It Takes Two: Why Treating Only Women for BV Misses Half the Problem
If you’ve ever dealt with the frustrating cycle of bacterial vaginosis (BV), you know how defeating it can feel. You do everything right—take the antibiotics, skip the bubble baths, avoid new partners—and yet… it comes back. Again.
So why does BV keep returning for so many women?
A landmark study published in Cell Reports Medicine in March 2025 is offering new clues—and a new direction for treatment. Spoiler: it’s not just about women’s bodies anymore. It’s time we start talking about the male microbiome.
The Study That Sparked a Conversation
The study, led by Dr. Jeanne Marrazzo and colleagues looked at heterosexual couples in monogamous relationships where the woman had been diagnosed with BV. It treated both the woman and her male partner—who received a combination of oral and topical antibiotics.
The results? Women whose partners were treated had lower recurrence rates of BV after 12 weeks.
That’s big news. It supports what many in women’s health have suspected: BV isn’t just a “women’s problem.” The microbes living on and inside the penis can reintroduce BV-causing bacteria—even after treatment.
But Before We Break Out the Champagne...
Let’s pump the brakes for a second. From a clinical perspective, this is promising—but also packed with nuance.
Here are some important details from OB-GYN Jen Gunter who reviewed the study:
80% of male partners were uncircumcised. Circumcision has been associated with a lower risk of BV in female partners, likely due to less bacterial buildup under the foreskin. This raises questions: Would the same antibiotic regimen be effective in circumcised men? The study wasn’t powered to answer that.
25% of the women used IUDs—but we don’t know if they were copper or hormonal. Copper IUDs are a known risk factor for BV, so this could affect recurrence rates.
The couples were all monogamous for 8+ weeks. Translation: we can’t apply these results to people with multiple or short-term partners.
The role of adherence matters. Women whose partners took 100% of the prescribed medication had the lowest recurrence rates. But 14% of men used less than 70% of their doses. Like any treatment, it only works if you stick with it.
Not all communities were represented. In North America, Black and Hispanic women have the highest rates of BV, yet the study doesn’t say whether results varied by race or ethnicity. That’s a gap worth addressing in future research.
A New Frame for BV: From Blame to Biology
This isn’t just about bacteria—it’s about breaking a pattern of stigma. BV has long been framed as a hygiene issue or personal failure. When it recurs, women are often told it’s “just how their body is.”
But science tells a different story: this is a microbial imbalance, not a moral one—and it may involve more than one body.
Treating both partners could finally bring relief to the millions of women stuck in a frustrating treatment loop. It also opens the door to more equitable, informed conversations about sexual health and responsibility.
Where Do We Go From Here?
This study opens up exciting possibilities—but also many questions:
Would topical treatment alone for men be enough?
Could repeated or intermittent treatment reduce recurrence even further?
How would this strategy compare to consistent condom use?
What’s the right message for couples managing BV together?
We don’t have all the answers yet. But we do have something we didn’t before: proof that the male microbiome plays a role in BV recurrence. That’s a game-changer.
Final Thoughts: Changing the Narrative
It’s time to stop asking women to fix a problem that may not start—or end—with them. This study is a step forward, not just scientifically but culturally. It reminds us that real solutions require partnership—in treatment, in research, and in how we think about sexual health.
So if you’ve been stuck in the BV loop, know this: It’s not just you. It’s not in your head. And it might not even be just in your body.
