Tejal Somvanshi
A landmark Australian study has revealed that bacterial vaginosis (BV) is a sexually transmitted infection, challenging decades of medical understanding and opening new pathways for more effective treatment. Researchers found that treating male partners alongside women cuts BV recurrence by nearly half, potentially revolutionizing care for a condition affecting one-third of women globally.
The groundbreaking research, published in the New England Journal of Medicine, was conducted by Melbourne Sexual Health Centre and Monash University scientists who treated 164 couples in monogamous heterosexual relationships. The results were so compelling that researchers stopped the trial early when it became clear that partner treatment significantly outperformed the standard approach.
“This successful intervention is relatively cheap and short and has the potential for the first time to not only improve BV cure for women, but opens up exciting new opportunities for BV prevention,” said Professor Catriona Bradshaw, one of the study’s lead authors.
The study found that BV recurred in just 35 percent of women whose partners received treatment, compared to 63 percent in the control group where only women were treated – the current global standard practice.
For women like Hanae from Melbourne, who participated in the study, the findings offer hope after years of frustration. “It came back time and time again, no matter how many times I got antibiotic treatment,” she said. “I thought there was something wrong with me.”
In the trial, all women received standard antibiotics, while male partners in the treatment group received both oral antibiotics and a topical antibiotic cream for one week. The couples were then monitored for 12 weeks to measure effectiveness.
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The study overturns previous research from the 1980s and 1990s that had ruled out sexual transmission of BV. Those earlier trials only used oral antibiotics for male partners, which failed to clear bacteria from the penile skin.
“The key thing is that all previous trials had only tried oral antibiotics,” Professor Bradshaw explained. “No one had tried a topical antibiotic on the skin to also get rid of the bugs on the skin of the penis.”
BV occurs when normal healthy bacteria in the vagina are replaced by an overgrowth of harmful bacteria. Beyond causing distressing symptoms like unusual discharge and odor, BV increases risks of other STIs, pelvic inflammatory disease, miscarriage, and premature birth.
Despite the promising results, researchers noted some limitations. About 14 percent of men in the treatment group reported taking less than 70 percent of their prescribed medication, suggesting potential challenges with partner compliance.
Professor Rebecca Guy from the Kirby Institute’s Sexual Health Program, who wasn’t involved in the study, called it the “first study to show sustained and substantial benefit for a common and debilitating vaginal infection.”
The Melbourne Sexual Health Centre has already changed its clinical practice to treat couples and launched a website providing information for both healthcare professionals and patients. However, it may take years before partner treatment becomes standard practice in clinics nationwide.
Professor Bradshaw believes the condition needs a new name that reflects shared responsibility. As one male participant in the study noted, BV “is a shared responsibility.”
Frequently Asked Questions
What is bacterial vaginosis (BV) and how common is it?
Bacterial vaginosis is a condition where the normal healthy bacteria in the vagina are replaced by an overgrowth of other mixed bacteria. It affects nearly one-third of women of reproductive age worldwide. Common symptoms include unusual discharge and a fishy odor, though some women experience no symptoms.
Is bacterial vaginosis a sexually transmitted infection?
Yes, this new research confirms that bacterial vaginosis can be sexually transmitted between partners. The study found BV bacteria can be harbored by male partners and reintroduced during sex, which explains why many women experience recurrence after treatment.
What health risks are associated with bacterial vaginosis?
BV increases the risk of contracting other sexually transmitted infections, pelvic inflammatory disease, miscarriage, premature birth, and low birth weight in babies. It can also cause significant distress due to symptoms like unusual discharge and odor.
Why does bacterial vaginosis often come back after treatment?
The study found that reinfection from male partners is a major cause of BV recurrence. Current standard practice only treats women, leaving bacteria on male partners that can reinfect women during sexual contact. Other factors that might contribute to recurrence include IUDs, which can harbor bacterial biofilms, and the makeup of a person’s vaginal microbiome.
What was different about this study compared to previous research on BV?
Previous studies in the 1980s and 1990s only gave oral antibiotics to male partners, which wasn’t effective. This new study used both oral antibiotics and a topical antibiotic cream for male partners to eliminate bacteria both inside the urethra and on the penile skin. This combined approach proved significantly more effective at preventing BV recurrence.
When will partner treatment for BV become standard practice?
While the Melbourne Sexual Health Centre has already changed its clinical practice to treat couples, it may take time for national and international treatment guidelines to be updated. Medical experts note that “you can’t change guidelines until you have rock-solid evidence with very strong effect sizes.” The process could take several years, but this study provides the compelling evidence needed to start that change.
