If you’re wondering, “Why does my vagina smell like onions?” you’re not alone. You could be experiencing changes in your body in the transition to menopause. These changes can impact the chemistry of your vagina, which can result in some unexpected vaginal odor. Some mild vaginal odor is healthy and normal. That said, a strong smell or odor coming from your vagina might indicate an infection, or may simply be due to a change in what we call the vaginal biome: the unique mix of friendly bacteria and other organisms that colonize our bodies.
In our fertile years, estrogen levels are higher, meaning that the body stores sugar in the cells of the vaginal tissues. When the cells naturally turn over, the dead cells provide the perfect food for the friendly bacteria known as lactobacillus. Though it can feel strange to consider that we work in perfect harmony with the bacteria that live on and in us, the lactobacilli are our vagina’s best friend. They produce a chemical called lactic acid which helps keep the vaginal environment at a healthy, slightly acidic pH. This is the main way our bodies fight infection and overgrowth of other, less friendly bacteria.
Going into the menopause transition means that our vaginal cells change and we no longer provide so much food for the lactobacilli: that means that the make up of our biome changes. And with it - so can our vaginal odor.
There are, of course, lots of causes of different vaginal odors, and not all of them are healthy. There are also lots of options for women who feel that the change they notice is not welcome.
Apart from these hormonal changes, a few common other causes of vaginal odor include:
- Sexually transmitted infections (STIs, formerly known as STDs)
- Reactions to foods and/or beverages
So, how do you know why does your vagina smell like onions? Its definitely a good idea, if you notice a change, always to visit your doctor. They can check your hormones and take swabs to check whats going on. You might get offered antibiotics or treatments like menopausal hormone therapy (MHT or HRT) to rebalance your hormones. Often, using a vaginal estrogen cream will help the vaginal cells to go back to storing sugars and help feed the healthy bacteria that help us to smell a bit sweeter. Vaginal estrogen cream can also help prevent a lot of the other changes, like thinning, dryness and itch, that women notice as they go through the menopause transition.
But hormone treatments are not what every woman wants, or can have. Luckily, there are some steps you can take at home to treat some of the causes of vaginal odor yourself. Let’s take a closer look at some of the common causes of vaginal odor around menopause and perimenopause.
Why Does My Vagina Smell Like Onions? STIs that Cause Vaginal Odor
Why is it so important to see your doctor? A strong, abnormal smell could indicate that you’ve contracted an STI. And, while most STIs can be easily treated with antibiotics or other medications, left untreated, they can wreak havoc on your health. Some STIs can cause cancer of the cervix and other potentially life-threatening conditions. Don’t risk your health - get medical attention if you have any reason to believe you have an STI. This is especially important at perimenopause when the changes in the vagina leave us less resistant to infection. Also, a lot of women link condom use with avoiding pregnancy, and may think that using barrier protection with a new partner is less important after menopause: this is definitely not a good idea. In some parts of the world, the group with the fastest rising rates of STIs is the over 55’s!
So, which STIs are most commonly associated with vaginal odors?
Bacterial vaginosis (BV) is an infection that causes an overgrowth of vaginal bacteria, resulting in an unpleasant smell from the vulva and vagina.
Trichomoniasis is an STI caused by a parasite. Along with a strong odor, other trichomoniasis symptoms include painful urination, vaginal discharge, and itching.
- Chlamydia and gonorrhea can occasionally present with a foul vaginal odor.
If you suspect that you may have an STI, make an appointment with your doctor ASAP. But, of course, STIs aren’t the only causes of odor around the vulval area. Let’s discuss a few other common causes — and what you can do to treat them.
Why Does My Vagina Smell Like Onions? Food and Vaginal Odor
As we already said, your vagina has a very specific pH balance. We know that hormone change can affect this, but it is thought that some of the foods you eat can throw that balance off, too. Some of the most common foods that cause vaginal odor for women in the transition to menopause include:
- Fried foods
If you’re experiencing strong vaginal odor and you consume a lot of one or more of the items on this list, you may want to try a brief elimination diet. Try cutting out the food(s) that you think may be causing vagina odor, and then add them each back in individually to test the difference in smell. After your experiment, you don’t have to completely eliminate the culprit(s) from your diet entirely. Just cut back on them and make sure you stay well hydrated: doing this is another good way to balance your gut flora and vaginal flora, flushing away bad bacteria, and keeping your body functioning properly.
Other Common Causes of Vaginal Odor in Perimenopausal Women
Of course, diet and STIs aren’t the only causes of vaginal odor, especially for women in the transition to menopause. A few other common causes for your vagina smelling like onions might include:
- Forgotten tampon
- Douching or over-washing
- Yeast infection
- Hormonal changes
When you’re under stress, your body’s apocrine glands can often become overactive. These glands are located in your armpits and groin area, which is why you may have worse underarm sweating when you feel stressed or nervous. This reaction can cause excess moisture in your groin, creating a pungent vaginal smell. Treat stress-related vaginal odor with meditation, sleep, exercise, and anything else that helps you relax and de-stress. If extra sweating seems part of your perimenopausal hot flushes, consider MHT or non-hormonal therapies to help calm the vasomotor symptoms down.
A forgotten tampon left over from your last menstrual cycle can cause a decaying, foul odor from your vagina. This is a more common cause for women who’ve had irregular or infrequent periods due to perimenopause and the transition to menopause. Forgotten tampons can cause a number of other issues, aside from vaginal smells, such as toxic shock syndrome and issues with the health of your cervix.
For years, women were told that they had to clean their vaginas out after sex or to avoid vaginal odors. But douching is actually not a great way to reduce smells from the vulva and vagina. It upsets your vaginal biome and can actually cause the odors it’s supposed to remove. This is also true of over-washing, or using harsh fragranced, or non-pH balanced products to wash that smell away. You can get stuck in a cycle with stripping the protective, friendly bacteria away. Make sure to use gentle, neutral fragrance free emollients to really look after this delicate part of you.
Finally, speaking of your vaginal biome, yeast infections can occasionally cause your vagina to smell like onions. This is rare, though, and is almost always accompanied by discharge and itching or burning. Remember to get this treated if it occurs: yeast infections can just add to the itch and discomfort felt by many women at this stage.
Treating Vaginal Odor Around Perimenopause
It’s not uncommon for perimenopause to cause vaginal odor. This is often due to hormone changes as we mentioned, or it could be due to other factors, like vaginal dryness and itching related to perimenopause. If you’re perimenopausal and you’re experiencing vaginal odor — especially if your vagina smells like onions — there are treatments available.
Before you do anything else, make an appointment with your doctor to discuss perimenopause and vaginal odor. The solution may be to balance your hormones medically, and allow your body to correct your vaginal pH. If not, you may also find that changing your diet, increasing your sleep, or taking other healthy steps we mentioned earlier could improve the smell of your vagina.