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Bacterial vaginosis can be passed to women by male sexual partners, researchers have said, challenging the longstanding view that it is not a sexually transmitted infection.
Experts say the study offers a new way to reduce the risk of the infection returning in women, with another scientist saying it showed up the UK’s NHS website as “outdated and misleading”.
BV is thought to affect up to a third of reproductive-aged women and is caused by an overgrowth of harmful bacteria in the vagina and a reduction in “good” bacteria.
While some people experience no symptoms, BV can cause unusual, unpleasant-smelling discharge and can increase the chance of miscarriage and premature birth in pregnant women. It has also been associated with an increased risk of infertility.
Writing in the New England Journal of Medicine, researchers in Australia report how they studied two groups of monogamous, heterosexual couples in which the women had BV. In one group of 81 couples, the women and their male partners were given oral and topical antimicrobial treatment. In the other group of 83 couples, only women received the tablets and cream. The results were stark.
“The trial was stopped by the data and safety monitoring board after 150 couples had completed the 12-week follow-up period because treatment of the woman only was inferior to treatment of both the woman and her male partner,” the researchers write.
Overall, 24 of 69 women (35%) in the group where both partners were treated had BV return, compared with 43 of the 68 women in the group where only women were treated. In addition, the team found the average time until an infection returned was longer when both partners were treated.
While sex has long been known to be a trigger for BV, experts previously thought it did not meet the criteria for a sexually transmitted infection, partly because earlier research found no improvement in cure rates in women with BV when male partners alone were given oral antimicrobials.
Dr Janet Wilson, a consultant in sexual health at Leeds teaching hospitals NHS trust who was not involved with the work, said the study, while small, offered some evidence to support the view BV was an STI. But she added that many people with BV became “celibate” and found the condition could still be difficult to clear – meaning treating partners did not provide a full solution for preventing infections recurring.
“This is a great paper and it will change how we manage BV in those in long-term monogamous relationships,” she said, adding it was a “big step forward”.
Of the NHS website’s current page on BV, she said: “Much of the information is outdated and misleading. It should be updated in line with current evidence.”
