From the Guidelines
Yes, males can be tested for the bacteria that causes bacterial vaginosis (BV), although it's not routinely done. BV is caused primarily by an overgrowth of bacteria like Gardnerella vaginalis and other anaerobic organisms that disrupt the normal vaginal flora. According to the 2018 update by the Infectious Diseases Society of America and the American Society for Microbiology 1, testing for BV typically involves methods such as wet mount, quantitative Gram stain, and DNA hybridization probe, which can be applied to various specimens including vaginal discharge, urethral swabs, or urine samples. However, men don't develop BV as it's specifically a condition of the vaginal environment. While men can carry the bacteria associated with BV, they're generally asymptomatic carriers.
Key Points to Consider
- Testing males might be considered in cases of recurrent BV in female partners to determine if there's a pattern of reinfection, though current clinical guidelines don't routinely recommend partner testing or treatment 1.
- The bacteria can colonize the male genital tract temporarily but doesn't cause the same imbalance as it does in the vaginal environment due to different pH levels and microbial ecosystems.
- Recent advancements in microbiome-based multiplex NAATs have improved the diagnosis of BV, offering greater specificity and consistency in results 1.
Implications for Clinical Practice
- The decision to test a male partner for BV should be made on a case-by-case basis, considering factors such as the frequency of recurrent BV in the female partner and the potential benefits of identifying asymptomatic carriers.
- Clinicians should be aware of the latest diagnostic methods and guidelines for BV, including the use of NAATs and the interpretation of test results in the context of clinical presentation and medical history.
From the Research
Bacterial Vaginosis Diagnosis
- Bacterial vaginosis (BV) is typically diagnosed in women using clinical criteria such as Amsel criteria and Nugent score 2, 3, 4.
- The Amsel criteria include four clinical signs: thin, white, yellowish, homogeneous vaginal discharge; presence of clue cells; pH of vaginal fluid >4.5; and a fishy odor of vaginal discharge before or after addition of 10% KOH (whiff test) 3.
- The Nugent score is a Gram stain-based method that evaluates the presence of lactobacilli, Gardnerella vaginalis, and Mycoplasma hominis in vaginal secretions 2, 4.
Male Testing for Bacterial Vaginosis
- There is no direct evidence in the provided studies that males can be tested for the bacteria that causes bacterial vaginosis using the same methods as females 2, 3, 4, 5, 6.
- The studies focus on the diagnosis of bacterial vaginosis in women, and the methods used are specific to female vaginal secretions and flora.
- It is not clear if the bacteria that cause bacterial vaginosis in women can be detected in males using similar methods, or if different methods would be required.
Alternative Testing Methods
- Quantitative real-time PCR assay has been shown to be a sensitive and specific method for diagnosing bacterial vaginosis in women 5.
- This method detects the DNA of Gardnerella vaginalis and Atopobium vaginae, which are associated with bacterial vaginosis.
- However, it is not clear if this method can be used to test males for the bacteria that causes bacterial vaginosis.