From the Guidelines
Men can carry bacterial vaginosis (BV) bacteria on their genitals, but they do not develop BV themselves since they lack a vagina. While men do not require treatment for their own health, they can transmit BV-associated bacteria to female partners during sexual contact, as suggested by the studies 1. The most recent and highest quality study, 1, indicates that BV is associated with having multiple sex partners, but it is unclear whether BV results from acquisition of a sexually transmitted pathogen. Key points to consider include:
- Men can harbor BV-associated bacteria in their urethras or under the foreskin, creating a reservoir for reinfection during sexual activity.
- Treatment of the male sex partner has not been beneficial in preventing the recurrence of BV, according to 1.
- Routine treatment of male partners is not standard practice for isolated BV cases, as BV can also develop from natural disruptions to vaginal flora without sexual transmission. In the context of real-life clinical medicine, it is essential to consider the potential role of male partners in the transmission of BV-associated bacteria, particularly in cases of recurrent BV infections. However, the current evidence does not support routine treatment of male partners, and treatment decisions should be made on a case-by-case basis, taking into account the individual patient's circumstances and medical history.
From the Research
Bacterial Vaginosis in Men
- Bacterial vaginosis (BV) is estimated to affect 1 in 3 women globally, and evidence suggests that male partners may be reinfecting women with BV-associated bacteria 2.
- Studies have shown that male partners can carry BV-associated bacteria, which can contribute to the recurrence of BV in women 3, 4.
- A randomized controlled trial found that treating male partners with oral and topical antimicrobial therapy reduced the rate of BV recurrence in women compared to standard care 4.
Male Partner Treatment
- Male partner treatment has been shown to be effective in reducing the recurrence of BV in women, with a lower rate of recurrence observed in the partner-treatment group compared to the control group 4.
- The treatment of male partners with oral metronidazole and 2% clindamycin cream has been found to be acceptable and tolerable, with few adverse events reported 3, 4.
- Men's attitudes towards BV and partner treatment are influenced by the nature of their relationships, with acceptance of treatment largely being a demonstration of care and support for their partner 5.
BV Recurrence and Treatment
- BV recurrence is common, with up to 50% of women experiencing recurrence within 12 weeks of treatment 3, 6.
- Current treatment options for BV, such as antibiotics, provide a short-term cure but often fail to provide a consistent long-term cure 6.
- Researchers are exploring alternative approaches to treatment and prevention, including probiotics, vaginal microbiome transplantation, and behavioral modifications 6.