No Treatment Needed for Asymptomatic Male Partner
The asymptomatic husband does not require antifungal treatment, as vulvovaginal candidiasis is not sexually transmitted and partner treatment has not been shown to prevent recurrence in women. 1, 2
Key Evidence Against Partner Treatment
The CDC explicitly states that routine treatment of sexual partners is not warranted because vaginal candidiasis is not typically acquired through sexual intercourse. 2 This recommendation is consistent across multiple guidelines and applies specifically to asymptomatic male partners. 1
When Partner Treatment May Be Considered
The only exception is if the male partner develops symptomatic balanitis (penile inflammation with redness, itching, or discharge), in which case topical antifungal cream may be beneficial. 2 However, this is uncommon and would be obvious to the patient.
Why This Differs from Other Vaginal Infections
This contrasts sharply with trichomoniasis, where concurrent treatment of sexual partners is mandatory to prevent reinfection and reduce transmission. 1, 3 Candida, however, is not a sexually transmitted infection—it represents overgrowth of organisms that normally colonize the vagina in 10-20% of women without causing symptoms. 2
Reassurance for the Patient
The patient can be reassured that:
- Candida is not sexually transmitted and represents normal vaginal flora that has overgrown due to pregnancy-related hormonal changes. 2, 4
- His wife's infection poses no risk to him unless he develops obvious penile symptoms. 2
- Treatment of asymptomatic partners has been studied and found to be ineffective in preventing recurrence in women. 1
- The pregnancy itself increases candidiasis risk through elevated estrogen levels and vaginal glycogen production, not sexual transmission. 4
Common Pitfall to Avoid
Do not prescribe antifungal treatment "just to be safe" for asymptomatic partners—this wastes resources, may cause unnecessary side effects, and provides no clinical benefit based on guideline-level evidence. 1, 2