This common vaginal condition may be sexually transmitted. What women should know

A common yet potentially serious vaginal infection affecting nearly one in three women worldwide should be recognised as a sexually transmitted infection (STI), according to a new study.

Bacterial vaginosis (BV) has long been dismissed as just another women’s health issue, but new research is turning that belief on its head. If confirmed, this could transform how the condition is treated, with both partners being involved in the process.

Ahead of International Women’s Day, it’s the perfect time to shed light on this common but often overlooked condition. So, what exactly is bacterial vaginosis, what are its symptoms, and how can it be treated? Let’s take a closer look.

What is bacterial vaginosis?

Bacterial vaginosis (BV) occurs when the natural balance of bacteria in the vagina is disrupted, leading to an overgrowth of certain bacteria while the “good” bacteria decline.

While antibiotics can treat BV, the condition is notoriously persistent, often forcing patients to undergo treatment repeatedly—sometimes five, six, or even ten times, which can take a toll on their quality of life and intimate relationships, said Dr Paul Nyirjesy, co-director of the Jefferson Vulvovaginal Health Center in Philadelphia, as reported by the New York Times.

“The bacteria that cause BV can be located in men, especially in penile skin and also in the urethra,” Lenka Vodstrcil, a senior research fellow at the Melbourne Sexual Health Centre at Monash University said in a news release. “This suggests that BV is probably sexually transmitted, and that is why so many women get it back again after treatment.”

According to Vodstrcil, around 50 per cent of women experience BV again within six months of treatment.

Hanae, a participant in a clinical trial on BV in Melbourne, Australia, shared her personal struggle with the condition.

“I started getting them quite recurrently. I’d go to doctors and get treated with antibiotics, and it would almost always come back,” she told CNN.

Frustrated by the cycle, she added, “It’s like not really worth it for me to even go to doctors.”

What are the symptoms and risks involved?

Bacterial vaginosis (BV) can cause itching, pain during urination, an unusual odour, and a thin, white vaginal discharge. However, for many women, BV does not show any symptoms at all.

If left untreated, BV can increase the risk of HIV and other STIs, according to the World Health Organization (WHO). Additionally, women with BV may develop pelvic inflammatory disease (PID)—an infection affecting the fallopian tubes, ovaries, or uterus, as noted by the WHO.

Experts warn that such infections can lead to infertility.

“We see very significant changes in a range of inflammatory markers, inflammatory cells and bacterial enzymes and products that result in damage to the epithelium — the lining of the reproductive tract,” Catriona Bradshaw, a sexual health physician at Melbourne’s Alfred Health and researcher at Monash University told CNN.

BV is also particularly dangerous during pregnancy, with the WHO warning that it can lead to premature birth, spontaneous abortion, and low birth weight in babies.

The ‘paradigm’ shift in BV treatment

For years, BV treatment focused solely on women. However, a recent Australian randomised trial has provided strong evidence that treating both partners—male and female—can significantly reduce the recurrence of BV.

The study, published in the New England Journal of Medicine, involved 164 heterosexual monogamous couples, divided into two groups.

In the first group, only women were treated with antibiotics, following the current global standard. In the second group, both partners received treatment—women took oral antibiotics, while men were given oral antibiotics along with a clindamycin cream to apply to the penis.

The results were striking: BV recurred in only 35 per cent of the partner-treatment group, compared to 63 per cent in the group where only women were treated.

“This highly effective intervention is inexpensive and brief, and for the first time, it has the potential to not only enhance cure rates for BV but also to prevent severe complications of BV,” said Bradshaw, one of the study’s authors.

Dr Christina Muzny and Dr Jack Sobel, infectious disease specialists who were not involved in the study, highlighted its importance.

“This trial gives us crucial information to teach clinicians and patients about the sexual transmission of BV and the advantages of treating the male partner. It is time to begin the discussion,” they wrote in an editorial accompanying the study.

Dr Muzny added that the findings of this study represent a “paradigm” shift that may even lead to medical bodies, like the US’ Centres for Disease Control, changing their treatment guidelines. “It’s time for men to take shared responsibility for treating this infection, she said.

The Melbourne Sexual Health Centre has already updated its treatment protocols, now treating both partners when BV is diagnosed.    If the condition is officially classified as an STI, it could become the most common sexually transmitted infection in the world—even surpassing chlamydia.

With input from agencies