Symptoms of Bacterial Vaginosis in Men
Male partners of women with bacterial vaginosis (BV) are typically asymptomatic and do not require treatment, as BV is not considered exclusively a sexually transmitted disease. 1
Understanding BV in the Context of Male Partners
Bacterial vaginosis is a clinical syndrome resulting from the replacement of normal vaginal flora with high concentrations of anaerobic bacteria. While BV is associated with sexual activity, as women who have never been sexually active are rarely affected, it is not classified as a conventional sexually transmitted disease.
Key points regarding men and BV:
- BV-associated bacteria can colonize the male genital tract but typically do not cause symptoms in men 2
- The bacteria found in BV (including Gardnerella vaginalis, Bacteroides species, Mobiluncus species) may be part of the normal male genital flora 1
- Male partners of women with BV do not develop a "male version" of bacterial vaginosis 1
Detection of BV-Associated Bacteria in Men
Research has shown that BV-associated bacteria can be found in male partners:
- In a 2023 study, researchers found that 21.1% of men who have sex with women had Sneathia species, 11.4% had BVAB2, and 5.4% had Mageeibacillus indolicus 2
- These bacteria can persist in men for varying periods (median persistence ranging from 30.5 to 87 days) 2
- Having multiple sexual partners increases the likelihood of carrying these bacteria 2
Clinical Implications for Men
Despite the presence of BV-associated bacteria in men, there are no established clinical syndromes or symptoms:
- BV-associated bacteria are not associated with non-gonococcal urethritis in men 2
- Male partners of women with BV do not require treatment according to established guidelines 1
- Traditional treatment guidelines specifically state that "male sex partners of women with BV are not symptomatic" 1
Treatment Considerations
The question of treating male partners has been extensively studied:
- Traditional guidelines state that "treatment of male partners has not been shown to alter either the clinical course of BV in women during treatment or the relapse/reinfection rate" 1
- A 2016 Cochrane review found high-quality evidence that antibiotic treatment for sexual partners of women with BV does not increase the rate of clinical or symptomatic improvement in women 3
- However, a recent 2025 study challenges this view, suggesting that combined oral and topical antimicrobial therapy for male partners resulted in lower rates of BV recurrence in women 4
Important Distinctions
It's important to distinguish BV from other conditions that can affect male genital health:
- BV is different from balanitis, which can cause inflammation of the glans penis
- BV-associated bacteria should not be confused with sexually transmitted infections like chlamydia, gonorrhea, or trichomoniasis, which do cause symptoms in men
- G. vaginalis can be isolated from vaginal cultures in about half of normal women, and can also be found in men without causing symptoms 1
Clinical Takeaway
For healthcare providers, the key message is that while BV-associated bacteria can colonize men, they do not cause a clinical syndrome requiring diagnosis or treatment in men themselves. The focus should remain on diagnosing and treating symptomatic BV in women, with emerging evidence suggesting potential benefit of partner treatment in preventing recurrence, though this is not yet reflected in current guidelines.