Male partner treatment and the potential sexual transmission of bacterial vaginosis: considerations for patient counseling and clinical application in the United States.

Abstract

Bacterial vaginosis, the most common cause of vaginal complaints among reproductive-aged women, is highly recurrent and often challenging to treat. Whether bacterial vaginosis is sexually transmissible has long been questioned by patients, providers, and researchers. Multiple prior studies evaluating male partner treatment have failed to show an improvement in outcomes. However, for the first time, an open-label, randomized controlled trial in Australia showed a decrease in bacterial vaginosis recurrences in women whose male partners were treated with a combination of oral metronidazole and topical clindamycin cream over 12 weeks. Many unanswered questions remain; more research is needed to investigate whether the results of this trial are applicable to broader populations. Nonetheless, these results have garnered substantial public attention. This has resulted in increasing questions from patients regarding both male partner treatment and the sexual transmissibility of bacterial vaginosis. Here, we review evidence regarding the sexual transmission of bacterial vaginosis, discuss complexities with potential implementation of male partner treatment, and provide a framework from which to counsel patients.