Perimenopause usually begins during your 30s or 40s. Your estrogen levels are in flux during this time, which may cause your menstrual cycle to differ from one month to the next.
As your body navigates longer, shorter, or even skipped periods, changes to vaginal discharge may follow. You may also experience vaginal dryness as perimenopause advances and estrogen levels continue to drop.
Before perimenopause, your discharge may be:
- mild, but not foul, in odor
During perimenopause, your discharge may take on a brownish tint. It may also be thin and watery or thick and clumpy. These changes usually aren’t cause for concern.
During your reproductive years, your estrogen and progesterone levels rise and fall at regular times during your menstrual cycle. These hormones help control the amount of discharge your vagina produces.
In perimenopause, your estrogen levels become more erratic. Estrogen will rise and fall at random as your body begins its transition into menopause.
Eventually, your estrogen levels will settle into a steady decline. This decrease in estrogen has a direct impact on vaginal discharge production. The closer you get to menopause, the less discharge your body will produce.
Desquamative inflammatory vaginitis (DIV)
Although DIV is uncommon overall, it’s more common in women who are perimenopausal. It’s often associated with changes in vaginal discharge.
See your doctor or other healthcare provider if your discharge is:
- unusually sticky
Dried discharge can also cause your vaginal area to become red, itchy, or swollen.
See your doctor or another healthcare provider if you experience:
- yellow, green, or gray discharge
- foamy or frothy discharge
- bloody discharge
- foul odor
- severe itchiness
- burning or tenderness
- pelvic or abdominal pain
- pain during sex or urination
To help them confirm a diagnosis, your doctor or healthcare provider will ask you questions about your health history. Be prepared to provide information about:
- the date of your last period
- whether you have any new sexual partners
- any medications you may be using
- whether you’re experiencing pain in your pelvis, back, or abdomen
- whether you’ve used anything in the vaginal area, such as menstrual products like tampons or pads, douches, or lubricants
After discussing your symptoms, your provider will perform a pelvic exam.
During the exam, they’ll check your vulva for unusual redness, swelling, or other symptoms. They’ll insert a speculum into your vagina so they can inspect inside the vagina and cervix.
Your provider may take a small sample of discharge to send to a lab for testing. The lab technician will likely check the pH level. A high pH level means your discharge is more basic. It’s easier for bacteria to grow in a more basic environment. This is a pH level above 4.5.
They may also view the sample under a microscope to look for yeast, bacteria, and other infectious substances. An infection can change the texture, amount, or smell of your discharge.
The results of these tests will help your healthcare provider determine whether treatment is necessary, and if so, which treatment is best.
Fluctuations usually result from changing estrogen levels and don’t require treatment.
If your doctor diagnoses DIV, they may recommend topical clindamycin or hydrocortisone to symptoms.
If your symptoms are the result of a fungal or bacterial infection, your doctor will recommend an over-the-counter or prescription topical to soothe irritation and clear the infection.
Treatment options are also available for symptoms that result from a sexually transmitted infection or other cause unrelated to perimenopause.
To manage discharge
- Use warm water and non-soap cleansers to wash your vaginal area.
- Wear cotton underwear instead of synthetic fabrics.
- Avoid overly hot baths and scented bath products.
- Avoid douching.
Unless you’re experiencing other unusual symptoms, these changes usually aren’t cause for concern.
If you have questions about vaginal discharge during perimenopause or after menopause, speak with your doctor or other healthcare provider.