Objective <p>Through retrospective analysis of the results of morphology and function of vaginal secretions in women, to understand the characteristics and differences of vaginal microecology in women at different physiological stages.</p> Methods <p>Select women (n = 184) who had their first gynecological outpatient visit between January 1, 2018, and April 30, 2024, have a sexual history, and meet the inclusion and exclusion criteria. According to the STRAW + 10 standard and whether they have symptoms such as vulvar itching and abnormal leukorrhea, they were divided into asymptomatic group (n = 118), including premenopausal group (n = 43), perimenopausal syndrome Group I (n = 33), menopausal group (n = 42), and perimenopausal syndrome Group II with symptoms of vulvar itching and abnormal leukorrhea (n = 66). Collect vaginal secretions from each female in the above groups for morphological and functional analysis.</p> Results <p>Lactobacillus morphology, Gardnerella morphology, pH, and hydrogen peroxide positivity were significantly different in perimenopausal syndrome groups I and II, respectively (P &lt; 0.05); in asymptomatic women, Lactobacillus morphology and Gardnerella morphology were significantly different from perimenopausal syndrome group I and menopausal group, respectively, in the premenopausal group (P &lt; 0.05); in addition, Gram-negative bacilli in perimenopausal syndrome group I were significantly different from premenopausal and menopausal groups, respectively (P &lt; 0.05).</p> Conclusion <p>In addition, the decrease or absence of lactobacilli and the increase of Gardnerella positive rate are the main characteristic changes of vulvar pruritus and abnormal leucorrhea in perimenopausal syndrome women.</p>