A common vaginal infection affecting nearly one in three reproductive-aged women worldwide should be reclassified as a sexually transmitted disease (STD), according to a new study published in the New England Journal of Medicine. The condition has traditionally been considered a women’s health issue, often leaving sexual partners untreated. However, researchers argue that this oversight contributes to the high recurrence rates among women.
The study, led by researchers from the Melbourne Sexual Health Centre at Monash University, found that for half of all women treated for bacterial vaginosis (BV), the infection returns within a week of completing antibiotics, the current standard treatment.
“The bacteria that cause BV can be located in men, especially in penile skin and also in the urethra,” Lenka Vodstrcil, the study’s first author and a senior research fellow at Monash University, said in a news release. “This suggests that BV is probably sexually transmitted, and that is why so many women get it back again after treatment.”
The study noted: “Evidence of sexual exchange of bacterial vaginosis–associated organisms between partners suggests that male-partner treatment may increase the likelihood of cure.”
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Bacterial Vaginosis: Symptoms, Health Risks, Complications
Bacterial vaginosis (BV) can present differently in women — while some may not notice any symptoms, others might experience unusual vaginal discharge, a strong fishy or musty odour, itching or irritation around the vagina, and a burning sensation during urination.
According to the World Health Organization (WHO), BV is a common condition and generally does not lead to serious complications, but leaving it untreated can increase the risk of health issues. It has been linked to pregnancy complications such as spontaneous abortion and preterm delivery, a higher susceptibility to sexually transmitted infections, including HIV, and the development of pelvic inflammatory disease.
Certain habits can contribute to the risk of developing BV. Vaginal cleansing and douching disrupt the natural balance of bacteria, making infection more likely. Additionally, intra-vaginal practices such as inserting herbs or other products into the vagina can further increase susceptibility to BV, WHO says.
“We see very significant changes in a range of inflammatory markers, inflammatory cells and bacterial enzymes and products that result in damage to the epithelium — the lining of the reproductive tract,” explained senior author Professor Catriona Bradshaw of the Melbourne Sexual Health Centre.
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New Treatment Approach Shows Promise
As many as 164 monogamous couples were part of the randomised clinical trial conducted at multiple centres across Australia.
The study tested a new approach to treatment in which both partners received oral antibiotics, and male partners used topical creams. This method significantly reduced the recurrence rate by over half, reinforcing the theory that BV is sexually transmitted.
“Our trial has shown that reinfection from partners is causing a lot of the BV recurrence women experience, and provides evidence that BV is in fact a STI (sexually transmitted infection),” said Bradshaw.
At the Melbourne Sexual Health Centre, protocols have been changed and they are now treating both partners if BV is detected, a CNN report quoted Bradshaw as saying. She added that the research team is now developing a website with all information on male partner treatment.
An editorial published alongside the study said it would be a “paradigm shift” to see a common vaginal infection such as BV as an STD, and doctors would have to sensitise the male partners on transmission and encourage them for treatment.
“Our trial showed that treating male partners with a week of oral metronidazole and topical clindamycin, together with treatment of women, resulted in a lower rate of recurrence of bacterial vaginosis within 12 weeks than treatment of the woman alone,” the story noted.
While it was meant to be a 12-week trial, researchers stopped it early — not because there was anything wrong but because it became quickly apparent that treating both partners reduced BV occurrence to just 35 per cent.
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