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Health

Is Perimenopause Making You ... Smelly?

When you have that stinking feeling.

People sometimes describe perimenopause, the period in which your body’s estrogen production gradually slows to a standstill, as “puberty in reverse.” Indeed, many of the symptoms — mood swings, acne breakouts, hairs popping up in weird places — can make you feel like you’re reliving your middle school years. And there’s one more delightful puberty symptom that can come roaring back in your 40s: intense BO.

That’s right, perimenopause could be making you smellier.

In large part, the odor is thanks to all the extra sweating you’re probably doing. “During perimenopause, your internal temperature control starts going kerflooey,” says Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology at Yale School of Medicine and the founder of madameovary.com, an informational website about menopause and other reproductive topics. “It’s not just the hot flashes. Perimenopausal women tend to sweat more in general.”

Then there’s what’s happening below-the-belt. Estrogen is what keeps your skin moist and plump. When the hormone starts drying up, so does your skin — and we’re not just talking about crepey folds near your eyes or sandpaper hands.

“While hot flashes tend to ease up over time, vaginal dryness gets worse,” says Minkin. “At the same time, the cells that line the vagina lose glycogen, which is basically what feeds the good bacteria you need for a healthy vaginal pH.”

As your vaginal pH rises, you can end up with an overgrowth of nasty bacteria, leaving the door open for infections like bacterial vaginosis — infections that often come with a telltale odor. If you’re also experiencing bladder leakage (ever have a little bit of pee that comes out when you sneeze?), that only compounds the problem.

Still, that doesn’t mean it’s time to start stockpiling Febreze and Chanel No. 5. If you feel you’ve become a bit more, er, pungent recently, there are things you can do to help clear the air.

As a first line of defense, Minkin suggests switching to a stronger antiperspirant and browsing the drugstore aisle for topical vaginal moisturizers (like Replens or Syren) and pH balancers (like RepHresh or Summer’s Eve). Still, she notes that over-the-counter treatments don’t always do the trick. Need something stronger to ban BO? Talk to your doctor about a prescription remedy.

“There are vaginal estrogens in many forms — suppositories, creams, rings — that can help ease symptoms related to vaginal dryness, including odor, itching or painful sex,” says Minkin.

If your doctor says you’re not a good candidate for hormone replacement therapy, there are two other prescription products that could help keep things moist and fight the funk. A suppository called Intrarosa (prasterone) delivers a synthetic form of a different hormone called DHEA, which then gets converted into estrogen and testosterone by cells in your vaginal lining. Or your doctor might recommend an oral medication called Osphena (ospemifene), which acts like estrogen in certain parts of the body, including the vagina, where it can restore moisture and rebalance your pH.

The good news: all the night sweats, hot flashes and increased body odor will generally simmer down over time. In the stinky meantime, there's always a relaxing bath and Chanel No. 5, right?

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