Can Vulvovaginal Candidiasis Be Transmitted to Sexual Partners?
Vulvovaginal candidiasis is not considered a sexually transmitted disease and routine treatment of asymptomatic male partners is not recommended, as partner treatment has not been shown to reduce recurrence rates in women. 1, 2
Understanding Transmission and Partner Involvement
VVC is fundamentally not an STD. The CDC explicitly states that vulvovaginal candidiasis has been excluded from the ranks of sexually transmitted diseases, and approximately 10-20% of women normally harbor Candida species in the vagina without infection. 1, 3
Sexual transmission is uncommon but possible. While VVC can occur in women who have never been sexually active, the condition is associated with sexual activity primarily because sexual intercourse can alter the vaginal environment, not because of direct pathogen transmission. 1
Partner treatment is only indicated in specific circumstances. The CDC and recent guidelines recommend treating male sexual partners only when they have symptomatic balanitis (inflammation of the glans penis), not routinely for asymptomatic colonization. 2
When Partner Treatment Should Be Considered
Symptomatic male partners require treatment. If your male partner develops penile itching, redness, or irritation (balanitis), he should receive topical antifungal therapy with the same azole preparations used for vaginal treatment. 2
Recurrent infections may warrant partner evaluation. In cases of recurrent vulvovaginal candidiasis (RVVC), defined as three or more episodes within one year, the American Academy of Family Physicians suggests considering partner treatment, though evidence supporting this practice remains limited. 2
Important Clinical Distinctions
Asymptomatic colonization does not require treatment. Neither a woman with asymptomatic Candida colonization nor an asymptomatic sexual partner should receive antifungal therapy, as this leads to unnecessary medication exposure without clinical benefit. 2, 4
Recurrence is typically not due to reinfection from partners. Most recurrent VVC cases result from host factors (uncontrolled diabetes, immunosuppression, antibiotic use, hormonal changes) rather than sexual reinfection, making partner treatment ineffective for preventing recurrence. 2, 5
Common Pitfalls to Avoid
Do not automatically treat partners. Unlike trichomoniasis or bacterial STDs where partner treatment is essential, routine partner treatment for VVC is not evidence-based and should be avoided. 1, 2
Do not confuse VVC with actual STDs. VVC can coexist with sexually transmitted infections, so appropriate testing for gonorrhea, chlamydia, and trichomoniasis should be performed when clinically indicated, but VVC itself is not transmitted sexually. 1, 2
Avoid barrier methods during treatment. Condoms and diaphragms may be damaged by topical antifungal creams and fail to prevent pregnancy or STDs during the treatment period. 6