In a pretty big sexual health milestone, new research has discovered the missing link for people suffering from recurring (and frustrating!) bacterial vaginosis could be their sexual partners with a penis.
Questioning long-held beliefs around how bacterial vaginosis (BV) can be passed on, the finding could hold implications for the way we treat the condition — including possible changes to national guidelines down the line.
The research from Monash University and Alfred Health, published on Thursday, has found BV shouldn’t just be chalked up to a vaginal imbalance because it’s actually a sexually transmitted infection (STI) passed from partners with penises too.
Now in case you’re one of the lucky few who’ve managed to avoid the excruciating rounds of antibiotics and creams needed to kick these to the curb, let’s jump into a quick sexual health lesson.
Bacterial vaginosis (BV) is a pretty common condition, affecting about one-third of women globally. It’s long been approached as an imbalance in the vaginal microbiome, as in, an overgrowth of harmful “bad” bacteria in the vagina.
While some people may be asymptomatic, you might also know the condition for the tell-tale itchiness and “fishy” odour that’ll have you rushing to the GPs, stat.
But beyond the insane discomfort, the condition could also cause some serious problems, such as infertility, premature births, miscarriages, and a greater risk of catching STIs.
According to the government’s Health Direct website, most cases of BV are related to sexual activity. You could be more likely to get it if you have a new or multiple sexual partners, typically don’t use a condom, are a smoker, practice douching, or have a sexual partner with a vagina — because BV is known to spread between female sexual partners.
Now the new research by Professor Catriona Bradshaw and Dr Lenka Vodstrcil, published in the New England Journal of Medicine this week, could have huge implications for women’s health, including better prevention and fewer recurrence rates of this pesky infection.
What did the BV study find?
The standard practice of treating BV as a disruption to the vaginal microbiome — prescribing oral antibiotic or a topical antibiotic cream to women — means that more than 50 per cent get it back within three months after the standard week-long treatment, the researchers noted.
But through the trial of 164 heterosexual and monogamous couples with BV, the researchers found that treating the condition as an STI — with both sexual partners treated simultaneously — achieves significantly higher cure rates than the current practice.
In fact, they even stopped the trial early — at 12 weeks after treatment — when it became pretty apparent that BV recurrence was halved in the partner treatment group compared to treating women alone.
Why is this a big deal? Well, it means partners with penises actually could be carriers of the bacteria responsible for BV, and if they’re not treated, they could be unknowingly passing it back, leading to frustrating cycles of recurrence.
The trial was so successful they were able to end it early. (Image source: PeopleImages / iStock)
“This successful intervention is relatively cheap and short and has the potential for the first time to not only improve BV cure for women, but opens up exciting new opportunities for BV prevention, and prevention of the serious complications associated with BV,” explained Professor Bradshaw in a statement.
In the past, studies have shown that men may harbor bacterial species associated with bacterial vaginosis on the penile skin and inside the penis. But previous trials that included male partners didn’t show improved cure rates in their female partners, she noted.
“This was interpreted as evidence against sexual transmission,” Professor Bradshaw said.
“However, these studies had design limitations, and none used a combination of oral and topical antibiotics to adequately clear BV bacteria in men, especially from the penile-skin site.
“Our trial has shown that reinfection from partners is causing a lot of the BV recurrence women experience, and provides evidence that BV is in fact an STI.”
What happens now with BV treatment?
Following the results, the Melbourne Sexual Health Centre — where the research was conducted — has changed its clinical practice to treat couples.
A new website for health professionals and consumers has also been designed for all the information needed to prescribe and access partner treatment.
This was meant to make the important information accessible to all, Professor Bradshaw said, noting changes in national and international treatment guidelines “always take time”.
“So we felt an obligation to provide accurate online and downloadable information at the time that the results of the trial are published,” she said.
Ged Kearney, assistant minister for health and aged care, acknowledged the significance of the study.
“Bacterial vaginosis is a common condition that can have serious consequences for women, such as early pregnancy loss and premature labour. It’s critical that we have a more effective way to treat it,” she said.
So does this mean we’re going to see health guidelines revamped soon? Maybe not just yet, according to Clare Keogh, sexual health doctor at at SHINE SA, who described the trial as “promising” although it would not change clinical practice at this stage.
“We don’t have enough evidence to change guidelines currently,” she told ABC News.
Additionally, there are questions around the way compliance with the regime could work, given the partner with the penis aren’t directly affected by the condition.
But still, it’s a pretty big finding for those of us who’ve had to deal with repeated rounds of antibiotics and creams, and should spark an important conversation between partners around their sexual health.
In case you’re curious to check out the study in full, you can read it here.
Lead image: IMDb
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