Should the sexual partner of a female patient with Bacterial Vaginosis (BV) be treated as well?

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From the Guidelines

No, partners of women with bacterial vaginosis (BV) typically do not need treatment. BV is not considered a sexually transmitted infection, although sexual activity can disrupt the vaginal microbiome. The standard treatment for BV includes antibiotics such as metronidazole or clindamycin for the affected woman only.

  • The cause of BV is associated with having multiple sex partners, douching, and lack of vaginal lactobacilli, but it is unclear whether BV results from acquisition of a sexually transmitted pathogen 1.
  • Studies have not shown that treating male partners reduces BV recurrence rates in women, with the Centers for Disease Control and Prevention stating that treatment of the male sex partner has not been beneficial in preventing the recurrence of BV 1.
  • BV occurs when there's an imbalance in the normal vaginal bacteria, with an overgrowth of certain bacteria like Gardnerella vaginalis and a reduction in protective Lactobacillus species.
  • While sexual activity is associated with BV, treating partners has not demonstrated clinical benefit in preventing recurrence, which affects about 30% of women within 3 months after treatment.
  • The recommended treatment regimen includes oral or topical metronidazole or clindamycin cream, with follow-up visits unnecessary if symptoms resolve, but patients should return for additional treatment if symptoms recur 1.

From the Research

Treatment of Bacterial Vaginosis in Female Partners

  • Bacterial vaginosis (BV) is a common condition that can be treated with antibiotics such as metronidazole and clindamycin 2, 3, 4.
  • The current treatment regimens for BV provide a short-term cure, but recurrence is common, with 50-80% of women experiencing a recurrence within a year of completing antibiotic treatment 2, 3.

Treatment of Male Partners

  • There is evidence to suggest that treating the male partner may help prevent recurrence of BV in the female partner 5.
  • A study found that treating the male partner with oral and topical antimicrobial therapy in addition to treating the female partner resulted in a lower rate of recurrence of BV within 12 weeks compared to standard care 5.
  • However, not all studies support the treatment of male partners, with some suggesting that it is not necessary 4.

Recurrence and Prevention

  • Recurrence of BV is a common problem, and further studies are needed to find effective ways to prevent it 2, 3, 6.
  • Adjuvant therapy with probiotics may have a significant role in improving efficacy and preventing recurrences 6.
  • Other potential strategies for preventing recurrence include behavioral modifications such as smoking cessation, condom use, and hormonal contraception 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Characterization and Treatment of Recurrent Bacterial Vaginosis.

Journal of women's health (2002), 2019

Research

Bacterial vaginosis: review of treatment options and potential clinical indications for therapy.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 1995

Research

Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis.

The New England journal of medicine, 2025

Research

Treatment of bacterial vaginosis: what we have and what we miss.

Expert opinion on pharmacotherapy, 2014

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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