It makes sense to want to turn things around quickly when you’re dealing with an itchy vaginal condition. So it’s understandably frustrating when you get treatment, only for the condition to return again and again. Unfortunately, that’s the reality for many people with bacterial vaginosis (BV).
Now there are new treatment recommendations for BV, and they require more than just treating the patient. New guidance from the American College of Obstetricians and Gynecologists (ACOG) suggests treating you and your sexual partner to lower the odds you’ll end up dealing with BV again in the near future.
The new guidance is a slight departure from how BV has been treated in the past, but there is solid data to suggest taking this approach could help you finally move forward with better vaginal health. Here’s what you need to know.
Bacterial vaginosis is the most common vaginal condition in younger women.
The condition happens when there is too much of a certain bacteria in your vagina, leading to an imbalance, according to the Centers for Disease Control and Prevention (CDC).
Doctors don’t know exactly what causes BV, but you have a higher risk of developing the condition if you douche, don’t use condoms, and have new or multiple sexual partners.
BV can cause uncomfortable symptoms like more discharge than usual with a strong, fishy odor, along with itchiness, according to ACOG. The discharge may also be thin, dark or dull gray, or even green. If it goes untreated, BV is linked with a higher risk of serious health issues, including getting or spreading HIV, delivering your baby too early if you’re pregnant, and getting STDs like chlamydia and gonorrhea, which can interfere with fertility.
BV usually recurs (meaning, it comes back). Up to 66% percent of women with bacterial vaginosis will have it again within a year of treatment for their original diagnosis. As a result, many women need to repeat treatment or even do treatment for up to six months, per ACOG.
The new treatment recommendations are slightly different from the old ones.
Until now, BV has been treated with one of several antibiotics, including metronidazole and clindamycin, which can be taken orally or put into your vagina in the form of a cream or gel. But sexual partners weren’t treated in the past.
The new guidelines suggest treating male sexual partners to try to lower the risk you’ll pass BV back and forth to each other. (More research is needed to see whether you both should be treated if you’re in a same-sex relationship, per ACOG.) “Male sexual partners play a role in BV recurrences and transmission of the bacterial species linked to the condition,” Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, tells SELF.
There is data to support treating both of you, most recently via a randomized controlled trial published in The New England Journal of Medicine earlier this year. For the trial, researchers split 150 monogamous couples into two groups: In one group, the woman and her partner were treated for BV and monitored for 12 weeks; in the other, just the woman was treated. (The men took metronidazole tablets and applied clindamycin cream to the skin of their penis twice a day for a week.)
The researchers stopped the trial early after it became clear that just treating the woman was “inferior” to treating both partners. Only 35% of women who were treated alongside their partner saw their BV return, while 63% of women who were the only partner treated had BV recur.
“Treating sexual partners is important because sexual activity plays a significant role in the incidence and recurrence of bacterial vaginosis,” Archana Pradhan, MD, MPH, professor and interim chair of Obstetrics, Gynecology, and Reproductive Sciences at Rutgers Robert Wood Johnson Medical School, tells SELF. Treating both partners not only helps lower the risk of BV coming back, it also can help patients feel better, faster, Dr. Radhan says.
There are a few things to do if you suspect you have BV.
If you think you may have BV, it’s important to make an appointment with an ob-gyn or primary care provider to be tested. If your doctor confirms that you have BV, they’ll likely prescribe metronidazole or clindamycin. But they’ll also likely want to connect with your sexual partner if you’re in a monogamous relationship.
Unfortunately, next steps are a little tricky. “Ob-gyns may initiate the conversation and recommend treatment,” Dr. Pradhan says. But “male partners will likely need to see their own physician for evaluation and prescription of appropriate antimicrobial therapy,” she says. Meaning, your partner may need to go through an additional step to get treatment.
Sure, that’s slightly annoying and definitely adds a layer that wasn’t there before. But if it means that you can get on the path to wellness sooner—and stay there—it’s definitely a treatment plan worth considering.
Related:
- Do Vaginal Probiotics Do Anything?
- 6 Common Behaviors Ob-Gyns Wish You’d Stop Doing
- Yeast Infection or Bacterial Vaginosis? Here’s How to Tell
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