About BV
Bacterial vaginosis (BV) is a very common vaginal infection that affects about 1 in 3 people with a vagina worldwide. BV is caused by a disruption in the bacteria present in the vagina. In BV, the ‘good’ or ‘healthy’ bacteria that are normally present in the vagina (called lactobacilli) are replaced with a group of ‘bad’ or ‘non-optimal’ bacteria (referred to as BV-bacteria). This disruption in bacteria can cause symptoms such as discharge and odour. Most people with BV do not experience complications, but BV can increase the risk of developing pelvic inflammatory disease, getting a sexually transmitted infection, and experiencing pregnancy complications like preterm birth.
BV can be treated with oral or vaginal antibiotics given only to the individual diagnosed with BV. However, 1 in 2 people with a vagina will experience BV recurrence within 3 to 6 months of completing antibiotics. People with a regular sexual partner are more likely to get BV back again after antibiotics.
BV-bacteria can be carried by partners with a penis and exchanged during sex
Research studies have shown that people with a penis who have a partner with BV can carry BV-bacteria in the urethra (the tube that passes urine) and on the skin of the penis (particularly under the foreskin, but also on the head of the penis and the penile shaft). Penile carriage of BV bacteria is usually asymptomatic and there is no current method to test for BV-bacteria on the penis, so people with a penis can carry the BV-bacteria without knowing. Research has shown that BV-bacteria can be exchanged between partners during sex. This exchange of BV-bacteria can result in people with a vagina acquiring BV for the first time. In people who have recently been treated for BV, this exchange of BV-bacteria during sex can result in the BV coming back after treatment.
Preventing BV recurrence
A recent clinical trial found that BV cure is greatly improved when partners with a penis are treated with antibiotics at the same time as the partner diagnosed with BV. The treatment for people with a penis involves taking two different antibiotics: metronidazole, which is a tablet that is taken by mouth, and 2% clindamycin cream, which is an antibiotic cream that is applied to the skin of the penis. Both antibiotics are taken twice a day for 7 days and are best taken at the same time the partner with a vagina is taking their antibiotics. We have medication instructions that explain the use of these two antibiotics.
Safety and efficacy of partner treatment
Both clindamycin and metronidazole have been used for many years to treat people with a vagina who have BV. In the trial both antibiotics were shown to be safe in people with a penis. A small number of people may experience mild redness or irritation of the penile skin from the clindamycin cream, and this usually does not result in the need to stop the cream.
Where can I get help?
- Visit your local doctor or regular healthcare professional
- Visit us at MSHC
- Visit one of our partner GP clinics
- Visit a sexual health service near you
- Access treatment through PACT; a partner treatment study at MSHC for monogamous LGBTQIA+ couples
We acknowledge that our research may not fully reflect the diversity of the community we aim to support, including people who are intersex. We encourage individuals to discuss their needs with their clinician to determine the most appropriate care.