Vaginal discharge and menopause: what you need to know

The female body undergoes several hormonal shifts in the years leading up to menopause, including a decrease in the sex hormone oestrogen. Oestrogen contributes, among other things, to vaginal health. It keeps the vagina moist and clean. It also plays a role in maintaining an optimal vaginal flora (the balance between healthy and so-called pathogenic bacteria), preventing the growth of unwanted bacteria and fungi. 

During perimenopause, progesterone levels drop faster than oestrogen levels. This can lead to an oestrogen dominance, resulting in more vaginal discharge. 

When oestrogen levels drop even further around menopause, it can disrupt vaginal balance. Low oestrogen levels can cause thinning and drying of the vaginal wall, and a decrease in the amount of healthy bacteria and fungi in your vagina. This can disrupt the balance of your vaginal microbiome. Vaginal dryness can cause irritation and your discharge to change in colour, quantity, appearance or smell. 

Something similar happens during your menstrual cycle. Right after your period (when the lining of the uterus builds up again) you usually have a few days with less and clear discharge. Around ovulation discharge increases and is often thin, clear and slippery – kind of like raw egg whites. After ovulation, it’ll get creamy and sticky, and is usually pale yellow, white or cloudy. 

Hormonal changes can also trigger a variety of menopausal symptoms, such as hot flashes, sleep problems and mood swings.

Certain factors can affect how much vaginal discharge you have. Being sexually active or vaginal irritation, for instance, makes your body produce more vaginal discharge. Stress or changes in the lining of the vagina may also increase your vaginal discharge.  

Certain medications, health conditions (such as diabetes) and vaginal care products can also cause changes in discharge. And last but not least, a vaginal infection or an STI can cause abnormal discharge. 

Vaginal discharge can have many different appearances, ranging from watery to sticky and from clear to brown – and all these variations can be normal. It’s also normal for your discharge to change as you go through different life stages. Moreover, what is normal for you may be abnormal for someone else. There is no standard of normal when it comes to vaginas because they're all different.  

Studies suggest that almost two-thirds of menopausal women experience vaginal issues, the most common one being vaginal dryness. However, the opposite can also happen: some women notice an increase in vaginal discharge or more slimy discharge.

About 25 percent of women suffer from heavy or abnormal discharge. After menopause, when oestrogen reaches a permanently low level, these symptoms will likely decrease. 

Changes to your vaginal discharge are a common and normal part of menopause. Here are some tips for taking good care of yourself and your vagina. 

• Supplement your diet with probiotics. Although science is still inconclusive on the matter, research on probiotics seems to show that it stimulates the growth of good bacteria – and this contributes to a healthy vaginal flora. Foods that are high in probiotics include yoghurt, kefir, sauerkraut and kimchi (fermented products). You could consider taking a supplement. 
• Avoid using vaginal hygiene products. Do not use vaginal douches, soaps or other products that claim to maintain genital health. This will only irritate your vagina more. The vagina is self-cleaning, so there’s no need to clean it with soaps, washes, or douches. All you need is a soft washcloth and lukewarm water.  
• Wear cotton underwear. Cotton is soft and absorbs moisture, allowing the skin to 'breathe’ (unlike synthetics, such as nylon and lycra). It can also help to avoid tight clothes. 
• Use vaginal tablets or creams for severe symptoms. There are products available for treating vaginal issues. Discover more below.