A groundbreaking study has suggested that bacterial vaginosis (BV)—a common vaginal infection affecting nearly one in three women worldwide—should be reclassified as a sexually transmitted infection (STI). The research, published in The New England Journal of Medicine, found that treating both male partners and female patients significantly reduced the recurrence of BV.

Currently, BV is treated as a women’s health issue, with medical professionals focusing solely on female patients. However, this study indicates that treating only women may not be enough to prevent reinfection. When male partners were also given antibiotics, the recurrence rate among women dropped by 60%.

Understanding Bacterial Vaginosis (BV) and Its Risks

BV occurs when the natural balance of bacteria in the vagina is disrupted, leading to an overgrowth of harmful bacteria. While some women experience no symptoms, others may notice:

• Unusual vaginal discharge (thin, grayish-white, or watery)
• A strong fishy odor, especially after sex
• Itching or irritation
• Painful urination

But beyond discomfort, BV can lead to serious health complications if left untreated. According to the World Health Organization (WHO), BV increases the risk of:

• Contracting HIV and other STIs
• Pelvic inflammatory disease (PID), which can cause infertility
• Preterm birth and pregnancy complications

Professor Catriona Bradshaw from the Melbourne Sexual Health Center at Monash University explains that BV causes inflammation in the reproductive tract, damaging vaginal tissues and making it easier for infections to spread.

The Study That Changed Everything

To investigate the role of male partners in BV transmission, Australian researchers conducted a clinical trial with 164 monogamous couples. They divided participants into two groups:

1. Both partners received treatment – Women took oral antibiotics, while their male partners took oral antibiotics and applied a topical antibiotic to their genital area.
2. Only women received treatment – Their male partners were left untreated.

The results were remarkable. Women whose partners were also treated had a 60% lower recurrence rate compared to those whose partners were not treated.

Lenka Vodstrcil, the study’s lead researcher, explained:

“The bacteria that cause BV can be found in men, especially on the skin of the penis and inside the urethra. This suggests that BV is likely sexually transmitted, which is why so many women experience recurring infections.”

Because the difference was so significant, the study was stopped early—a rare occurrence in medical trials. Researchers concluded that BV should be classified as an STI, which would change how doctors treat it worldwide.

What This Means for BV Treatment

If BV is officially recognized as an STI, the medical approach to treating it would shift dramatically. Doctors would no longer treat only women; instead, male partners would also receive treatment to prevent reinfection.

This would require:

• Educating healthcare providers about BV as an STI
• Informing male partners about their role in reinfection
• Encouraging dual treatment (both partners taking medication)

Doctors Christina Muzny (University of Alabama at Birmingham) and Jack Sobel (Wayne State University School of Medicine) wrote an editorial supporting this change, emphasizing that:

“Male partners will need to commit to taking both oral and topical medications once they are informed that their female partner has BV.”

Will Men Follow Through with Treatment?

A common concern was whether men would actually take their antibiotics. However, the study found that men had no issues completing treatment.

Professor Bradshaw reported:

“We have now treated nearly 300 men with this medication and have had no reports of side effects that would prevent them from completing treatment.”

This suggests that getting male partners to take antibiotics is not a major barrier—a significant relief for researchers advocating for dual treatment.

Changing Medical Guidelines

The Melbourne Sexual Health Center has already updated its BV treatment protocols to include male partners. However, changes to national and international guidelines will take time.

To bridge this gap, researchers have created an online resource for:

• Healthcare professionals looking to implement dual treatment
• Couples wanting to learn more about treating BV together

Professor Bradshaw stressed the importance of providing accurate information so people can make informed decisions about their health:

“In the meantime, we want to ensure that accurate and accessible information is available for those who need it.”

The Future of BV Treatment

This study challenges decades of medical thinking about BV. If global health organizations accept BV as an STI, doctors will need to change their approach, and men will need to take an active role in treatment.

This shift could:

Reduce BV recurrence rates significantly
Lower the risk of STIs like HIV
Improve women’s reproductive health

While medical guidelines take time to change, this research brings us one step closer to a more effective approach to BV prevention and treatment.

FAQs

1. What is the main takeaway from this study on BV?

The study found that treating male partners along with female patients reduced BV recurrence by 60%, suggesting that BV should be classified as an STI.

2. Why is BV currently not considered an STI?

BV has traditionally been viewed as an imbalance of vaginal bacteria, not an infection transmitted through sex. However, this study suggests that BV is sexually transmitted and often reinfects women through their male partners.

3. Will male partners experience side effects from BV treatment?

According to the research, nearly 300 men have undergone treatment with no serious side effects. The medication is safe and effective.

4. How soon could medical guidelines change?

Medical guidelines take time to update, but some clinics, like the Melbourne Sexual Health Center, have already changed their protocols. Widespread adoption may take a few years.

5. What should women with recurrent BV do now?

Women with recurrent BV should talk to their doctor about treating their partner as well. While official guidelines have not changed yet, some doctors may already be open to this approach.