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Is This Embarrassing Odor Normal for Older Women?

Every month in Sex at Our Age, award-winning senior sexpert Joan Price answers your questions about everything from loss of desire to solo sex and partner issues. Nothing is out of bounds! To send your questions directly to Joan, email sexpert@seniorplanet.org.

I’m a 64-year-old woman, and I have two issues. After orgasm, my clitoris is hypersensitive, and I can’t stand to be touched for quite a while. This isn’t a new problem, but it’s worse now that I’m older.

I also have an odor problem: Oral sex and manual clitoral stimulation used to be my favorites, but now feminine odor — which my gynecologist says is normal — has me too embarrassed to even engage at all.

My gynecologist says that the natural changes after menopause cause changes in pH that lead to odor. She reassures me that I don’t have an infection. I haven’t been in a relationship for over a year because I’m so embarrassed about the unpleasant change in my genital odor. Oral sex is no longer an option. And why would anyone put their hands in there? What am I supposed to say? “Don’t touch me there!”

For the odor problem, I’m now trying a vaginal gel called RepHresh that eliminates odor for three days at a time. It’s working so far. Is there anything else you recommend? —Embarrassed

Let’s address the easy question first: It’s common for a woman not to want her clitoris touched right after orgasm. I suggest you let go of expectations that you need to be ready to go again right away and, instead, bask in the afterglow. Many of us need a recovery period before we want more stimulation. When you’re with a partner, cuddling, sweet talk and attending to your partner’s body or your own can keep you connected without direct stimulation to your already happy clitoris. If you’re flying solo, just relax into that lovely sense of well-being.

Your second question is more complex. It’s hard to know from what you’ve told me whether your odor is strongly unpleasant or just unfamiliar — not what you used to know as your scent. Since I don’t know which is the case for you, I’ll cover both possibilities.

A Really Bad Genital Odor

If your genital odor is strongly unpleasant, it can be a sign of a medical problem that your gynecologist missed. Get a second opinion from another doctor who specializes in post-menopausal women. Dr. Owen Montgomery, a nationally certified menopausal practitioner, told me this: “Yes, changes in a woman’s hormones after menopause — mostly diminished estrogen production — affect her vulvar and vaginal environment and can change sensation, lubrication, friction, smell and even the types of normal bacteria present in her vagina. However, there should not be a foul odor as a normal change of menopause.”

Dr. Montgomery says that unpleasant vaginal odor may be due to a number of causes:
1. A bacterial overgrowth called bacterial vaginosis that causes a vaginal discharge and odor
2. New bacteria from a new sexual partner
3. Concentrated urine due to dehydration
4. Urinary tract infections
5. Mild urinary leakage

It’s never a good idea to try and clean your vagina with soap or perfume, or by douching. “This is likely to make the situation worse, as it causes additional irritation and washes away the natural protection of the vagina,” Dr. Montgomery says. He recommends washing the vulva (your external genital area) with gentle soap and water only. If you feel the need to wash internally, use only warm water — no chemicals or soap -— and do this infrequently. Drink plenty of liquids and eat foods with vitamin C to improve the PH balance in your vagina and urine, which will help reduce bacteria counts.

“Most important,” Dr. Montgomery says, “Any woman who feels her symptoms are not being addressed needs to be assertive with her provider about getting better treatment or being referred to a different provider for consultation.”

Just a Different Genital Odor

If the odor is just different, what you’re experiencing is probably normal, natural and nothing to be embarrassed about. Sexual health educator and counselor Ellen Barnard, co-owner of A Woman’s Touch Sexuality Resource Center, explains: “The change in odor is due to the change in pH that happens after menopause, Some women describe it as a change from a ‘sweet’ odor to a more ‘musky’ or ‘sweaty’ one. The way to address it is to restore the vaginal pH through a combination of healthy eating, exercise and internal vaginal massage. This could be the Vaginal Renewal program or some other internal massage that promotes blood flow to the vaginal skin and encourages skin cell turnover.

Although a product like RepHresh gel doesn’t treat the underlying cause, it can be a quick fix, as long as you have no irritation or sensitivity to any of the ingredients, Barnard says.

I was struck by your adamant refusal to let a partner give you oral sex or even touch your genitals because of the odor that you’re concerned about. You can always use a Glyde scented dam — a latex barrier that covers the vulva but lets sensation through — for cunnilingus. It seems unlikely that your partner would notice your odor through manual stimulation unless there really is a medical problem. In fact,
I wonder if you are overestimating what your partner might experience because of your anxiety about the smell. You say you’re not in a relationship now because of this. Get yourself checked out by a second doctor, and if, indeed, there is no medical problem, I hope you’ll try Barnard’s suggestions and open yourself to the pleasures of a future relationship. —Joan

 

joan-priceWould you like to see more questions and answers? See all of Joan’s advice in Sex @ Our Age.

Send Joan your questions by emailing sexpert@seniorplanet.org. All information is confidential.

Joan Price is the author of the new “Ultimate Guide to Sex After 50: How to Maintain – or Regain! – a Spicy, Satisfying Sex Life”;  the award-winning self-help book “Naked at Our Age: Talking Out Loud about Senior Sex”; and the sexy memoir, “Better Than I Ever Expected: Straight Talk about Sex After Sixty.” Visit Joan’s  blog, “Naked at Our Age,” and her Facebook page.

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13 comments
  • FRANK CARMEN, L.r.c.
    REPLY

    I performed oral sex on a young woman, one time, who used boric acid douches.
    It was a horrible experience and I never saw this Woman again!

    Educate your selves. Every woman has her own natural scent– and we men get off on that!!

    Unless a Doctor told you to do it, don’t douche with anything.

  • Marilyn
    REPLY

    I am an 89 year old widow remarried after 59 years. I lack an interest in sex at times, but my husband is still interested. He complains that I used to be more responsive, but now it is very difficult to get me aroused. Is it my age?

  • LT
    REPLY

    Hi, just wanted to share some info that has helped me. Granted, I am only a year into menopause at 56, but during the peri years I had some dryness & irritation & noticed a change in odor, as well. My GYN suggested a product that I continue to use daily. It’s called Luvena Vaginal Moisturizer. It keeps the pH balance right. You don’t use it internally, but daily external application does the trick. It has a lovely light cranberry scent, is non-irritating & doesn’t have any harmful things in it – safe to use daily (or more.)

    The other thing I did was give up soap “down there” & switched to Emerita Feminine Wash. (Again, no synthetic fragrance, etc. – read the labels, ’cause most of the drugstore fem washes were loaded w/chemicals.) In my experience, irritating synthetic fragrances contributed to my odor problem. Even though I’ve been “officially menopausal” for a year, the dryness & odor thing has not come back since I’ve been on the above routine for a few years. Hope this might be of help to someone out there.

  • Joan Price
    REPLY

    Thank you, Ellen Barnard, for adding your savvy advice.

    Elizabeth Haypenny, it troubles me that you found my response “dismissive.” I certainly do feel compassion for Embarrassed, and, within the limited space of this column, I aim to give helpful advice. I consulted an additional expert about your comment — Paul Nyirjesy, MD, Drexel University Professor of Obstetrics and Gynecology, Director of the Drexel Vaginitis Center and a national expert in gynecologic infections. He said this:

    “There’s a whole list of things that could cause vaginal malodor, and in approximately one third of women who seek help for this, no cause is identified. The management of genital odor beyond common vaginal infections remains poorly studied.

    “We use boric acid capsules (not douches) specifically for certain types of yeast infections and as an adjunct to treatment for bacterial vaginosis. Because boric acid douches are more dilute, it’s not clear if they do anything, which is why I don’t know a single expert who uses them. Might boric acid douches be helping the reader through some sort of nonspecific effect? Maybe. We don’t know.

    “However, when the reader says that boric acid restores the normal vaginal pH, she is incorrect. It sounds intuitive that it lowers pH, but websites and literature that state that boric acid works by lowering the pH are wrong. Boric acid is a weak acid, and it equilibrates in the vagina to a pH of 5 or 5.5 (which is higher than the normal pH in premenopausal women of 4-4.5). In fact, when I check pH on women who are using boric acid, the pH is always high, except for in those patients who are non-compliant. In an 84 year old woman who probably has a high pH because she is menopausal, boric acid probably will not affect her pH one way or the other, but I would not expect it to lower it.

    “On the other hand, there is no evidence that boric acid, either in a douche or capsules, causes severe harm (it can cause discharge, irritation, burning). There is essentially no information on long-term safety, so my last sentence should be interpreted with caution. Douching itself can cause pelvic inflammatory disease, although an 84 year old would be at low risk for this.”

    — Joan

    • Ellen Barnard
      REPLY

      I am glad to hear that Luvena works well for you. I think it is important to note that the company has been told by the FDA to discontinue the claims that they make about the product and that there are lawsuits against them because some women get quite irritated by the polypropylene glycol or the PEG-12 in it and because the product has not gone through the irritation testing required by the FDA there is no way to know if these products are safe for most vulvas. The company is currently getting around the FDA regulations by suggesting the product be used externally only but that does not mean they have proven that it won’t cause irritation.

      We recommend always using only water to wash the vulva. Scented products and soaps, antibacterial cleaners and some moisturizing soaps can cause a lot of irritation, as you point out. I am glad the Emerita works for you and I recommend to everyone to go with just a water rinse if at all possible.

      • LT
        REPLY

        I’m so sorry – I got my products mixed up! I’m using Luvena ENHANCED PERSONAL MOISTURIZER. The liquid one in the pump. The Restorative Vaginal Moisturizer in the pre-filled individual applicators is something totally different – & does burn with internal application. I don’t recommend that one! I’d not heard about their lawsuit, but a quick search found the false advertising claims about “preventing infection.” Maybe it works for me because I’m using it for moisture & odor; completely different things.

        Unfortunately, a water wash isn’t enough for me – between regular exercise & the lovely hot flashes, I sweat too much – so the Emerita wash is a lifesaver. If water only does the trick, you are lucky indeed!

  • JD
    REPLY

    It took me years, and a painful divorce, to finally find a the cause and treatment for the horrible “fishy” smell I was plagued with for years. Bacteria vaginosis was the underlying cause of the recurring odor and I was finally able to get it under control with a prescription from a physician who took the time to diagnose me correctly and daily supplements of Acidophilus tablets. Now that I understand my bodies ph levels and how stress can excaserbate symptoms I feel like a person again. I absolutely understand this woman’s feelings, have listened to my “soul mate” tell me he couldn’t handle the smell and how it lingered so badly other people commented. I was ashamed and embarassed believing I had poor hygiene habits! This is treatable and I thank her for bringing this topic forward.

  • Ellen Barnard
    REPLY

    Elizabeth,

    You are correct that it is the change in pH that makes the smell change. Yes, a strategy to reduce the vaginal pH is appropriate; that is what Rephresh does.

    The issue with using a boric acid douche is that there is no perfect recipe and if you use a solution that is concentrated it can cause a burning sensation, especially in women who have very severe atrophic vaginitis that has resulted in tears in the skin.

    Many pre-made douche products on the market have scents in them and other products that disrupt the vaginal environment even more severely. That is why we generally suggest that women not douche; most women will not make their own solution and will instead purchase something at the drugstore. That’s where a challenging situation can get worse. Douching too often can also remove the protective lipids on the surface of the skin and dry that skin out even more. That is not something that a woman with severe dryness wants to do.

    Am I going to say that YOU should never douche with boric acid? No. But if someone wants to try this then I suggest being very careful about the concentration, not doing it more than 2 times per week, and discontinuing the practice if there is any pain, burning or irritation. I would prefer that you insert a small amount of a pH balanced (pH of 4.5-5/2) moisturizing lubricant and that you practice internal vaginal massage on a regular basis to encourage blood flow to the vaginal skin that will push the vaginal pH down to pre-menopausal levels.

    I am happy you have found something that works for you. I am reluctant to recommend it to a wider audience because it does take some skill to use it and not create more problems. Good for you for finding the balance that works best for you. Since everyone is very different in how their body chemistry works I encourage every woman to explore a variety of options that make sense and to be careful to not cause irritation that could start a chain of vulvar or vaginal reactions that end up being worse than the original problem.

  • Elizabeth Haypenny
    REPLY

    Joan Price is almost always right on, but this time I feel she is not really listening to the reader. I have this problem myself; it didn’t appear until my 84th year, and believe me, I know that there is no identifiable infection and the stink is HORRID. No latex barrier is going to remove that odor – and the very idea of a barrier between the flesh and the tongue is abhorrent anyway – for the male a major pleasure is both the taste and the smell of vaginal fluids (attested to by many, including my own lovers in the past). A modicum of googling reveals that the horrid odor is a common problem for old women and it is extremely inhibiting, and so far I haven’t found anyone who seems to know precisely what causes it. It seems likely to me that some microorganisms are involved that the aged vagina is susceptible to.

    Also, I don’t understand the widespread view that douching is a no-no. A boric acid douche restores normal vaginal pH and cures common infections like vaginosis. It also takes care of that nasty odor we’re talking about for several days. The odor comes back but in the meantime you’re free, and I suspect that the aged vagina loses its ability to maintain a normal pH, which then allows the odor-causing microorganisms to thrive, and the boric acid takes care of that until the vagina loses it pH again. So until I can find a better solution, I’ll use boric acid. I have never had any reason to suspect it does any harm, regardless of wrong-headed medical dogma that dies hard.

    Joan, your column is usually a treasure of understanding, compassion, sanity, good sense, and solid information, the best there is. But in this case you went off the tracks and I think you were dismissive of your reader’s concerns and didn’t really do enough researching.

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