Bacterial Vaginosis (BV) is a common condition resulting from an imbalance of the vaginal flora, the bacteria naturally present in the vagina. This imbalance occurs when protective Lactobacillus bacteria decrease, allowing an overgrowth of other bacteria. The relationship between BV and male partners is often misunderstood, leading to questions about transmission and influence.
What Bacterial Vaginosis Is
Bacterial Vaginosis is a disruption of the natural vaginal environment, not a traditional sexually transmitted infection (STI). A healthy vagina is dominated by Lactobacillus species, which produce lactic acid to maintain an acidic environment. BV occurs when these protective bacteria are reduced, leading to an overgrowth of anaerobic bacteria, such as Gardnerella vaginalis and Atopobium vaginae.
Symptoms often include a thin, watery vaginal discharge that is typically white or gray. This discharge is frequently accompanied by a distinct, foul-smelling, or “fishy” odor, which can become stronger after sexual intercourse. Some individuals may also experience mild irritation, itching, or a burning sensation during urination, though many people with BV report no symptoms at all.
How Male Partners Influence BV
While BV is an internal imbalance and men cannot technically “get” or show symptoms of it, male partners play a significant role in its recurrence. Studies suggest that BV-associated bacteria can colonize the male genital area, particularly the urethra and skin, allowing the bacteria to be exchanged during sexual activity.
During intercourse, the introduction of these bacteria, or factors like the slightly alkaline pH of semen, can disrupt the delicate vaginal environment. This disruption can trigger the bacterial overgrowth that leads to BV symptoms in the female partner, which is why BV is strongly associated with sexual activity.
Recent research shows that treating the male partner can significantly reduce the BV recurrence rate in the female partner. This suggests that re-exposure to the BV-associated bacteria carried by the male partner is a major contributor to recurring infections.
Effective Treatment Options
The standard medical treatment for BV involves prescription antibiotics to eliminate the overgrowth of anaerobic bacteria. The most common medications are metronidazole and clindamycin, available as oral tablets or as topical gels and creams applied directly into the vagina.
A standard treatment course for metronidazole is typically 500 mg taken orally twice a day for seven days. It is necessary to complete the full course of medication as prescribed, even if symptoms disappear quickly, to ensure the infection is fully cleared and prevent recurrence or resistance.
Historically, routine treatment for male partners was not recommended. However, in cases of persistent or recurring BV, a healthcare provider may now recommend combined oral and topical antibiotic treatment for the male partner. This approach aims to clear the BV-associated bacteria from the male genital area, reducing the high rate of recurrence for the female partner.
Steps to Prevent BV Recurrence
Preventing BV recurrence centers on maintaining a healthy, acidic vaginal environment and minimizing the introduction of disruptive factors. It is recommended to avoid douching, as this practice washes away protective Lactobacillus bacteria and upsets the natural pH balance. Similarly, avoid scented products like bubble baths, scented soaps, and feminine hygiene sprays, which can irritate the area and disrupt the flora.
Adopting hygiene and behavioral habits can also aid in long-term maintenance:
- Wipe from front to back after using the toilet to prevent bacteria from the rectal area from entering the vagina.
- Wear cotton underwear instead of synthetic fabrics to promote airflow and keep the genital area dry.
- Use condoms consistently during sexual activity to act as a barrier against the exchange of BV-associated bacteria.
- Rinse the genital area with water before and after intercourse to reduce the disruptive effect of semen or bacterial exchange.
Probiotics or boric acid suppositories are sometimes suggested as supplementary measures to help restore the Lactobacillus flora, but these should always be discussed with a doctor first.