Bacterial Vaginosis May Be Classified as an STI: What You Need to Know

New Research Challenges BV’s Classification

Bacterial vaginosis (BV), a common vaginal infection affecting millions of women worldwide, may soon be reclassified as a sexually transmitted infection (STI) due to groundbreaking research. While BV has traditionally been viewed as a condition originating from an imbalance of vaginal bacteria, new evidence suggests it may be transmitted sexually. A recent study published in The New England Journal of Medicine found that treating both partners significantly reduces the high recurrence rate of BV in women, challenging the perception that BV is not an STI. This discovery could revolutionize how BV is diagnosed, treated, and prevented.

BV as an STI: What Does the Research Reveal?

The study, conducted by researchers at the University of Melbourne, involved 164 heterosexual monogamous couples where the female partner had BV. In the treatment group, both partners received antimicrobial therapy: women were given standard antibiotics, while men received a combination of oral and topical antibiotics. The results were striking—women whose partners were also treated had a 35% recurrence rate of BV within 12 weeks, compared to a 63% recurrence rate in the control group where only the women were treated. This strong evidence suggests that BV may be transmitted between sexual partners and that treating both partners can significantly improve outcomes.

The researchers also noted that BV-associated bacteria are exchanged during sexual intercourse, with men carrying these bacteria in the urethra and on the penile skin. This challenges the long-held belief that BV originates from an overgrowth of bacteria naturally present in the vagina. The study’s findings align with the profile of an STI, where treatment of both partners is essential to prevent reinfection.

A Breakthrough in BV Treatment

The study’s lead author, Dr. Catriona Bradshaw, emphasized the importance of this breakthrough. She explained that previous attempts to reduce BV recurrence by treating male partners had failed, largely because they only used oral antibiotics. This study, however, used a combination of oral and topical antibiotics for men, targeting bacteria on both the penile skin and in the urethra. This dual approach appears to have been key to the study’s success, with mild side effects such as nausea, headache, and a metallic taste being the only downsides.

For women, BV is often treated with antibiotics, but the infection is notoriously difficult to cure, with high recurrence rates. By addressing the bacteria in both partners, this new approach could reduce the likelihood of reinfection and improve treatment success.

Why BV Hasn’t Been Classified as an STI—Until Now

Despite the mounting evidence, BV has not been widely classified as an STI because it has been believed to originate from an imbalance of naturally occurring bacteria in the vagina. However, this new research suggests that sexual transmission plays a significant role in BV’s development and recurrence. For example, BV is more likely to develop after exposure to a new sexual partner without the use of condoms or other barrier methods. Additionally, the risk of recurrence is threefold higher when a woman has a regular sexual partner, further supporting the idea that BV may be sexually transmitted.

Dr. Bradshaw and her team have spent 20 years building a body of evidence to challenge the traditional understanding of BV. Their work highlights the need for a reclassification of BV as an STI, which could have important implications for public health and clinical practice.

Implications for Treatment and Prevention

The study’s findings are a game-changer for BV treatment and prevention. Healthcare providers may now consider treating both partners when diagnosing BV in women, similar to how other STIs are managed. This approach could significantly reduce recurrence rates and improve quality of life for women who experience the uncomfortable symptoms of BV, such as unusual vaginal discharge, a fishy odor, and vaginal itching.

However, more research is needed to confirm these findings in diverse populations and settings. Dr. Bradshaw and her team are now investigating why some women continue to experience BV even after treatment, as well as whether specific strains of bacteria in men may be responsible for recurrence in women. These insights could lead to better diagnostic tests for both men and women and more targeted treatment strategies.

What This Means for the Future

The reclassification of BV as an STI could also raise awareness about the importance of preventive measures, such as using condoms and limiting the number of sexual partners. For women without a current partner, the study underscores the importance of regular gynecological check-ups and education about BV symptoms and risks.

In addition to their research, the study authors have created a website with resources for healthcare professionals, patients, and male partners to help spread awareness about BV and its treatment. As more research emerges, the hope is that BV will be better understood and managed, reducing its impact on millions of people worldwide.