BV research and treatment in 2023
We do not know exactly what causes BV. We think it may be sexually transmitted and studies of partner treatment are underway.
While antibiotic treatment is usually effective at time of treatment, it is really common for women to get BV back again, especially if they are sexually active.
We haven’t been able to keep women free of BV when they are off treatment and sexually active.
Evidence suggests that antibiotic treatment for BV works well for women at the time of treatment but when women have sex with their partner again they often get BV back. We think BV may be sexually transmitted and that many women are getting BV back again when they have sex with their partners again after treatment. Studies have shown that women who have the same male partner before and after treatment for BV are more likely to get BV back again. We also know that not using condoms all the time increases your risk of BV.
Currently, male partner treatment is not part of the treatment guidelines for BV. We need to do more research to see how common the bacteria is among men and how it is transmitted. Researchers from the Melbourne Sexual Health Centre have received funding from the Australian government to investigate whether treating male partners of women with BV prevents their BV from coming back.
If you are interested in learning more about male partner treatment for BV please visit the StepUp page
We know that many women do not like taking antibiotics.
At the moment, there is no hard and fast scientific evidence that anything other than antibiotics will treat BV.
A suppressive treatment is one that is taken everyday to try and reduce your chance of getting the condition back again.
Some suppressive treatments, such as boric acid (internally), appear to reduce the symptoms of BV but the symptoms can come back after treatment is stopped.
Two alternative treatments that may hold promise are the use of probiotics and lactic acid treatment. Further studies are required before any specific product can be recommended.
Not all probiotics or lactic acid products are the same. Ingredients vary as do the quantities of the active product.
Evidence suggesting one product may help does not mean other products in the same category will also work.
Over the next few years it is likely that non-antibiotic therapies will be recommended in combination with antibiotics. Right now these products need further careful evaluation.
There are lots of different bacteria which can be beneficial or potentially harmful for vaginal health.
‘Good’ bacteria including lactobacilli can acidify the vagina. Other bacteria can cause bacterial vaginosis or inflammation and increase a woman’s risk of getting STIs or HIV.
We have discovered that lactic acid produced by lactobacilli can reduce inflammation and potentially protect against BV and HIV.
Lactic acid kills the vaginal bacteria that cause BV but not the beneficial lactobacilli. We have also seen that it can kill HIV in our laboratory.
Studies of young South African women’s reproductive health confirm these findings.
We have received funding from the Australian government to test these findings further. We want to confirm that lactic acid delivered into the vagina decreases inflammation and reduces the bacteria that cause BV.
These studies are critical to inform larger clinical trials and develop strategies to help prevent other STIs and adverse reproductive health outcomes.
“..He [the doctor] was checking it and telling me that it’s not something bad, it’s not contagious, it’s just something normal.
. .So I was obviously feeling a lot better and knowing that I would have not done anything by having sex with people but still feeling a lot of shame around it.”
If this sounds like you, you are not alone. Talk to your doctor about your symptoms today