Vaginal thrush during menopause

• A vaginal yeast infection is unpleasant but a common occurrence during menopause.
• When sex hormones fluctuate, the healthy balance of bacteria in the vaginal flora can be disrupted, increasing the risk of infection.
• Other factors can also contribute to a yeast infection, such as stress, poor sleep, antibiotic use, and smoking.
• Infections can be particularly challenging during menopause, especially if they are recurrent.
• There are various ways to prevent and treat a yeast infection. Focus on a fibre-rich diet, probiotics, and supporting your immune system. Wash your vagina only with a washcloth and water.

The vagina is a tubular part of the female reproductive system that extends from the vulva (the external part of the vagina) to the cervix. In vaginal thrush, the healthy balance of bacteria and fungi in the vagina is disrupted. Seventy-five per cent of women will experience vaginal thrush at some point in their lives.

One of the causes is menopause. Sex hormones stimulate the growth of good bacteria in your vagina, such as lactobacilli. These bacteria help protect you from infections. They maintain a normal vaginal pH level, which can also help prevent vaginal dryness. This pH level ensures there are enough good bacteria.

However, when oestrogen and progesterone levels fluctuate and decrease, other (less beneficial) bacteria and yeasts have the opportunity to grow. Lower oestrogen levels also result in a lower pH level, making it harder for good bacteria to survive. This promotes the growth of fungi and yeasts in the vagina, including candida, the fungus responsible for most cases of vaginal thrush. The result? The healthy balance of bacteria is disrupted, and the risk of vaginal thrush increases.

One reassurance: after menopause (one year after your last menstrual period), vaginal thrush generally becomes less common.

Other menopausal symptoms can also trigger a yeast infection. Additionally, it has been shown that hormone replacement therapy(vaginal oestrogen) increases the risk of a yeast infection, as does certain medication. Discuss with your doctor whether the medication you are using might disrupt a healthy vaginal flora.

Factors that further increase the risk of a yeast infection:

• Smoking
• Stress
• A weakened immune system
• Fatigue (which weakens your immune system)
• Antibiotic use (e.g., for a urinary tract infection; conversely, a yeast infection can increase the risk of a urinary tract infection)
• Type 2 diabetes (spikes in blood sugar levels feed the ‘bad’ yeasts in the vagina)

Typical symptoms of a vaginal yeast infection include:

• Itching and/or a burning sensation
• White, sometimes clumpy discharge
• Red, swollen vagina
• Pain during urination or intercourse

The symptoms of a yeast infection can resemble those of vaginal dryness. Consult your doctor to determine the cause of your symptoms and find the right solution.

There are various ways to effectively address menopausal symptoms. You don’t have to suffer in silence. You can support your body naturally with healthy nutrition, sufficient exercise, and rest. Additionally, supplements, medications, and hormone replacement therapy (HRT) can help. Below are the different options for preventing and treating vaginal thrush.

During menopause, hormonal changes can affect your energy levels, sleep, digestion, and metabolism. Healthy nutrition, regular exercise, and rest can help prevent or alleviate symptoms. Small adjustments can already make a difference in how you feel.

If you use medications or supplements, a healthy lifestyle supports the absorption of nutrients and the processing of medications, making supplements and medications more effective.

• Take care of your gut. A healthy vaginal flora is closely linked to a healthy gut flora. Research shows that the growth of candida in the vagina is connected to the growth of candida in the gut. Support your gut flora by eating enough fibre, vitamins, and minerals, which you can get from vegetables, fruits, whole grains, beans, nuts, and seeds.
• Drink plenty of water. Water helps your body absorb nutrients and seems to support a greater diversity of bacteria in the gut.
• Take (extra) probiotics. A lot of research has been done on the effects of probiotics. While there is still much to learn, probiotics appear to contribute to good gut health. They also stimulate the growth of good bacteria. Probiotics can be found in yoghurt, kefir, sauerkraut, kimchi, and kombucha (fermented products). You can also consider a supplement.
• Wear cotton underwear. Breathable underwear helps reduce moisture and warmth in the vaginal area, which can prevent the growth of fungi and bacteria.
• Avoid irritants. Perfumed products and (harsh) soaps irritate the vagina and can disrupt the vaginal flora. Avoid cleansing products. Wash your vagina only with a soft washcloth and lukewarm water. That’s all you need, as the inside of the vagina cleans itself.

Supplementing the hormones that decline during menopause is the most effective treatment for various menopausal symptoms. Hormone replacement therapy (HRT) directly addresses vasomotor symptoms, such as hot flushes and night sweats. For troublesome symptoms during menopause, hormone replacement therapy (HRT/HT) is the most effective treatment. It may also indirectly assist with thinning hair.  
HRT is not the right choice for everyone. A doctor will always carefully evaluate whether this treatment is appropriate for your health and symptoms.  

Many people are unaware that, in addition to hormone replacement therapy (HRT), there are also proven effective hormone-free medications to ease menopausal symptoms. While hormone replacement therapy can alleviate multiple symptoms simultaneously, hormone-free medication often targets a specific symptom. For instance, certain antidepressants (SNRIs) for hot flushes, anti-inflammatory drugs for joint pain, or antacids for heartburn.  
Hormone-free medication is always prescribed by a doctor and can be a suitable option for those who do not wish to or cannot use hormone replacement therapy. It works directly on the symptom without impacting your hormonal balance. This allows you to address symptoms in a targeted manner and support your body.  

During menopause, changes occur in how your body produces energy, builds muscle, and repairs skin. You can support these processes naturally with high-quality supplements. Supplements promote overall health and can help reduce menopausal symptoms. Magnesium, vitamin D, and omega-3 are recommended for every woman going through menopause.

The effectiveness of supplements depends on your lifestyle and health. It can also vary from person to person. Additionally, the quality of the product determines how well it works. Choose high-quality supplements without unnecessary fillers.