Menopause discharge: what's normal, what changes, and when to see a GP

Maybe there's more of it than there used to be, or less. Maybe it's thinner and more watery, a slightly different colour, or there's a smell you haven't noticed before. It's not something people talk about much, so it's easy to worry.

Changes in menopause discharge are common. Women's Health Concern, the patient arm of the British Menopause Society, says many women find their discharge becomes more watery, discoloured and slightly smelly after the menopause. It says this is usually down to hormone changes, not something more serious.

But some changes do need checking, especially anything with blood in it. This page explains what's normal, what else it could be, and when to see your GP.

What is normal vaginal discharge?

Discharge is normal at any age. The NHS says it's a fluid or mucus that keeps the vagina clean and moist, and helps protect it from infection.

Normal discharge:

• doesn't have a strong or unpleasant smell
• is clear or white
• can be thick and sticky, or slippery and wet

The amount varies from person to person and over time. Women's Health Concern says it's normal for most women to notice a slight white discharge. The moisture is slightly acidic, which helps keep the area healthy and protects against infections such as thrush.

Perimenopause discharge: what can change?

We couldn't find good UK guidance on discharge in perimenopause specifically, so we'll keep this short and honest.

The NHS says discharge changes through your monthly cycle. It's often clearer and wetter around the middle of your cycle, when you release an egg. In perimenopause, your periods and cycles change (see perimenopause period changes). So the pattern of your discharge may feel less predictable too.

Women's Health Concern says perimenopause is when menopause symptoms tend to begin. That can include the vaginal changes described below.

Perimenopause doesn't protect you from infections either. Thrush, bacterial vaginosis and sexually transmitted infections can all still change your discharge.

Vaginal discharge after menopause

After menopause, the ovaries make very little oestrogen. Women's Health Concern explains that without it, the skin of the vulva and vagina becomes thinner and less stretchy, and the vagina can become dry.

This can change your discharge. Women's Health Concern says it may become:

• more watery
• a different colour
• slightly smelly

You may also feel irritation or burning. Some women have less moisture overall and feel dry and sore. Doctors call these changes genitourinary syndrome of menopause (GSM), and we cover them on our vaginal dryness page.

These symptoms can feel like thrush or a sexually transmitted infection. Women's Health Concern warns that buying thrush treatment when it isn't thrush can make things much worse. So if you're not sure, get it checked.

Menopause discharge colours: what might they mean?

This table is a rough guide only. The NHS advises not to diagnose yourself, and to get advice if you're worried.

What you notice	Possible cause
Thin, watery or slightly smelly, after menopause, maybe with dryness	Hormone changes (GSM)
A strong fishy smell, especially after sex. May be thin and greyish-white	Bacterial vaginosis (BV)
Thick and white, like cottage cheese, usually no smell, with itching	Thrush
Green, yellow or frothy, may smell fishy	Trichomoniasis, a sexually transmitted infection
With pain in your pelvis or bleeding	Chlamydia or gonorrhoea
With blisters or sores	Genital herpes
Pink, brown or blood-stained, after menopause	Bleeding that needs a GP check

Sources: the NHS pages on vaginal discharge, bacterial vaginosis, thrush, trichomoniasis and bleeding after menopause, and Women's Health Concern.

Vaginal odour during menopause

A slight change in smell can be part of the hormone changes above. But a strong smell is worth looking into. Normal discharge doesn't have a strong or unpleasant smell.

Bacterial vaginosis (BV) is a common cause of a fishy vaginal odour (odor). The NHS says BV is caused by a change in the natural balance of bacteria in the vagina. The smell is often stronger after sex. BV doesn't usually cause itching or soreness, and about half of people with it have no symptoms at all.

It isn't a sexually transmitted infection, but sex can trigger it. Using perfumed products in or around the vagina makes it more likely. It's treated with antibiotics from a GP or sexual health clinic. The NHS says BV often comes back within a few months, and your GP can help if it keeps happening.

Trichomoniasis can also cause a fishy smell. The NHS says many people with it get no symptoms at all. Others notice yellow-green, frothy discharge, itching or soreness, or pain when peeing.

It can be tempting to wash more, or use an intimate wash or spray. Please don't. The NHS advises avoiding perfumed soaps, intimate washes, vaginal deodorants and douching, and says perfumed products make BV more likely.

Thrush after menopause

Thrush is a yeast infection. The NHS says it causes white discharge, often like cottage cheese, that usually doesn't smell. It also causes itching and soreness. The NHS lists HRT, antibiotics and poorly controlled diabetes among the things that make it more likely.

You can buy thrush treatment from a pharmacy if you've had thrush diagnosed before and recognise the signs. But the NHS says to see a GP if:

• it's your first time with thrush symptoms
• you're over 60
• you get thrush more than 4 times in 12 months
• treatment hasn't worked

There's more on this, and on other causes of itching, on our page about menopause vaginal itching.

Can you still get an STI after menopause?

Yes. Age doesn't protect you. Trichomoniasis, for example, is spread through sex without a condom, and you can have it without knowing. The NHS suggests testing for it when you have a new partner, or once a year.

Sexual health clinics treat problems with the genitals and bladder, not just infections. The NHS says many offer walk-in appointments and often get test results back faster than GP surgeries.

What can help with menopause discharge

Things you can do yourself

These come from the NHS pages on vaginal discharge, bacterial vaginosis and thrush.

• Wash gently. Use warm water, or a mild, unperfumed soap, on the skin around the vagina.
• Don't wash inside the vagina (douching). It cleans itself.
• Skip perfumed products. That means scented soaps, gels, intimate deodorants and scented wipes.
• Have a shower rather than a bath if you're prone to BV.
• Use a gentle detergent for your underwear.
• Wear cotton underwear, and avoid very tight underwear or tights.

Treatments to talk to your GP or pharmacist about

Treatment depends on the cause, which is why getting checked matters.

• For infections: antibiotics for BV or trichomoniasis, or antifungal treatment for thrush.
• For hormone changes: vaginal oestrogen is a low-dose treatment that goes inside the vagina. Women's Health Concern says it can help put the vagina's natural acid balance and bacteria back on track. Because it works locally, it says the risks are minimal. Our vaginal dryness page explains more.

When to see a GP about discharge

The NHS says to get advice from a GP, a sexual health clinic or NHS 111 if:

• your discharge changes colour, smell or texture
• you have more discharge than usual
• you feel itchy or sore
• you bleed between periods or after sex
• it hurts when you pee (see urine infections in menopause)
• you have pain in your pelvis

And always see your GP about any blood after menopause, even pink or brown staining. The NHS says bleeding after menopause is not usually serious, but it can be a sign of cancer, so it should be checked. Your GP should refer you, and you should not wait more than 2 weeks to see a specialist.

A change in discharge is also on the NHS list of womb cancer symptoms. The NHS says these symptoms are common and usually have other causes. But it's worth getting them checked, because finding cancer early makes it easier to treat.

If sex has become uncomfortable as well, see our page on painful sex after menopause.

Related

Changes in discharge often come with vaginal dryness in menopause and menopause vaginal itching. You can see them all in our list of perimenopause symptoms.

This page is general information, not medical advice. If you're worried about any symptom, please talk to your GP or pharmacist.

See all perimenopause symptoms