Does Treating Male Partners Really Cure BV? A Closer Look
Lately, news articles have been claiming that bacterial vaginosis (BV) is actually a sexually transmitted infection (STI) and that treating male partners could be the miracle we’ve all been looking for. Headlines have made many people believe that this is the big solution for those struggling with BV. Headlines such as: “A Third of Women Get This Infection. The Fix: Treat Their Male partners”, “BV is and STD and we’ve been treating it wrong for years”, and “…landmark study reveals men are the missing link”, which paint an oversimplified and misleading picture. These sensationalized claims don’t just distort the science-they misinform the public.
While this study is a step forward, it does not provide a definitive solution to BV. Treating chronic BV is far more complex than headlines suggest. Bacterial Vaginosis results from imbalances in vaginal bacteria, specifically the loss of protective lactobacillus and the lactic acid it produces, shifts in the immune system, hormones, and other factors. This is why some women develop BV infections without being sexually active, proving that it’s not as simple as transient bacteria from a male partner’s skin or urethra. The way this new research is being talked about makes it sound like treating a male partner is a guaranteed fix-which it isn’t.
What the Study Actually Found
The most recent study released by the New England Journal of Medicine that fueled this discussion looked at 164 couples (although studies treating the male partner aren’t new). It found that when both the woman and her male partner were treated with metronidazole antibiotics, particularly the addition of topical metronidazole antibiotic applied to the penile skin, the rate of recurrence dropped from 63% to 35%. This suggests that treating male partners can help some women but we still don’t know which women will benefit from partner treatment and which won’t or WHY the addition of topical metronidazole helped reduce recurrence rates. If BV was simply an STI, and treating the male partner was the panacea we’ve been waiting for, then the cure rate would be 100%.
I agree that treating the male partner alongside the patient can be warranted, but since the antibiotic metronidazole carries some risks, automatically prescribing it without first assessing the male partner’s medical history to ensure they can safely take metronidazole is not a responsible approach.
What The Study and Headlines Left Out
If we accept male partner treatment as the ultimate solution as headlines suggest we risk overlooking other critical factors in chronic BV infection and recurrence particularly WHY the beneficial bacteria are depleted in the first place.
Certain lactobacillus bacteria play a key role by producing lactic acid, which keeps the vaginal pH between 3.5 and 4.5, creating an inhospitable environment for BV-associated bacteria. A comprehensive approach to BV treatment should consider:
- Temporarily supplementing with the right probiotic strains until lactobacillus levels are restored (specifically L. crispatus or L. gasseri)
- Evaluating hygiene habits that could be contributing to bacterial imbalances
- Addressing hormonal influences or underlying medical conditions that impact the vaginal beneficial bacterial
- Investigating chronic inflammation affecting the vaginal microbiome, mucosal, or pelvic regions.
- Prophylactically treating the male partner as an adjunct to standard treatment
A critical point missing from both the study and media coverage is that BV-associated bacteria are often transiently present in the vagina—but in a healthy vaginal microbiome, they do not automatically cause infection. A properly functioning immune response, along with sufficient levels of lactobacillus bacteria (particularly L. crispatus and L. gasseri), helps prevent these BV-associated bacteria from overgrowing by maintaining the production of lactic acid, keeping vaginal pH in a range that inhibits the BV-associated pathogens from becoming problematic.
It’s important to emphasize that this is not about blaming or shaming women for causing their BV infection. However, the fact remains that the if the vaginal microbiome is depleted of lactic acid producing lactobacillus, treating the male partner is unlikely to result in long-term success, as has been shown numerous times via the various studies conducted on this very topic. Without restoring the necessary beneficial lactobacillus bacteria and acidity levels—a critical factor, the very foundation of vaginal health, that has been ignored in both the study and the media frenzy surrounding it, chronic BV is likely to persist or return, regardless of dual partner treatment.
The Flawed 12-week Endpoint: A Critical Oversight
If that weren’t enough let’s talk about the GLARING problem with how this study partially measured success: it blatantly ignored the well-documented timeline of BV recurrence. Typically, 50% of BV recurrences happen 12 weeks after treatment, yet this study conveniently ended at that exact timeframe making this an incredibly flawed endpoint for measuring success going so far as to claim the regimen was so effective that an independent safety-monitoring group recommended halting the trial early so all participants could access it. Seriously? Cutting the study at 12 weeks and declaring “game-changing” success isn’t just misleading, it’s bad science. Shame on them for pushing this as a major breakthrough while stopping the study at the very timeframe where failure is most likely to start occurring!! Follow participants for 1 year and then tell me how successful your treatment plan is.
The Bottom Line
This study offers valuable insights, but it does not redefine BV as an STI or confirm that treating male partners is the magic bullet some headlines suggest. While dual treatment shows promise for reducing recurrence in some cases, BV remains a complex condition influenced by far more than sexual transmission.
Instead of embracing flawed conclusions drawn from study methods that failed to account for key confounding factors such as vaginal microbiome or hormonal influences prior to treatment, we need research that extends beyond the 12-week window, where recurrence is most likely to appear, and accounts for the lactic acid producing lactobacillus levels before and after treatment. Without addressing why L. crispatus or L. gasseri levels are depleted in the first place, co-treating male partners will never be a universal solution.
Moving forward, the conversation should shift away from quick fixes and toward comprehensive approaches that prioritize investigating underlying causes, restoring a healthy vaginal microbiome, and tailoring treatment accordingly. Only then can we hope to develop real, lasting solutions for BV—ones based on well-designed study methods, not sensationalism.
References:
Healthy Hooha 
Leave a comment