Can Lyme disease, caused by Borrelia burgdorferi (B. burgdorferi), be transmitted sexually?

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Last updated: May 22, 2025View editorial policy

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From the Guidelines

Lyme disease cannot be sexually transmitted, as there is no scientific evidence to support this mode of transmission. The primary mode of transmission is through the bite of infected blacklegged ticks (Ixodes scapularis or Ixodes pacificus) [ 1 ]. According to the study published in MMWR Recommendations and Reports [ 1 ], Lyme disease is not spread by person-to-person contact or by direct contact with infected animals. Key points to consider include:

  • The bacterium Borrelia burgdorferi is primarily transmitted through tick bites [ 1 ]
  • There is no evidence to suggest that B. burgdorferi can be transmitted through sexual contact [ 1 ]
  • Transplacental transmission of B. burgdorferi has been reported, but the effects on the fetus remain unclear [ 1 ]
  • Transmission in breast milk has not been described [ 1 ] If you're concerned about Lyme disease, focus on prevention methods like:
  • Using tick repellents
  • Wearing protective clothing in tick-prone areas
  • Performing regular tick checks after outdoor activities
  • Promptly removing attached ticks If you suspect Lyme disease due to symptoms like the characteristic bull's-eye rash, fever, fatigue, or joint pain after potential tick exposure, consult a healthcare provider for proper diagnosis and antibiotic treatment.

From the Research

Lyme Disease Transmission

  • The primary mode of Lyme disease transmission is through the bite of an infected tick, specifically the deer tick (Ixodes scapularis) 2, 3.
  • However, there is speculation about the possibility of sexual transmission of Lyme disease, with some studies suggesting that it may be possible 4, 5.
  • A study published in 2015 explored the clinical, epidemiological, and experimental evidence for sexual transmission of Lyme disease in animal models and humans, but found that the likelihood of sexual transmission remains speculative 4.
  • Another study published in 2021 highlighted the need for extensive research to confirm or refute the existence of sexual transmission of Borrelia burgdorferi, citing the potential implications for Lyme borreliosis epidemiology 5.

Current Understanding of Lyme Disease

  • Lyme disease is a multisystem inflammatory disease caused by infection with Borrelia burgdorferi 6, 2.
  • The disease can manifest in various stages, including an initial skin rash, followed by potential neurological, cardiac, and joint involvement 6, 3.
  • Treatment typically involves antibiotics, with the specific regimen depending on the stage and severity of the disease 6, 2, 3.

Research Gaps and Controversies

  • There is ongoing debate and controversy surrounding the treatment of post-Lyme disease syndrome and chronic Lyme disease, with some arguing that prolonged antibiotic therapy may be beneficial 6, 2.
  • However, the majority of evidence suggests that prolonged antibiotic therapy is not indicated or efficacious 6, 2, 3.
  • The possibility of sexual transmission of Lyme disease remains a topic of speculation and debate, with further research needed to fully understand the potential risks and implications 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Diagnosis and management of Lyme disease.

American family physician, 2012

Research

Sexual Transmission of Lyme Borreliosis? The Question That Calls for an Answer.

Tropical medicine and infectious disease, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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