Bacterial vaginosis (BV) is a common vaginal condition caused by an imbalance of bacteria. It often presents with unusual discharge and odor. The transmission of BV, particularly concerning male partners, is frequently misunderstood.
Understanding Bacterial Vaginosis
Bacterial vaginosis occurs when the natural balance of bacteria in the vagina is disrupted, involving an overgrowth of certain anaerobic bacteria and a decrease in beneficial Lactobacillus species. While BV is the most common vaginal infection, it is not considered a sexually transmitted infection (STI) in the traditional sense, as it can affect individuals who are not sexually active. However, sexual activity can increase its likelihood. Common symptoms include off-white, gray, or greenish vaginal discharge, a “fishy” odor that may be stronger after sex, and sometimes vaginal itching or burning during urination. Many individuals with BV experience no symptoms.
Male Partners and BV Influence
Men do not “get” BV or transmit it like a typical infection, as they do not have vaginas. However, male partners can influence the vaginal microbiome, potentially contributing to BV development. A primary mechanism is the alkaline pH of semen. The vagina naturally maintains an acidic environment due to Lactobacillus bacteria, which helps keep other bacteria in check. When semen is introduced into the vagina, its alkaline pH can temporarily raise the vaginal pH, creating conditions favorable for anaerobic bacteria to thrive and disrupt the natural balance.
The introduction of new bacteria from a partner can also trigger an imbalance in the vaginal ecosystem. Sexual activity can upset the normal balance of vaginal bacteria. Men typically do not experience BV symptoms, making it difficult to identify their potential role.
Role of Male Partners in Recurrence
Male partners can contribute to the recurrence of BV, even after successful treatment. Continued exposure to semen’s alkaline pH through unprotected intercourse can repeatedly alter the vaginal environment, making it susceptible to bacterial overgrowth. Sexual activity during or immediately after treatment might also reintroduce disrupting factors before the vaginal flora has fully recovered. It is generally recommended to avoid sexual activity for about seven days after completing BV treatment to allow the vaginal environment to stabilize.
While current guidelines generally do not recommend routine treatment of male sexual partners for BV, recent research suggests that treating male partners with certain antibiotics might reduce recurrence rates in women. One study indicated that treating male partners with oral and topical antibiotics significantly reduced BV recurrence. This indicates that BV-associated bacteria may be exchanged during intercourse, highlighting a potential role for male partners in recurrence.
Prevention and Management Strategies
Implementing practices can help prevent BV and manage its recurrence. Consistent condom use during sexual activity can minimize semen exposure and the introduction of new bacteria, which may help lower the risk of BV. Studies show that condom use can reduce the risk of BV by a significant percentage. Maintaining proper hygiene for both partners is beneficial, including showering before and after intercourse.
Avoid vaginal irritants such as douching, scented products, and harsh soaps, as these can disrupt the natural pH balance of the vagina. Open communication between partners about sexual health and BV can facilitate understanding and adherence to prevention strategies. If BV symptoms are present or recurrent, consulting a healthcare provider for diagnosis and appropriate treatment is important. A healthcare professional can also discuss the potential role of partner involvement in managing persistent cases.