Many women with bacterial vaginosis (B.V.) are asymptomatic, while others experience increased discharge, a fishy odor, and vaginal discomfort. Infected individuals face higher risks of other STIs and complications during pregnancy. Standard treatment involves a week of antibiotics, but B.V. often recurs, requiring multiple treatments that can affect quality of life. A study involving 164 monogamous couples showed that treating both partners reduced recurrence rates significantly. Factors like having an intrauterine device or an uncircumcised partner can increase recurrence risk. Past research suggests B.V. may be sexually transmitted, with evidence of matching bacteria between infected women and their male partners.
A significant number of women do not show symptoms; however, those who do may notice increased vaginal discharge, a fishy smell, and sensations of burning or itching. Women with bacterial vaginosis (B.V.), whether symptomatic or not, face a heightened risk of contracting other sexually transmitted infections like chlamydia or H.I.V., and they are also more vulnerable to pelvic inflammatory disease. Additionally, B.V. in pregnant women has been linked to a higher likelihood of preterm birth.
Dr. Paul Nyirjesy, co-director of the Jefferson Vulvovaginal Health Center in Philadelphia, PA, explained that the typical treatment for B.V. involves a week-long course of antibiotics, either taken orally or vaginally. However, due to the condition’s high recurrence rate, patients find themselves needing to be “treated repeatedly—five, six, or even ten times,” which can adversely affect their quality of life and intimate relationships. Some patients might require extended treatment regimens lasting six to seven months to manage bacterial levels, but infections frequently return after discontinuing treatment.
In a recent study carried out at several sexual health and family planning centers in Australia, researchers provided a group of 83 monogamous couples with the standard seven-day antibiotic treatment for the female partners. Meanwhile, another group of 81 monogamous couples received additional treatment for male partners, which included a seven-day course of oral antibiotics along with a topical antibiotic applied to the penis. After a 12-week period, 35 percent of women in the partner treatment group experienced a recurrence of B.V., while the recurrence was 63 percent in the standard treatment group. Most men reported experiencing no side effects from the treatment, although some did mention nausea, headaches, or a metallic taste.
Identified potential risk factors for B.V. recurrence include the use of an intrauterine device and engaging in sexual activity with an uncircumcised partner. The study revealed that even among patients exhibiting these risk factors, treating both partners resulted in a reduced rate of recurrence, according to Dr. Catriona Bradshaw, the study’s lead author and a clinician at the Melbourne Sexual Health Centre at Monash University.
For many years, experts in reproductive health have theorized that B.V. may be sexually transmitted. While conducting research in central and east Africa over two decades ago, Dr. Bradshaw discovered that “recurrence was double or triple in women who had an ongoing sex partner,” she noted. It was also observed to occur more frequently among individuals who did not use condoms—both indicative of a possible S.T.I. connection. Additional studies over the years have further supported this theory, including more recent research that found a correlation between the bacteria in infected women and those found on penises.