Infections in the vaginal area are more common after menopause. When estrogen levels are lower, vaginal pH levels tend to be higher. A higher pH level means that the vagina is less acidic — and less able to keep bacteria under control. Tissues inside the vagina and bladder are more susceptible to infection and inflammation.
Below are some of the most common types of infections, along with treatment options. If you’re getting infections frequently, you may find it helpful to use a vaginal moisturizer, if you’re not already doing so for vaginal dryness and irritation. Vaginal moisturizers are applied directly to the vagina several times per week to hydrate the vaginal tissues and lower pH levels in the vagina. For more information, see Treatments for Vaginal Dryness and Irritation.
Also, with infections, self-diagnosis is never a good idea. If you’re having pain, discomfort, or discharge in the vaginal area, see your doctor and get tested to figure out the exact cause. You and your doctor may need to rule out sexually transmitted infections, such as genital herpes, gonorrhea, and chlamydia. Discharge also can result from vaginal atrophy (thinning and inflammation of the vaginal wall) and medications such as tamoxifen.
Yeast infections affect the folds of the vagina and vulva and can cause discomfort, odor, and a thick white discharge. Yeast infections usually respond well to treatment. Yeast-fighting creams and suppositories, which are applied directly into the vagina, typically need to be used for a few days to a week. Examples include Monistat and Terazol. Another option is a single or double dose of an oral medication called Diflucan (chemical name: fluconazole).
Bacterial vaginosis results from the overgrowth of certain vaginal bacteria, causing a fishy odor and discharge that can be grayish-white or yellow. If the symptoms are bothersome, they can be treated with antibiotics taken by mouth, or as cream or suppositories inserted into the vagina. These have to be prescribed by your doctor. Common choices include Flagyl (chemical name: metronidazole) and Cleocin (chemical name: clindamycin).
Urinary Tract Infection (UTI)
A UTI is the overgrowth of bacteria in the bladder. The bacteria travel there via the urethra, the tube that carries urine from the bladder to the outside of the body. Loss of estrogen leads to shortening of the urethra, which makes it easier for bacteria to get into the bladder. A UTI isn’t a vaginal infection per se, but the changes in vagina’s pH levels can make you more likely to get them. Symptoms include pain or burning while urinating, a constant urge to urinate, odd-smelling urine, and/or blood in the urine or a change in its color.
UTIs are treated with prescription antibiotics taken by mouth. Many different antibiotics can be used, but the most commonly prescribed are Bactrim (chemical name: trimethoprim/sulfamethoxazole); Macrobid, (chemical name: nitrofurantoin); and Cipro (chemical name: ciprofloxacin).