Treatment of male partners along with women can help stop bacterial vaginosis

Treatment for two than one can help prevent another period of an ordinary and unpleasant vaginal syndrome.

For many women who develop bacterial vaginosis, the syndrome returns weeks or months after treatment. A clinical test of women in monogamous relationships with male partners found that the treatment of both partners significantly reduced the chance of repetition, researchers report on March 5 New England Journal of Medicine. When both partners were treated, 35 percent of women again developed bacterial vaginosis, while in the treatment group only for women, it was 63 percent.

The treatment approach is based on past research finding that sexual transmission can constitute several recurrent episodes of bacterial vaginosis. In the new trial, women received standard treatment: either an oral antibiotic or an intravaginal antibiotic cream or gel. In the group in which both partners were treated, the male partner took the oral antibiotic and applied an antibiotic cream to the penis skin for seven days. In the treatment group only for women, 43 out of 68 developed bacterial vaginosis within 12 weeks, while only 24 of 69 did when both partners received treatment.

Bacterial vaginosis affects approximately 30 percent of women of reproductive age worldwide. The syndrome stems from an imbalance in the vagina microbiot. In a healthy vagina, Lactobacillus Bacteria prevail. In bacterial vaginosis, there is a decrease in Lactobacillus and an overload of some pathogenic bacteria. The cause of imbalance is not known.

One challenge in the treatment of bacterial vaginosis is that “is not the same in all people,” says Caroline Mitchell, director of the Vulvovaginal Disorder Program at Massachusetts General Hospital in Boston. There may be a predominant abundance of a particular pathogenic bacteria or a mixture of pathogenic bacteria without a predominant type, she says.

Women with bacterial vaginosis can be asymptomatic. Those with symptoms have discharge and vaginal odor. Some women suffer irritation, too. Bacterial vaginosis also increases the risk of some gynecological complications and pregnancy, including sexually transmitted infections, inflammatory pelvic diseases and premature births.

“It’s a big deal,” says Mitchell, who was not involved in trial. “People think about it as a worrying state – it’s more than that. It is very divisive to people. “

A study of 62 women who had repeated bacterial vaginosis found that the situation adversely affected sexual health by 70 percent, physical health for 68 percent and mental health by 75 percent, researchers reported in 2023 in BMC Women’s Health.

The syndrome is considered repeated if it occurs three or more times within a year. It is not known why it can be difficult to cure bacterial vaginosis. Antibiotics resistance or the development of biofilms that support treatment from pathogenic bacteria are possible explanations. Sexual transmission is another possible contributor. Pathogenic bacteria can inhabit the skin of the penis and in the urethra. Past research has found that women with a regular sexual partner were twice as likely to experience repetition compared to those without.

“We have so few remedies” to treat bacterial vaginosis – both classes of antibiotics recommended for treatment have remained the same since 1982, says Mitchell. She sees this new approach as another tool, and while it is not important for all repeated occasions, “I think for some people it will be a great tool.”