Body odour changes in menopause: why you smell different

Two kinds of sweat

Eccrine glands are distributed over most of the body and produce the watery sweat used for cooling. It is almost odourless.

Apocrine glands are concentrated in the armpits, groin and around the nipples, and they produce a thicker secretion containing proteins and lipids. That secretion is also odourless when fresh. Skin bacteria break it down, and the products of that breakdown are what smells.

So body odour is not sweat. It is bacterial metabolism of a particular kind of sweat, which is why deodorants targeting bacteria and antiperspirants reducing sweat work differently.

Why menopause changes it

Vasomotor symptoms involve both gland types, so hot flashes and night sweats increase apocrine secretion specifically, giving skin bacteria more substrate.

Skin pH rises as estrogen falls, which shifts the balance of the skin microbiome towards different bacterial populations, and different populations produce different odour compounds.

There is also evidence that body odour changes with age independently of sweating, through changes in skin lipid composition. Taken together, a genuinely different smell rather than simply more of the same is an expected outcome.

What makes it worse

• Synthetic fabrics, which trap bacteria and odour compounds in the fibres in a way natural fibres do not
• Anxiety and stress, which stimulate apocrine glands specifically
• Alcohol, spicy food, garlic and onion, which produce compounds excreted through sweat
• Excess weight, through skin folds that stay warm and moist
• Antiperspirant used only in the morning, when applying at night is more effective because the ducts are less active

What else to consider

A marked or qualitatively unusual change in smell is worth a thought rather than simply more washing:

• A sweet or fruity smell, which can indicate uncontrolled diabetes and needs prompt assessment
• Thyroid disease, which increases sweating substantially when overactive
• Infection, particularly in skin folds, where fungal and bacterial overgrowth produce a distinct smell
• Some medications, including certain antidepressants, which increase sweating
• A strong change in vaginal odour, which is a separate question and usually points to bacterial vaginosis
• Trimethylaminuria, a rare metabolic condition producing a fishy odour, which is diagnosable

When to see someone

Treating the hot flashes usually addresses the sweating that drives this, which is the most direct route and the one most often overlooked.

See a clinician for a sweet or fruity smell, sweating severe enough to soak clothing regardless of temperature, or a change accompanied by weight loss, fever or palpitations.