Antibiotic treatment of men with partners with BV – do they work?

Three confused bumbly bacteria with antibiotics raining down on their heads.

TL;DR

Recent studies reveal that antibiotic treatment in male partners does not significantly aid in the treatment of bacterial vaginosis (BV) in women. Despite multiple trials, the effectiveness of antibiotics in preventing or treating BV through male treatment remains unsubstantiated, highlighting the need for alternative approaches and the importance of condom use in preventing transmission.

So far there have been six randomised controlled trials to determine whether treating a male sexual partner helps in the treatment of bacterial vaginosis in women. Five of the six failed to show any benefit of treating men with antibiotics.

The studies have their own issues in terms of methodology, but the fact is that antibiotics do not address the biofilm and thus have no way to be very effective in either men or women. Antibiotics are not a very effective treatment for recurrent BV in women, and the same remains true for any lingering bacteria found in the genital tract of men.

When it came to condom use a means of preventing BV transmission, it works to protect men from biofilm formation on their penises, particularly in uncircumcised men. There have been several studies that there is a consistent overall protective effect of reinfection and first instance incidents of BV in women, which isn’t much help with recurrent BV in women.

We’ve written a book just for men on removing disruptive penile microbiomes, Killing BV: Penis Treatment Guide. It’s the only one of its kind in the world.

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Antibiotic treatment in men is not a solution to BV in women.

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Studies into antibiotic treatment of men for female BV

#1. “Unfortunately, no evidence was found supporting the treatment [with antibiotics] of partners of women affected by bacterial vaginosis.”

Vutyavanich T, Pongsuthirak P, Vannareumol P, Ruangsri RA, Luangsook P. A randomized double-blind trial of tinidazole treatment of the sexual partners of females with bacterial vaginosisObstet. Gynecol. 82 (4 Pt 1), 550–554 (1993).

#2.  “Treatment of the male partner [with antibiotics] did not affect subjective symptoms [of BV], clinical signs, and isolation rates of Gardnerella vaginalis at 1 and 5 weeks after treatment.”

Vejtorp M, Bollerup AC, Vejtorp L et al.Bacterial vaginosis: a double-blind randomized trial of the effect of treatment of the sexual partnerBr. J. Obstet. Gynaecol. 95(9), 920–926 (1988).

#3. “In conclusion, treating [with antibiotics] the sexual partners of women with bacterial vaginosis does not seem to increase the cure rate.”

Moi H, Erkkola R, Jerve F et al.Should male consorts of women with bacterial vaginosis be treated?Genitourin. Med. 65(4), 263–268 (1989).

#4. “Recurrence rates  [of BV] by Gram-stained smear criteria between patient and partner treatment groups at five and eight weeks after initiation of treatment [with antibiotics] were also not significantly different between the two patient regimens.”

Mengel MB, Berg AO, Weaver CH et al.The effectiveness of single-dose metronidazole therapy for patients and their partners with bacterial vaginosisJ. Fam. Pract. 28(2), 163–171 (1989).

#5. “This study … does not support the suggestion that male treatment [with antibiotics] markedly reduces the short term recurrence rate [of BV].”

Colli E, Landoni M, Parazzini F. Treatment of male partners and recurrence of bacterial vaginosis: a randomised trial.Genitourin. Med. 73(4), 267–270 (1997).



Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
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