Yes, Bacterial Vaginosis Can Be Sexually Transmitted

Just in time for International Women's Day, a new Australian study offers evidence for something many of us have suspected for years - bacterial vaginosis can indeed be passed on by male partners in the bedroom. For decades, the medical community has classified bacterial vaginosis as a "non-sexually transmitted condition" despite a bulk of anecdotal evidence of a clear link between getting it on and a BV occurrence. Join our in-house medical expert, Dr Sarah Welsh, as we explore why this research is so significant and what it could mean for BV treatment…  

What is Bacterial Vaginosis?

“Bacterial vaginosis (BV) is the most common vaginal infection in women of reproductive age, affecting approximately 15-30% of women in the United Kingdom. This condition occurs when there's an imbalance in the vaginal microbiome - when the "good" bacteria (lactobacilli) that normally dominate the vaginal environment become outnumbered by other bacteria types.

Symptoms of bacterial vaginosis typically include:

• A thin, grayish-white discharge

• A strong, fishy odour, particularly after sex

• Vaginal itching or irritation

• Burning during urination

However, many people who experience BV (about 50-75%) experience no symptoms at all, making it an often silent but persistent condition that isn’t always diagnosed. It’s really important to pick up on BV quickly, as if left untreated, it can increase the risk of sexually transmitted infections, cause complications during pregnancy including preterm birth, and lead to pelvic inflammatory disease. The infection can also cause uncomfortable symptoms like unusual discharge, itching, and odour. If in doubt, head along to your GP or healthcare provider for a chat.

What Was Traditionally Thought to Cause Bacterial Vaginosis?

BV has typically been thought to result from:

• Natural imbalances in vaginal pH

• Hormonal changes

• Use of perfumed products in the genital area

• Douching

• New or multiple sexual partners

However, whilst it was thought that penetrative sex could "trigger" BV, it wasn't necessarily believed to be "transmitted" during intercourse. The prevailing wisdom suggested that an element of sex - perhaps semen altering vaginal pH - could disrupt the microbiome, rather than specific bacteria being passed between partners. This perspective persisted partly because earlier studies showed treating only male partners with oral antibiotics didn't improve BV cure rates in women. As a result, standard treatment guidelines have focused exclusively on treating the female partner.

The Groundbreaking New Research

If you've been wrestling with BV's dodgy discharge and explored all possible explanations, the results of this study might seem obvious. However, this study is the first properly compelling evidence that BV can actually be a sexually transmitted infection. In this latest study published in New England Journal of Medicine, researchers in Australia studied 164 heterosexual, monogamous couples where the women had bacterial vaginosis (BV). When both partners received antimicrobial treatment, results were significantly better than when only women were treated.

Specifically, the study found that when both partners received treatment:

• The rate of BV cure in women after three months doubled (from approximately 40% to 80%)

• Recurrence rates dramatically decreased

• The presence of BV-associated bacteria in male partners also decreased significantly

The researchers identified that certain BV-associated bacteria were present on the penises of male partners and could be reintroduced during sexual intercourse, explaining the "revolving door" experience many have with recurring BV despite treatment.

Why This Research is Brilliant News for Women

This research represents a watershed moment for women's health for several reasons:

1. Validation: During my 10+ years working in NHS gynaecology, I heard many stories from women who reported a pattern of BV recurring after sex with the same partner, despite following treatment as advised. It can be really isolating and frustrating to repeatedly experience BV symptoms despite ‘doing everything right’, so it’s really positive to see validation of experiences that have often been dismissed.

2. Reduced Stigma: By acknowledging BV can be sexually transmitted, this research helps remove the implicit blame and shame often placed on women for "poor vaginal hygiene". I also hope that the wide publicising of this research encourages women to seek help from their GP if they have felt too ashamed or awkward to talk about smelly discharge. I promise you, we’ve heard it all and just want to help! If you’re unsure, show this study’s results to your healthcare provider to help explain why you’re there.

3. More Effective Treatment: Most importantly, this could lead to treatment protocols that actually work long-term, potentially ending the frustrating cycle of recurrence that affects up to 80% of people with BV within a year of treatment.

4. Framework for Further Research: A 2024 study from researchers at Harvard found a fatty acid present in olive oil might prove game-changing in blocking recurrent BV infections. Now, this latest research adds to the greater knowledge we’re building about how to treat and prevent reinfection.This study opens the door for more research into other conditions affecting women's reproductive health that may have been similarly misunderstood. As healthcare professionals, we need all the information and tools at our disposal to better help patients. Governments, let’s get more funding into women’s health research! 

Does This Change Bacterial Vaginosis Treatment?

So, what does this mean for BV VIPs (aka the club where we didn't ask for membership)? Well, it could potentially change how the condition is handled in longterm monogamous relationships. Current guidelines from major health organisations, including the NHS in the UK, may need to be updated to recommend:

• Treatment of male sexual partners alongside women

• Different antimicrobial approaches that address the specific bacteria found in male partners

• New conversations about prevention strategies for couples. Several studies have shown that condoms are up to 45% effective at preventing BV, and the Centre for Disease Control recommends their use for this purpose. Top tip: make sure to use natural, unscented/spermicide-free condoms to avoid irritation, soreness or yeast infections.

Looking Forward

Whilst it's very pleasing to see these results, it's equally frustrating that we've had to wait for so long to get evidence of something the HANX community, and women worldwide, have been shouting about for years. If you've been struggling with recurrent BV, this research suggests it may be worth discussing partner treatment with your healthcare provider. While official guidelines may take time to change, this groundbreaking study offers new hope for more effective long-term management of this common but often misunderstood condition. Roll on improved care - and even more research into women's health, please!”

Want more?

• Order same-day-dispatch BV treatment with discreet shipping now.

• Dive deep into the relationship between vaginal microbiome and BV. Read on.

• Is this fatty acid the holy grail of future BV treatment? Explore this pioneering study.

• Does your girlfriend keep getting UTIs? Here’s our gynae-approved guide for partners.