From the Guidelines
Treating the male partner is not recommended as a standard practice for recurrent bacterial vaginosis (BV) and vaginal yeast infections, as current evidence does not strongly support that it significantly reduces recurrence rates in women. The primary focus for managing these conditions should remain on treating the woman with appropriate medications and addressing risk factors. For BV, studies have shown that treating the male partner with antibiotics has not consistently demonstrated benefit in preventing recurrences in female partners 1. Similarly, for vaginal candidiasis (yeast infections), male partners typically remain asymptomatic even when colonized, and treating them has not been proven to reduce recurrence rates in women 1.
Key Considerations
- The cause of BV is not fully understood, but it is associated with sexual activity, although it is not considered exclusively an STD 1.
- Vaginal candidiasis is not usually acquired through sexual intercourse, and treatment of sex partners is not recommended but may be considered in women who have recurrent infection 1.
- A minority of male sex partners may have balanitis, which can be treated with topical antifungal agents to relieve symptoms 1.
- The primary focus for managing recurrent vaginal infections should remain on treating the woman with appropriate medications (metronidazole or clindamycin for BV; fluconazole or topical antifungals for yeast infections) and addressing risk factors such as douching, frequent antibiotic use, and certain sexual practices.
Treatment Approach
- Treat the woman with appropriate medications for BV or vaginal yeast infections.
- Address risk factors such as douching, frequent antibiotic use, and certain sexual practices.
- Consider treating the male partner if he shows symptoms of balanitis or other genital infections.
From the Research
Treatment of Male Partners in Recurrent Bacterial Vaginosis (BV) and Vaginal Yeast Infections
- The question of whether male partners should be treated in cases of recurrent BV and vaginal yeast infections is complex and has been studied in various research papers 2, 3, 4, 5, 6.
- Studies have shown that BV is a common but treatable condition, with effective treatments including oral and intravaginal metronidazole and clindamycin 2.
- However, recurrence of BV is common, with up to 50% of women experiencing recurrence within 1 year of treatment 2.
- The underlying mechanisms of recurrent BV are not fully understood, but possible reasons for recurrence include persistence of residual infection, resistance, and reinfection from male or female partners 2.
- Some studies suggest that treatment of male partners may be beneficial in preventing recurrence of BV 4, 6.
- A 2025 study published in The New England Journal of Medicine found that treatment of male partners with oral and topical antimicrobial therapy reduced the rate of recurrence of BV within 12 weeks 6.
- However, other studies have found that antibiotic treatment of male partners does not increase the rate of clinical or symptomatic improvement in women, and may even increase the frequency of adverse events reported by male partners 4.
Vaginal Yeast Infections
- Vaginal yeast infections are typically caused by Candida albicans, and can be treated with antifungal medications such as fluconazole 3.
- Recurrent yeast infections may be treated with fluconazole 150mg weekly for up to 12 consecutive weeks 3.
- However, there is limited evidence on the effectiveness of treating male partners in cases of recurrent vaginal yeast infections.
Conclusion is not allowed, so the response will continue with more information
- It is essential to note that the treatment of male partners should be considered on a case-by-case basis, taking into account the individual circumstances of each patient 6.
- More research is needed to fully understand the role of male partners in the recurrence of BV and vaginal yeast infections, and to determine the most effective treatment strategies 2, 4, 6.