How Menopause Can Lead to Recurring Vaginal Yeast Infections

Medically Reviewed by Dany Paul Baby, MD on April 25, 2023
4 min read

When you go through menopause, your menstrual periods stop and your ovaries stop making hormones, including estrogen. This leads to changes in the female reproductive system. For some women, these changes can cause recurring yeast infections -- even though they’re rare after menopause.

Women who have recurrent yeast infections typically have intense vaginal discomfort. They may also have odorless discharge, vaginal itching, painful sex, and pain when peeing. Other symptoms are redness, swelling, and rash.

During and after menopause, the vagina changes due to a drop in hormone levels.

When hormone levels drop during and after menopause, nearly half of women have vaginal atrophy. The vagina’s lining becomes thinner and less stretchy, becomes drier, and is more likely to tear during sex.

Vaginal atrophy can result in itching, burning, pain during sex, and other symptoms like having to pee more often, being unable to control when you pee, and getting urinary tract infections (UTIs). Women who’ve had their ovaries removed or are taking certain breast cancer medication also may experience these symptoms.

These symptoms are similar to those of yeast infections, so you should talk with your doctor to find the cause.

The hormones estrogen and progesterone promote the growth of healthy organisms in the vagina, which lowers the risk of vaginal infections. These beneficial organisms actually protect against infection. When hormone levels decrease during menopause, it’s easier for harmful organisms, like certain bacteria and yeasts -- to multiply inside the vagina.

Women with bacterial and yeast infections tend to have lower amounts of “good” vaginal bacteria, like lactobacilli, compared with healthy women. This shift may cause bacterial infections.

Lower estrogen levels in menopausal women also result in higher pH levels in the vagina. But the risk of getting a yeast infection seems to decline over time after menopause for most women.

But other aspects of menopause may raise your risk. For example, taking hormone replacement therapy (HRT) can increase your risk of getting a yeast infection.

As you go through menopause, you may notice that your vaginal tissue dries out. Not only can this affect libido and make sex painful, but it also makes any type of infection more likely, including yeast infections. 

“The superficial cells that line your vagina lose glycogen,” says Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University School of Medicine. “The good bacteria in your vagina, known as lactobacilli, feast on glycogen, so if they don’t have enough to eat, they’ll decline.” The result? You'll have a more acidic environment in your vagina that also kills off good bacteria. As a result, it’s easier for your vagina to become overgrown with other things, including yeast.

A recurrent yeast infection is when you have four or more yeast infections within a year or at least three unrelated to taking antibiotics.

You may also notice a spike in yeast infections if your doctor puts you on vaginal estrogen, says Minkin. That’s because high levels of estrogen can also trigger an overgrowth of yeast. This is why you also may have had more yeast infections when you were pregnant or on the birth control pill.

In addition, as women age, they become more likely to get conditions such as type 2 diabetes, which has also been linked to yeast infections. “Poorly controlled diabetes raises blood sugar levels, which easily feeds the growth of yeast,” says Jennifer Wu, MD, an OB/GYN at Lenox Hill Hospital in New York City. A recurrent yeast infection is defined as having four or more yeast infections within a year unrelated to taking antibiotics. If this happens to you, it’s important to see your doctor because the symptoms may be due to other causes or to more than one cause.

Other things that may lead to recurring yeast infections include:

Urinary tract infections (UTIs). Loss of estrogen shortens the urethra (which carries urine), making it easier for bacteria to get into the bladder and cause a bladder infection. UTIs are typically treated with antibiotics, which increase your chance of getting a yeast infection.

Urinary incontinence. More than half of women who’ve been through menopause have urinary incontinence, which is an inability to control when they pee and a symptom of vaginal atrophy. Excess moisture (like pee) in the vaginal area can cause yeast infections. Using pads or diapers don’t help either because they keep moisture near the skin.

Hormone replacement therapy. Although HRT helps reduce many menopause symptoms, it also ups your odds of getting yeast infections.

Recurring vaginal yeast infections may also be caused by uncommon types of yeast that are more difficult to treat. Your doctor may check a vaginal tissue sample under a microscope to determine what type of yeast is involved and how to treat the infection.

  • Take probiotics that promote growth of “good” vaginal organisms. Some studies show they can prevent vaginal infections in postmenopausal women and reduce symptoms like vaginal discharge and odor.
  • Don’t take antibiotics unless necessary. Using antibiotics over the long term can increase your chances of having recurring bacterial infections.
  • Wear comfortable, dry, and cool clothing. Tight or sweaty clothes or underwear can increase heat and moisture in and around the vagina. Instead, wear cotton underwear to reduce your chances of getting a yeast infection.
  • Try using a vaginal moisturizer. When applied directly to the vaginal area, a vaginal moisturizer can hydrate the tissue and lower pH levels in the vagina.
  • Change what you eat. 
  • Consider boric acid capsules.