Unpleasant Fishy Smell During Menopause: Causes and Prevention Tips

Understanding Vaginal Odor During Menopause

Many women experience changes as they enter menopause, the stage of life when menstruation ends. One of these changes for some women is experiencing a "fishy" vaginal odor, often described as smelling unpleasant, pungent or fish-like.

Why Does Menopause Cause Fishy Vaginal Odors?

During the reproductive years, the balance of bacteria and acidity level in the vagina helps limit unpleasant odors. After menopause, the decrease of estrogen causes changes to vaginal tissues and bacteria balance, which makes the vagina less acidic. This allows the growth of certain bacteria like Gardnerella and can cause bacterial vaginosis where more fishy odors occur.

Menopause also brings changes to vaginal secretions, including water loss. This can concentrate vaginal fluids and alter the normal acidic balance, also contributing to an environment for odor-causing bacteria to proliferate.

When to See Your Doctor About Fishy Odors

Having a fishy odor during menopause can be concerning. It's important to have a doctor examine you to determine the cause and recommend proper treatment.

See your doctor promptly if the odor:

• Is strong or gets worse
• Is accompanied by gray/white/green vaginal discharge
• Causes irritation like itching, burning or swelling
• Comes with bleeding after intercourse or abnormal periods

You should also make an appointment with your doctor if you experience pain or discomfort when urinating or have pain in your pelvic area.

What Causes Offensive Vaginal Odors During Menopause?

1. Bacterial Vaginosis

One main reason for odor is bacterial vaginosis (BV), an overgrowth of harmful bacteria like Gardnerella. BV is common, affecting up to 30% of menopausal women.

In addition to producing fishy odors, BV symptoms include:

• Watery gray, white or green vaginal discharge
• Burning sensation when urinating
• Irritation and redness around the vagina

2. Vaginitis

Vaginitis refers to inflammation of the vagina from infections that can produce odors, most commonly:

• Yeast infections: Cause thick white clumpy discharge along with odor, itching and redness.
• Trichomoniasis: Parasite infection leading to smelly yellow-green frothy discharge.
• Chlamydia and gonorrhea: STDs sometimes go unnoticed in older women but cause unpleasant discharge and odor.

3. Cervicitis

Cervicitis is irritation and inflammation of the cervix near the vaginal opening, often from STDs. Associated discharge can lead to foul fishy odors.

4. Forgotten Tampon or Foreign Object

A retained tampon, condom or sex toy that slip past the cervix may cause extremely foul odor requiring prompt medical removal.

5. Cancer

In rare cases, a stronger unpleasant persistent odor unresponsive to treatment could signify vulvar, vaginal, cervical or uterine cancers. It's important doctors examine any prolonged changes and odors.

Getting Treated for Smelly Vaginal Odor

To determine the cause of odor and recommend proper treatment, your doctor will ask about symptoms and perform an examination of the vulva and vagina. Tests may include:

• pH test of vaginal fluids
• Microscopic examination of discharge samples
• STD tests
• Blood tests to assess hormone levels

Based on test results, typical treatment approaches include:

• Bacterial vaginosis - Antibiotics, usually metronidazole oral tablets or antibiotic gel applied inside the vagina. Probiotic supplements can help rebalance bacteria.
• Yeast - Antifungal medications are prescribed, either one dose oral tablets or multi-dose creams inserted into the vagina daily for up to 7 days.
• Trichomoniasis - Oral antibiotics like metronidazole or tinidazole.
• STDs (chlamydia, gonorrhea) - Treat with appropriate antibiotics.
• Forgotten objects - Removal from vagina.
• Hormonal changes - Low-dose prescription estrogen creams or suppository capsules can help moisturize and rebalance vaginal environment.

Home Remedies to Help Treat Odors

While medical treatment is important, over-the-counter home remedies can also help provide relief when dealing with unpleasant vaginal odor during menopause:

• Wear cotton underwear and avoid tight clothes to keep the area dry and aired out.
• Clean the vaginal area daily using gentle unscented soap and water - avoid aggressive scrubbing.
• After a bowel movement, always wipe from front to back to avoid spreading bacteria to the vagina.
• Apply natural yogurt with active cultures to the labia and entrance of the vagina to restore healthy bacteria.

Check with your doctor before inserting any home remedies into the vagina to ensure it will not interfere with medical treatment or cause further irritation.

Preventing Vaginal Odors After Menopause

It's difficult to always prevent vaginal odor after menopause but practicing healthy habits can help lower your risks:

1. Maintain proper vaginal hygiene with gentle daily cleaning.
2. Wipe thoroughly after using bathroom - always front to back.
3. Change pads and tampons frequently during periods.
4. Avoid irritating feminine sprays, perfumes, douches which upset pH balance.
5. Have new sexual partners tested for STDs before sex.
6. Use condoms correctly every time you have sex.
7. Schedule well-woman exams yearly for pelvic exams, STD testing.
8. Bring up musty odors, unusual discharge immediately to your doctor.

Seeking Treatment for Vaginal Health

Having an unpleasant or fishy odor from one's vagina can be distressing but try to remember it's a common complaint among menopausal women. The key is seeing your doctor to accurately determine the reason for odor so the most effective treatment can quickly be started, curing infection if present and bringing back normal vaginal odor.

With prompt medical care, any associated irritation, discomfort or discharge from bacterial or yeast infections can also be relieved. Maintaining vigilant follow-up care and healthy prevention habits can help avoid recurrence of this unwelcome symptom.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.