- Many women entering new relationships later in life may not consider STI testing or prevention, even though the risk remains.
If you’ve recently had a new sexual partner or are noticing consistent odor changes, getting tested is a good step.
Symptoms to Watch For
Not all vaginal changes during perimenopause need medical attention—but some do. Knowing what’s normal and what’s not can help you respond appropriately without overreacting or overlooking important signs. Here’s what to look out for.
Abnormal Vaginal Discharge
Discharge during perimenopause may be lighter or less frequent due to lower estrogen levels. That’s normal. What’s not: noticeable changes in color, consistency, or smell.
- Color: Yellow, green, gray, or blood-tinged discharge (when not menstruating) can signal infection or irritation.
- Texture: Thick, clumpy discharge often points to a yeast infection. Thin, gray discharge is more typical of bacterial vaginosis (BV). Foamy or frothy discharge may indicate trichomoniasis.
- Odor: A strong or foul smell deserves attention, particularly if it’s new or persistent.
While some over-the-counter washes may help mask mild odor, they can actually make infections worse and are not a substitute for medical evaluation.
Itching, Discomfort, and Irritation
Itching is a common perimenopausal symptom, often due to thinning tissue and dryness from estrogen loss. But when itching is persistent or accompanied by other symptoms, it may signal something else:
- Yeast infections usually cause intense itching with thick, white discharge.
- BV may cause milder itching but stronger odor.
- Contact dermatitis (from new soaps, laundry detergents, or hygiene products) can also trigger irritation or redness.
If itching disrupts your sleep or daily comfort, or comes with discharge, odor, or swelling, it’s time to check in with your provider.
Recurrent Urinary Tract Infections (UTIs)
Hormonal changes during perimenopause increase your risk for UTIs. Thinning urethral tissue, reduced estrogen, and changes in vaginal pH make it easier for bacteria to enter and multiply.
Signs of a UTI include:
- Burning during urination
- Frequent urges to urinate
- Cloudy, foul-smelling urine
Some women notice their urine smells different before other symptoms appear. If you experience two or more UTIs within six months, talk to your provider about preventive strategies.
Probiotics may help support urinary and vaginal health by maintaining good bacteria levels.
How to Manage and Treat the Changes
Managing odor during perimenopause often involves a few straightforward changes. From supporting your vaginal microbiome to considering hormone therapy, there are several effective options depending on the cause and severity of your symptoms.
Support a Healthy Vaginal Microbiome
To maintain bacterial balance:
- Avoid douches, scented products, and harsh cleansers that can disrupt your natural flora.
- Use only warm water or a mild, unscented soap on the vulva (external area), never inside the vagina.
Lifestyle Tips to Manage Your Vaginal Odor Naturally
Small changes to your routine can reduce odor and irritation:
- Choose breathable cotton underwear and change it daily.
- Avoid tight-fitting clothes that trap heat and moisture.
- After workouts or sweating, change out of damp clothes promptly.
- Pat the vulva dry after bathing—or use a hair dryer on the cool setting to prevent moisture buildup.
Probiotics
Probiotics can also help. Look for:
- Oral supplements with Lactobacillus rhamnosus or Lactobacillus reuteri
- Vaginal suppositories for more localized support
You can also include probiotic foods like yogurt, kefir, sauerkraut, and kombucha in your diet. Prebiotic-rich foods (like garlic, onions, and bananas) feed good bacteria and support long-term balance.
Regular use of vaginal-specific probiotics can help restore and maintain a healthy pH.
- Choose oral probiotics with at least 10 billion CFUs and multiple Lactobacillus strains.
- Vaginal suppositories can be used after antibiotic treatment, at the first sign of odor, or on a preventative schedule (e.g., once or twice per week).
- Pairing probiotics with vaginal moisturizers can address dryness and bacterial balance together.
Vaginal Estrogen Therapy and Other Hormone Therapy
Dr. Tami Rowen suggests that when symptoms persist despite lifestyle changes, hormone therapy may help restore vaginal health.
Vaginal estrogen therapy:
- Comes in creams, rings, or tablets
- Works locally with minimal systemic absorption
- Helps restore tissue thickness, improve moisture, and rebalance pH
Menopause Hormone Therapy:
- Addresses broader perimenopausal symptoms, including vaginal changes
- May be an option if you’re also experiencing hot flashes, sleep issues, or mood shifts
Your provider can help you weigh the pros and cons based on your symptoms, history, and overall health.
When to Reach Out For Medical Advice
It’s not always easy to tell when a symptom needs medical attention. But if something feels off or isn’t improving, it’s worth checking in. Vaginal changes are common during perimenopause, but that doesn’t mean every change is harmless—or something you need to manage on your own. Here’s what to watch for.
Signs That Could Point to Vaginal or Cervical Cancer
Most vaginal symptoms during perimenopause are caused by hormonal shifts. But some changes may signal more serious conditions, especially if they don’t improve with typical care.
Warning signs include:
- Persistent odor that doesn’t respond to treatment
- Bleeding after sex or between periods
- Watery, blood-streaked discharge with a strong or foul smell
- Ongoing pelvic pain or vulvar itching
- Persistent pain during intercourse
- A lump or mass in the genital area
These symptoms don’t automatically mean cancer, but they do need evaluation. Routine gynecological exams and up-to-date Pap smears remain important in your 40s and beyond. If something feels unusual or continues without a clear cause, don’t wait.
When Odor and Discomfort Don't Go Away
If odor continues despite hygiene measures and over-the-counter treatments, it might be time to see your provider. The same goes for discharge that keeps returning or any vaginal discomfort that doesn’t improve.
A clinician can:
- Measure vaginal pH
- Examine the discharge under a microscope
- Order lab tests to identify specific bacteria or infections
Depending on what’s found, treatment might involve prescription antibiotics, antifungals, vaginal estrogen, or other interventions. While certain products may offer temporary relief, persistent symptoms may require more targeted care. Getting a proper diagnosis is the most effective way to treat the underlying cause and prevent the issue from coming back.
Having Healthy Vagina During Perimenopause (And Beyond)
Having to manage perimenopause vaginal odor is an uncomfortable but normal part of the transition. Your hormone levels shift, creating a different vaginal environment that may smell unfamiliar—but this doesn’t always mean there’s a problem.
Simple, consistent care can help maintain vaginal health: practicing good hygiene, supporting your vaginal microbiome with targeted probiotics, and using pH-balanced cleansers all make a difference.
Stay attentive to changes and address concerns early. Options range from lifestyle adjustments and over-the-counter products to medical treatments. What works varies from person to person, so some trial and error is normal when finding the right approach.
Don’t let embarrassment prevent you from seeking help. Vaginal health is a routine medical topic, and the right providers can recommend effective solutions tailored to your needs.
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Frequently Asked Questions (FAQ):
Does perimenopause cause an odor?
Yes. Hormonal shifts—especially lower estrogen—can change the vaginal environment, leading to altered odors.
Can hormonal imbalance cause odor down there?
Yes, hormonal imbalances affect vaginal bacteria balance, which can change your natural scent.
Why do I smell myself through my pants even after showering?
Persistent odor may be linked to hormonal changes, bacterial imbalance, or other health issues. If it continues, consult a healthcare professional.
Why does my discharge smell bad but not fishy?
A bad odor without a fishy smell might be caused by bacterial imbalance, diet, hygiene, or hormonal factors. A medical evaluation can help identify the cause.
