A new study from Australia has shed light on a common infection that affects millions of people globally, suggesting that it might be a sexually transmitted infection (STI) after all. Bacterial vaginosis (BV), a condition that affects many people with vaginas, has long been misunderstood in terms of its transmission and classification. Though it is not currently classified as an STI, this groundbreaking research, published in the New England Journal of Medicine, challenges that status and may change the way we approach and treat this condition.
What is Bacterial Vaginosis (BV)?
Bacterial vaginosis is a common vaginal infection that occurs when the balance of bacteria in the vagina is disrupted. Normally, the vagina contains a mix of “good” bacteria, like Lactobacillus, and “bad” bacteria. However, when the harmful bacteria outgrow the beneficial bacteria, it can lead to BV.
According to the Cleveland Clinic, about 35% of people with a vagina will develop BV at some point in their lives. While it often presents no symptoms, it can cause several noticeable issues for those affected. These include unusual, off-white vaginal discharge, a distinct “fishy” odor, and irritation in some individuals. However, some people with BV may not experience any symptoms at all, which can make it challenging to detect without a doctor’s examination.
How Can You Develop BV?
Anyone with a vagina can get bacterial vaginosis, but it is most common among people who are sexually active. Several factors can increase the risk of developing BV, including:
Having multiple sexual partners
Having a new sexual partner
Not using condoms or dental dams
Using douches, which can disrupt the natural balance of vaginal bacteria
Taking antibiotics, which can also affect bacterial balance
Pregnancy or using an intrauterine device (IUD)
These risk factors point to potential links between BV and sexual activity, suggesting that BV might have a sexually transmitted component, which has yet to be definitively proven in the scientific community.
Why Might BV Be an STI?
In the study led by researchers from Monash University and Alfred Health at the Melbourne Sexual Health Centre, 164 couples participated in a trial where the woman in each relationship had been diagnosed with BV. The couples involved in the study were all in monogamous relationships, which helped control for other potential sources of infection.
What set this study apart was its approach to treatment. In half of the couples, both the woman and her male partner were treated for BV. The male partner was given an oral antibiotic as well as a topical antibiotic cream. In the other half of the couples, only the women were treated.
The results were telling: the cure rates were significantly higher when both partners were treated, which mirrors the approach used for other sexually transmitted infections. This led the researchers to hypothesize that reinfection from male partners might be a significant cause of BV recurrence in women, further supporting the argument that BV could be sexually transmitted.
Lead researcher Prof. Catriona Bradshaw commented on the findings, saying: “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.” However, she acknowledged that the exact bacteria responsible for BV are still not completely understood. She believes that advances in genomic sequencing will eventually help identify the specific bacteria involved, which may clarify the full picture of BV’s transmission.
As a result of these findings, the Melbourne Sexual Health Centre has revised its clinical approach, now routinely treating both partners when BV is diagnosed.
Current Treatment for BV
BV is typically diagnosed by a healthcare provider through a physical exam and a sample of vaginal discharge. If diagnosed, treatment usually involves antibiotics, either in the form of a vaginal gel, cream, or oral pills. The most common treatment is metronidazole, which is effective at reducing the growth of the harmful bacteria.
While BV is generally treatable, it is not uncommon for the infection to recur, especially if only the woman is treated and the male partner is not. This recurring nature of BV has led many to wonder if addressing the infection in both partners might reduce recurrence rates and improve long-term outcomes.
It’s also important to note that BV is not an STI in the traditional sense (like chlamydia or gonorrhea), as it is not typically spread through penetrative sexual intercourse. However, the study’s findings suggest that sexual contact can facilitate the transmission of the bacteria involved in BV, hence the growing argument that it could be classified as an STI.
What Does This Mean for the Future?
The new findings regarding BV could have significant implications for how healthcare providers diagnose and treat the condition. If further research confirms that BV is indeed sexually transmitted, it could change public health recommendations and treatment protocols for this infection.
It also raises important questions about the classification of other vaginal infections and their potential link to sexual activity. Understanding BV’s full transmission cycle is critical to improving treatment and reducing the recurrence of the infection, which many people experience despite treatment.
Conclusion
Bacterial vaginosis is a common but often misunderstood infection, and the recent study from Australia has opened new doors to understanding how it spreads. If BV is officially recognized as a sexually transmitted infection, it could lead to changes in clinical practice and a more comprehensive approach to managing the condition.
For now, if you suspect you have BV, it is essential to consult a healthcare provider for a proper diagnosis and treatment. And, if you are in a monogamous relationship, it may be worth discussing the possibility of treating both partners to avoid reinfection and help manage the recurrence of BV.
