What is the treatment for males if their female partner has bacterial vaginosis (BV)?

Treatment for Males if Female Partner Has Bacterial Vaginosis

Routine treatment of male partners of women with bacterial vaginosis (BV) is not recommended according to established guidelines. 1, 2

Current Guidelines on Male Partner Treatment

• The Centers for Disease Control and Prevention (CDC) has consistently maintained that treatment of male sex partners does not influence:

  • The woman's response to therapy
  • The relapse or recurrence rate of BV 1, 2

• Male partners of women with BV:

  • Do not develop a "male version" of bacterial vaginosis
  • Do not require antimicrobial treatment as standard care 2
  • Are not routinely tested for BV-associated organisms

Rationale Behind the Recommendation

• Traditional clinical trials have shown that partner treatment does not improve clinical outcomes for the female partner 1
• BV-associated bacteria may be part of the normal male genital flora 2
• Gardnerella vaginalis can be isolated from approximately half of normal women and can also be found in asymptomatic men 2

Important Considerations

• BV recurrence is common, affecting up to 50% of women within one year of treatment 3
• The focus of treatment should remain on the female patient with confirmed BV using recommended regimens such as:
  • Metronidazole 500 mg orally twice daily for 7 days
  • Metronidazole gel 0.75% intravaginally once daily for 5 days
  • Clindamycin cream 2% intravaginally at bedtime for 7 days 1, 2

Emerging Research

While current guidelines do not recommend male partner treatment, recent research suggests this position may evolve:

• A 2025 randomized controlled trial found that treating male partners with combined oral metronidazole and topical clindamycin cream resulted in lower BV recurrence rates (35% vs 63% in control group) 4
• This suggests that sexual transmission may play a role in BV recurrence, though this has not yet been incorporated into official guidelines

Clinical Pitfalls to Avoid

• Treating male partners unnecessarily with antibiotics, which can:

  • Contribute to antimicrobial resistance
  • Expose patients to potential side effects (nausea, headache, metallic taste) 4
  • Incur unnecessary healthcare costs

• Failing to counsel couples about:

  • The high recurrence rate of BV despite appropriate treatment
  • The importance of female adherence to the full treatment course
  • The need for the female partner to return if symptoms recur

Bottom Line

Follow current guidelines that recommend against routine treatment of male partners of women with BV. Focus treatment on the female patient with confirmed BV using established antibiotic regimens. Be aware that emerging research may eventually change this recommendation, particularly for cases of recurrent BV.