For decades, bacterial vaginosis (BV) has been straightforwardly classified as a “female health problem.” It has long been understood as an imbalance in the vaginal flora that affects almost 30% of people with vaginal vaginas in the United States and is characterized by unpleasant emissions and odors. However, a groundbreaking study recently published in The New England Journal of Medicine could challenge this framework and forever change the way we understand vaginal state.
A quick review: What is BV?
Bacterial vaginosis (BV) occurs especially when there is an imbalance in the vaginal microbiome, when healthy lactic acid bacteria (a good bacteria that help maintain vaginal acid) are reduced and replaced by overgrowth of anaerobic bacteria such as Gardnerella vaginalis. This confusion leads to symptoms such as inflammation, discharge and odor, but many people do not experience any significant symptoms. It is important to note that BV is not caused by a single bacteria or a classical infection and is not considered a sexually transmitted disease (STI). Sexual activities such as not using condoms and using new or multiple sex partners often can cause or worsen the condition.
BV can cause the following symptoms:
Vaginal odor of light, grey-white draining fish during urination vaginal irritation or burning fever
However, many people with BV are asymptomatic. Without treatment, BV can increase the risk of preterm birth, pelvic inflammatory disease, and increased susceptibility to STIs such as HIV.
Big shift: What new research finds
Randomized controlled trials studied the effectiveness of treating both men and women when one partner had bacterial vaginosis (BV). In the study, male partners received oral metronidazole and topical clindamycin (applied to the penis), and female partners received standard BV treatment.
Twelve weeks later, the study concluded that only 35% of women treated with male partners showed recurrence of BV. Meanwhile, 63% of women treated alone experienced a recurrence of the infection.
Why is this a big deal?
Traditionally, BV has been considered a microbiological problem separated into the vagina. Treatment guidelines do not include male partners as men do not exhibit symptoms. However, this study suggests that male partners can act as reservoirs of BV-associated bacteria and can be unconsciously reintroduced during gender.
“This study confirms that many women and clinicians have long suspected. BV can become a shared state between partners, not just in the vaginal microbiome,” said Dr. Jennifer Hintzsche, CEO and Founder of Ferdal.
BV often occurs immediately after sexual intercourse. Therefore, it is suspected of having a sexually transmitted disease (STI). However, so far, studies in which both partners have been treated with antibiotics have not shown any expected reductions in recurrence rates. This is the first study to combine both oral and topical antibiotics for male partners. This combined approach can target BV bacterial species that can survive within the urethra and on the skin of the penis. ”
Rethinking the sexual health conversation
This study has great implications for how we approach BV in dealing with social stigma, not just clinical care. For too long, women had to deal with concerns about recurrent infections. It’s all I’m going to deal with many reported BVs and just come back within weeks or months for my unprocessed male partner. Hintzsche explains: “It is important that patients take the full dose according to drug guidelines. If only 99% of the bacteria are killed with antibiotics, this means that 1% of the remaining bacteria will survive the first dose of antibiotics and develop resistance.” She also notes that the go-to treatment for BV is antibiotics, such as metronidazole and clindamycin, which are usually prescribed only in women. However, this study focuses on treatments for both partners.
Currently, there is solid evidence suggesting that male partners involved in treatment can significantly reduce these recurrences. This could lead to:
Updates to BV treatment protocols provide broader education on the shared nature of reduced BV risk of stigma in repeated affected people
How to prevent BV in the first place
These findings are game-changers for treatment, but they also shed light on prevention. Understanding that BV is about not only individual hygiene, but also shared microbial environments, means that prevention efforts can go beyond the basics. From supporting the vaginal microbiome to making informed choices about sex, there are simple and aggressive steps that people can take to reduce the risk of developing or redeveloping BV.
Here are some ways to help prevent BV:
Avoid washing: It can destroy the natural bacterial balance in the vagina and make you more vulnerable to infection. Consistent use of condoms. Barrier protection can reduce the introduction of semen and bacteria that can disrupt vaginal pH. Practice excellent genital hygiene (no over-cleaning): Stick to fragrance-free products designed for warm water and vaginal areas. (Hintzsche also recommends that men practice proper hygiene to prevent BV from recurring.) Using harsh soaps can stimulate and destroy the microbiota. Limit sexual partners and discuss symptoms. New or multiple partners can introduce unfamiliar bacteria. Avoid smoking: Smoking is associated with lower levels of vaginal protective lactic acid bacteria. Supporting overall vaginal health: Incorporating vaginal probiotics such as HUM’s private parties can help you maintain a healthy bacterial environment. This daily supplement contains three clinically studied strains of lactic acid bacteria that function to maintain optimal pH levels, balance the vaginal microbiome, and support healthy urinary tract function. Stay tailored to your body: If symptoms appear, early treatment can help prevent serious infections and recurrence.
These steps do not guarantee you will never get a BV, but they will help create a healthier environment where beneficial bacteria will thrive. That’s the best line of defense.
