Explore the causes and management of vaginal odor during menopause. Learn about the vaginal microbiome, hormonal changes, and effective treatments like local HRT to maintain vaginal health with Spiced Pear Health.
Not the nicest subject, but one we think it’s helpful that you know about: vaginal odour.
Vaginal odour is usually a reflection of your vaginal biome – the mix of microbes that lives there. Your microbiota depends on your age, ethnicity, and physiology – but also very much on your sex hormones. It changes with hormonal contraceptives and also with menopause.
It’s not something we think about very often, but our microbiomes are really important parts of us – it’s estimated that the average human has 38 billion human cells and 39 billion microbiome cells! In recent years, medicine has become more interested in the influence of our microbiota on our health: our gut microbiome, for example, is now understood to play a vital part in gut health. Vaginal microbiomes are equally important.
In our premenopausal years, we have oestrogen, which creates vaginal cells rich in glycogen. These cells slough off thick inner walls (replaced every four hours or so), meaning we heal quickly from any damage – and the dead cells feed bacteria called lactobacilli.
A healthy premenopausal vagina is full of lactobacilli. They produce lactic acid, which keeps the vaginal pH low (4-4.5ish), and this helps us keep pathogenic, bad fungi and bacteria low and infections at bay. It also gives us the familiar odour and discharge of a healthy vagina.
When we get infections, such as thrush and bv, they disrupt this balance, and the quality and quantity of discharge can change, as can the odour.
Post menopausally, as part of the changes of loss of oestrogen, we lose the dominance of lactobacilli, so the vaginal pH rises and the biome changes significantly. This makes us more prone to vaginal infections and urinary tract infections, and it also changes the type and the smell of the discharge.
This sometimes makes women feel embarrassed or worry it’s “just them”: it’s not.
Local vaginal HRT (gels, creams, pessaries and rings) are almost universally safe to use and help a lot to keep this part of you healthy and working as it was originally designed to: a bit like a self-cleaning oven!
Throughout this website, we use the term women when describing people who experience hormonal symptoms. However, we acknowledge not only those who identify as women require access to menopause and hormone health information. For example, some trans men, non-binary people, intersex people or people with variations in sex characteristics may also experience menopausal symptoms and PMS/PME or PMDD, and we warmly welcome everyone who needs this support in our clinic.
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