Some vaginal discharge is normal throughout a person’s life. The amount of discharge may increase or decrease around menopause for various reasons.
After menopause, the body makes less of the hormones estrogen and progesterone. Very low levels of estrogen can have many effects throughout the body.
According to the Office on Women’s Health, the average age of menopause in the United States is 52 years old.
Menopause occurs when a person’s menstruation stops for 12 months in a row, but people may begin to notice bodily changes several years before this in a period known as perimenopause.
Many people experience changes in their vaginal discharge before and after menopause. This article looks at these changes, what they mean, and when to contact a doctor.
Around 60% of people experience symptoms involving the genitals or urinary system after menopause. These can include:
- vaginal atrophy, or a thinning or breakdown of vaginal tissue
- urethral atrophy, or a thinning or breakdown of urinary tract tissue
- a decreased libido, or a lower sex drive
The symptoms of vaginal atrophy include vaginal dryness, itchiness, and painful intercourse. Vaginal atrophy occurs in about 50% of people within 3 years of menopause.
Some research has linked low levels of an estrogen called estradiol with vaginal dryness. Decreasing estrogen levels causes a decrease in vaginal blood flow, which contributes to vaginal dryness and decreased vaginal lubrication.
Although vaginal dryness is common after menopause, some people may experience increased vaginal discharge.
In fact, in one 2018 study, vaginal discharge and infections were the second most common symptoms after vaginal dryness.
Vaginal atrophy can sometimes cause vaginal discharge. Discharge may also appear after local irritation, such as after sexual intercourse.
Excess estrogen during perimenopause can also lead to vaginal discharge, as can:
- vaginal infections
- skin conditions affecting the vulva, or vulvovaginal dermatoses
The vagina produces secretions to lubricate the vaginal walls. Some people experience increased discharge during perimenopause and reduced discharge after menopause.
Vaginal discharge is often normal, but some characteristics could indicate the presence of an infection or other condition. It is important to determine when discharge is healthy and when to contact a doctor.
According to some 2007 research, people may perceive vaginal discharge as abnormal when it is, in fact, physiological. Physiological vaginal discharge is white or clear and varies with changes in hormone levels in the body.
Knowing the difference between typical discharge and unusual discharge is important for people before, during, and after menopause.
Healthy vaginal discharge is typically white or clear. However, the amount, color, and consistency of vaginal discharge can vary widely from person to person.
Normal vaginal discharge has the following characteristics:
- clear or white
- does not stick to the walls of the vagina
- pools in the posterior fornix, which is a large recess behind the cervix
Healthy vaginal discharge also does not have a bad smell.
People who have passed menopause may develop vaginal atrophy because of the drop in estrogen levels, which causes the walls of the vagina to become thinner.
Vaginal atrophy can sometimes cause vaginal discharge, especially after something, such as sexual contact, has irritated the vagina.
If discharge appears thin, watery, and yellow or gray, it might indicate a rise in alkalinity and an overgrowth of bacteria in the vagina. These bacteria can lead to infections and inflammation of the vagina.
People with bacterial infections of the vagina may report whitish, cheese-like vaginal discharge that has a foul, fish-like smell.
Discharge can sometimes contain blood, but this is not always postmenopausal bleeding.
If a person is concerned about their vaginal discharge and whether or not it indicates a problem, they may benefit from speaking with a doctor.
Bad-smelling vaginal discharge that appears yellow or gray could indicate an infection.
A doctor may collect a sample to test the bacteria present in the discharge. Not all bacterial infections of the vagina will require treatment.
Healthcare providers can offer various treatments for vaginal infections and vaginal atrophy, which are two possible causes of vaginal discharge around menopause.
People can treat bacterial vaginosis with antibiotics. Treatments for yeast infections include antifungal creams or ointments.
Some treatment options for vaginal atrophy include:
- using an over-the-counter vaginal moisturizer every few days to keep the vagina lubricated, which prevents irritation
- using vaginal lubrication during sexual intercourse to reduce friction
- taking prescription medications to treat vaginal dryness, which can include hormonal birth control, menopausal hormone therapy, or prescription estrogen creams, gels, or rings
For optimal vaginal health, doctors may advise that people avoid using local irritants, such as scented soaps and shower gels.
People should also be cautious when using hygienic products such as wipes, powders, and sprays, as these may disturb the natural bacterial environment of the vagina.
Vaginal douches may increase the risk of bacterial vaginosis, so it may be better to avoid these.
People experiencing symptoms of vaginal atrophy can often reduce the discomfort by using treatments for vaginal dryness, such as estrogen products.
During menopause, vaginal dryness and discharge are the two most common complaints.
With changes in hormone levels that occur during menopause, people may experience a variety of symptoms, including vaginal discharge.
It is important to know when vaginal discharge is normal and when it is abnormal. Yellow or gray, thick, and foul-smelling vaginal discharge indicates that a person should contact a doctor.