From the Guidelines
No, sexual partners of women with bacterial vaginosis (BV) typically do not need treatment. BV is not considered a sexually transmitted infection, although sexual activity can disrupt the vaginal bacterial balance. Current medical guidelines do not recommend routine treatment of male sexual partners as this has not been shown to reduce recurrence rates in women with BV, as indicated by studies such as 1 and 1. The standard treatment for BV includes antibiotics such as metronidazole (500 mg orally twice daily for 7 days or 0.75% gel intravaginally once daily for 5 days) or clindamycin (300 mg orally twice daily for 7 days or 2% cream intravaginally at bedtime for 7 days) for the affected woman only. Some key points to consider in the treatment of BV include:
- BV occurs when there is an imbalance in the normal vaginal flora, with a decrease in beneficial lactobacilli and an overgrowth of anaerobic bacteria, as noted in 1.
- While sexual activity can influence this balance, treating partners has not demonstrated significant benefits in preventing recurrence, as stated in 1 and 1.
- Women should complete the full course of antibiotics even if symptoms resolve earlier to ensure complete treatment.
- The benefits of therapy for BV in nonpregnant women are to relieve vaginal symptoms and signs of infection, and reduce the risk for infectious complications after abortion or hysterectomy, as mentioned in 1.
From the Research
Treatment of Sexual Partners
- The question of whether sexual partners should be treated when a woman has bacterial vaginosis is a complex one, with various studies providing insights into the matter 2, 3.
- Research suggests that bacterial vaginosis may be sexually transmitted, and that treating only the woman may not be enough to prevent recurrence 2.
- The exchange of bacteria between partners during sexual activity is a possible mechanism for the transmission of bacterial vaginosis, and treating the partner may help reduce the risk of reinfection 2.
Evidence for Partner Treatment
- A study published in 2021 found that the pathogenesis of bacterial vaginosis recurrence is likely to be multifaceted, and that combined and individualized approaches to eradicate BVAB, support an optimal vaginal microbiome, and prevent reinfection from partners may be required 2.
- Another study published in 2009 noted that the aetiology, pathology, microbiology, and transmission of bacterial vaginosis remain poorly understood, but that observational evidence suggests the possibility of sexual transmission 3.
Treatment Options
- The standard treatment for bacterial vaginosis typically involves the administration of metronidazole, clindamycin, or tinidazole, either orally or intravaginally 4, 5, 6.
- Alternative strategies, such as antimicrobial substances, probiotics, prebiotics, and acidifying agents, may also be effective in preventing and treating bacterial vaginosis 4.
- Studies have compared the efficacy and safety of different treatment regimens, including clindamycin vaginal ovules and oral metronidazole, with varying results 5, 6.