Menopause & Discharge: What’s Normal?

Vaginal discharge is normal with most women experiencing it at some point, although it can vary from person to person. It’s a naturally produced fluid or mucus that keeps the vagina moist and clean and protects it from infection (1). However, during menopause, the hormonal fluctuations that occur may mean you notice a difference in the type or amount of discharge you get.

Such changes can be concerning, especially when you are contending with other menopause symptoms. Vaginal discharge is usually nothing to worry about but understanding what menopausal discharge looks like and signs of abnormal discharge can help make sure you get the right medical support and treatment when you need it.

Why can discharge change during menopause?

During menopause, changes in vaginal discharge are primarily linked to hormonal shifts, particularly the decline in oestrogen levels.

Vaginal lubrication

Oestrogen helps maintain the vaginal lining's thickness and lubrication. As levels drop, the lining becomes thinner and less elastic, reducing natural lubrication. This can make discharge less frequent or more sparse.

Vaginal pH

Oestrogen supports the production of glycogen in the vaginal tissues, which promotes the growth of healthy lactobacilli. A reduction in these bacteria can increase vaginal pH, creating an environment where other microorganisms might thrive, potentially leading to unusual discharge (2, 3).

Vaginal atrophy

With less oestrogen, the lining of the vagina can become thinner, drier and less stretchy. This can be uncomfortable and lead to inflammation, swelling and even small cuts near the vaginal opening. This irritation can sometimes cause changes to vaginal discharge (4).

What does healthy discharge during menopause look like?

Healthy discharge during menopause appears much the same as normal discharge at any other point in your life. It is typically:

Clear, cream or white
Thick and sticky
Slippery and wet
Odourless or without an unpleasant or strong smell (1)

Therefore, if you have what can be described as clear jelly or egg white discharge during menopause, it is likely to be normal, healthy discharge. It shouldn’t cause any irritation and usually consists of 1 to 5ml being secreted per 24 hours (2). You may have so little that you don’t even notice it or produce enough that you wish to wear a pantyliner on some days.

Signs of abnormal vaginal discharge during menopause

Vaginal changes during menopause, including alterations to discharge can be normal, but certain types of discharge may indicate an underlying issue.

Pink or brown discharge after menopause

The discharge may be light pink, rusty, or brown and can be watery or sticky in texture and is usually an indication that there is blood mixed in with it.

You can get this type of discharge on its own but may also experience pelvic discomfort or spotting outside of your period if you’re in perimenopause. If it’s been 12 months or more since your last menstrual period, you shouldn’t be seeing blood in your discharge.

This discharge could signal thinning of the vaginal walls (vaginal atrophy), small tears from irritation, or issues such as polyps or endometrial hyperplasia. Rarely, it could be an early sign of cervical or uterine cancer (5).

Green or yellow discharge after menopause

Green or yellow discharge can be a sign of infection. It may be thick, frothy, or foul-smelling, and appear bright yellow or green. It can also be accompanied by itching, redness, burning during urination, or pain during intercourse.

It can be a symptom of:

Vaginal atrophy
Trichomoniasis
Gonorrhoea
Chlamydia
Bacterial vaginosis
Pelvic inflammatory disease
A foreign object in the vagina (such as a ring pessary or forgotten tampon)
Inflammatory vaginitis (1, 5, 6)

Grey discharge after menopause

Grey discharge is often associated with bacterial imbalance. Bacterial vaginosis (BV) is the most common cause of grey discharge (7). BV occurs when healthy vaginal bacteria are overtaken by different bacteria.

Thick white discharge after menopause

Creamy, clumpy and thick discharge which resembles cottage cheese is often a sign of a yeast infection, also known as thrush (1). This occurs when too much yeast grows in the vagina, leading to inflammation. Thrush commonly also causes itchiness and irritation around the vulva and vagina, and soreness when urinatig (8)8.

With pelvic pain and/or bleeding

Discharge combined with pelvic pain or bleeding during menopause should always be checked as this could suggest sexually transmitted infections (STIs) such as chlamydia or gonorrhoea (1), conditions like pelvic inflammatory disease (PID) (9),, uterine fibroids, or endometrial abnormalities. In postmenopausal women, although rare, these symptoms may also point to more serious issues such as ovarian or uterine cancer.

With blisters or sores

Discharge may be clear, yellow, or tinged with blood, and often accompanied by visible sores or blisters on the vulva or near the vaginal opening. This could be a sign of genital herpes (1) or another STI, which requires prompt medical attention.

With an unpleasant odour

Foul-smelling discharge is usually a sign of infection or imbalance. If it smells fishy, it could be an indication of bacterial vaginosis (1), especially if it is greyish-white, thin and watery (10). If the discharge is yellow-green and has a fishy smell, this could be indicative of trichomoniasis (11).

Can HRT cause discharge in menopause?

If taking hormone replacement therapy (HRT) to treat other symptoms of menopause, you may experience changes to vaginal discharge as a side effect. Adding back oestrogen as HRT often leads to a return in normal physiological discharge which may be white or yellow. The adjustment in the vaginal microbiome when starting HRT or when adjusting doses may also transiently trigger an episode of thrush or BV, but in the longer term this should settle (12, 13).

Should you experience the onset of vaginal discharge or changes to vaginal discharge after you begin HRT, you can always discuss this with your doctor to rule out any possible causes.

Is vaginal discharge after menopause common?

It’s normal to have some discharge, even after menopause. In general, however, the lower your levels of oestrogen, the less discharge you’ll have. That’s why many women find that they have little or no discharge once postmenopausal.

How to manage discharge during menopause

While some changes in vaginal discharge are normal during menopause, there are several simple steps you can take to reduce discomfort:

Maintain good hygiene: Use warm water only to clean the external genital area and pat dry gently after bathing.
Stay hydrated: Drinking plenty of water supports overall health and vaginal hydration.
Use vaginal moisturisers or lubricants: These can help combat dryness and irritation.
Choose breathable underwear: Opt for cotton fabrics to reduce moisture and change them when wet.
Use an unperfumed panty liner: To help draw moisture away from the skin.
Sleep without underwear: To reduce skin irritation and improve ventilation, which helps keep the area dry.
Avoid irritants: Steer clear of douches, scented products, or harsh soaps (5).

When to seek help about discharge during menopause

If you’re concerned about your vaginal discharge, it’s always best to seek professional advice, even if only for peace of mind. However, signs that you might have an underlying issue which requires treatment include:

Discharge that is any colour aside from clear, cream or white
Any amount of bleeding within or in addition to discharge
Thick, lumpy discharge
Unpleasant odour
Excessive, persistent discharge
Discharge accompanied by burning, itching, irritation, inflammation or redness
Painful urination or intercourse
A genital rash or sores

At Menopause Care, we have a team of menopause specialists who are experienced in supporting women through the many changes that occur during menopause.

If you want to speak to someone about discharge or any other genitourinary symptoms during menopause, book a consultation with a menopause doctor.

DisclaimerAt Menopause Care, we ensure that everything you read in our blog is medically reviewed and approved. However, the information provided is not meant to replace professional medical advice, diagnosis, or treatment. It should not be relied upon for specific medical advice.

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