Although bacterial vaginosis (BV) is not officially categorized as a sexually transmitted infection (STI), emerging research indicates that sexual activity may play a more significant role in its spread than previously believed. The findings may lead to new recommendations for treatment and prevention, especially for individuals with recurring infections.
Key Highlights:
- A recent study found that women are less likely to experience recurring bacterial vaginosis when their male partners are also given antibiotic treatment.
- Most men who receive antibiotic therapy for BV-related bacteria report little to no side effects.
- Preventive measures such as avoiding douching, steering clear of scented soaps and feminine hygiene products, and practicing safe sex can significantly reduce the risk of developing BV.
A new study has revealed that treating both women and their male partners with antibiotics may significantly reduce the recurrence of bacterial vaginosis (BV), a common vaginal infection that affects millions of women worldwide. These findings could reshape how healthcare providers approach BV treatment and highlight a potential link between the condition and sexual activity.
Bacterial Vaginosis: A Widespread Issue Among Women
Bacterial vaginosis is a common condition, impacting about 1 in 3 women globally, according to the World Health Organization (WHO). It is caused by an imbalance in the vaginal microbiota, specifically when the healthy bacteria known as lactobacilli decrease and harmful bacteria known as anaerobes increase. Symptoms often include an unpleasant fishy or musty odor, abnormal vaginal discharge, and vaginal irritation or itching.
Although antibiotics can clear up BV, recurrence rates remain high. Many women experience multiple bouts of the infection, even after repeated treatment. This persistent recurrence has puzzled researchers and prompted a deeper investigation into possible causes—including the role of sexual transmission.
Treating Couples Reduces Recurrence by Nearly Half
The study, recently published in the New England Journal of Medicine, examined whether treating male partners alongside their female counterparts could reduce the risk of reinfection. Researchers from Monash University and the Melbourne Sexual Health Centre in Australia studied 164 heterosexual couples in monogamous relationships. Half of the couples followed the standard treatment protocol: a seven-day course of antibiotics for women only. The other half had both partners take oral antibiotics, with men also applying a topical antibiotic to the penis.
The results were striking. After 12 weeks, only 35% of women whose partners also received treatment experienced a recurrence of BV, compared to 63% of women whose partners were untreated.
“Our study has shown that reinfection from an untreated sexual partner is a significant driver of BV recurrence,” said lead author Lenka Vodstrcil, PhD. “This simple intervention will reduce a woman’s risk of reinfection and increase her probability of being cured.”
Could BV Be Sexually Transmitted After All?
Currently, BV is not officially classified as a sexually transmitted infection. However, these new findings suggest that sexual activity may play a much larger role in its transmission than previously thought.
Dr. Vodstrcil emphasized the need to reconsider how BV is approached, not just as a bacterial imbalance but potentially as a condition that can be passed between partners. “We need to look at BV in the same way we approach other infections where both partners are treated to break the cycle of reinfection,” she said.
Men Tolerate Treatment Well
One concern researchers addressed was whether treating men for a condition they may not have symptoms for would result in adverse effects. The study found that most male participants tolerated the antibiotic regimen well. Those who did report side effects mainly experienced mild symptoms such as nausea and headaches, indicating that broader partner treatment may be a safe and feasible approach.
Understanding the Root Causes of BV
According to the Mayo Clinic, BV stems from an imbalance in vaginal flora. This can occur naturally or be triggered by certain behaviors, such as over-cleaning or douching, which can disrupt the natural bacterial environment. The condition is also more prevalent in women with low levels of lactobacilli and those who engage in unprotected sex or have new or multiple sexual partners.
Preventive Measures to Keep BV at Bay
While antibiotics remain the standard treatment for BV, prevention remains an important aspect of managing the condition, especially for women prone to recurrent infections. The Mayo Clinic offers several tips to help reduce risk:
- Avoid scented hygiene products: Use only warm water to cleanse the genital area, steering clear of perfumed soaps, pads, or tampons.
- Skip douching: Douching can upset the natural bacterial balance in the vagina and increase susceptibility to infection.
- Practice safe sex: Using condoms and keeping sex toys clean can help reduce the risk of introducing harmful bacteria.
A Shift in Treatment Guidelines?
Experts unaffiliated with the study say the results could help inform future treatment protocols. Christina Muzny, MD, a professor of epidemiology and obstetrics and gynecology at the University of Alabama at Birmingham, supports the idea of partner treatment to reduce recurrence.
“We recommend consistent condom use in women, avoidance of douching, and now treatment of male sexual partners if they get a bacterial vaginosis infection,” Dr. Muzny said.
As research continues to uncover more about BV and its potential link to sexual activity, these findings may pave the way for more comprehensive and effective treatment strategies that address the infection at its source—potentially within both partners.