Does a man need to get treated for bv
Bacterial Vaginosis BV is an infection, which can be caused by a number of bacteria, including Gardnerella Vaginalis. Women with BV will have an altered PH balance in their vagina, which is more alkaline than normal. Women who have this infection will often develop a discharge that is greyish in colour and has a foul, fishy odour. The discharge may increase after having sex or around the time of menstruation. BV is not normally accompanied by any vaginal soreness or itching.SEE VIDEO BY TOPIC: Bacterial Vaginosis
SEE VIDEO BY TOPIC: Is it BV?Content:
Recurrence following recommended treatment for bacterial vaginosis is unacceptably high. While the pathogenesis of recurrence is not well understood, recent evidence indicates re-infection from sexual partners is likely to play a role.
The aim of this study was to assess the acceptability and tolerability of topical and oral antimicrobial therapy in male partners of women with bacterial vaginosis BV , and to investigate the impact of dual-partner treatment on the vaginal and penile microbiota. Couples provided self-collected genital specimens and completed questionnaires at enrolment and then weekly for 4-weeks. Genital microbiota composition was determined by 16S rRNA gene sequencing.
Changes in genital microbiota composition were assessed by Bray-Curtis index. Bacterial diversity was measured by the Shannon Diversity Index.
Twenty-two couples were recruited. Medication, and particularly topical clindamycin in males, was well tolerated. We observed a reduction in bacterial diversity of the vaginal microbiota and a decrease in the prevalence and abundance of BV-associated bacteria following treatment. A decrease in the prevalence and abundance of BV-associated bacteria in the cutaneous penile microbiota was observed immediately following treatment at day 8.
Combined oral and topical treatment of male partners of women with BV is acceptable and well tolerated. The combined acceptability and microbiological data presented in this paper supports the need for larger studies with longer follow up to characterize the sustained effect of dual partner treatment on the genital microbiota of couples and assess the impact on BV recurrence.
This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Behavioral data is required to be securely stored in keeping with the requirements of the Human Research and Ethics Committee of the Alfred Hospital. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist. Bacterial vaginosis BV is a common condition and is associated with adverse pregnancy outcomes, increased risk of pelvic inflammatory disease, and increased susceptibility to HIV and other sexually transmitted infections STIs [ 1 — 4 ]. It is a dysbiosis characterized by a decrease in the abundance of Lactobacillus spp.
BV-associated bacteria identified to date include Gardnerella vaginalis , Prevotella spp. Possible mechanisms for recurrence include reinfection from a sexual partner or endogenous source, persistence of BV-associated bacteria following treatment and failure to recolonize with desirable Lactobacillus spp. There is strong observational evidence that sexual activity plays a key role in both BV acquisition and recurrence[ 15 — 18 ]. Meta-analysis has shown associations between lack of condom use and exposure to new or multiple sexual partners with BV [ 19 ].
Additionally, two cohort studies of women who have sex with women reported a significant association between acquiring BV and reporting a new partner or a partner with BV[ 18 , 20 ]. Microbiological data support the contribution of sexual transmission to the pathogenesis of BV through the exchange of BV-associated bacteria between sexual partners. The coronal sulcus and distal urethra can harbour BV-associated bacteria[ 21 ], and male partners of women with BV are reported to have an increased abundance of BV-associated bacteria in their penile skin and urethral microbiota compared to male partners of women without BV[ 22 , 23 ].
Despite the strong evidence for sexual transmission of BV, randomised controlled trials RCTs of male partner-treatment have failed to reduce BV recurrence[ 24 — 29 ]. A recent Cochrane review rated the quality of the evidence as low to very low[ 30 ], and the discrepancy between current epidemiological evidence and the results of past RCTs is likely due to methodological limitations[ 31 ].
In addition none evaluated topical antibiotic therapy for males. We hypothesise that while urethral organisms are more likely to be effectively targeted by oral antibiotics, cutaneous colonisers of the coronal sulcus are more likely to be cleared by topical antibiotics. Thus it is plausible that combined oral and topical antimicrobial therapy is required to effectively clear BV-associated bacteria from both the coronal sulcus and distal urethra.
Topical therapy is also likely to be particularly important in uncircumcised males who have a high abundance of sub-preputial BV-associated bacteria[ 22 ]. Male circumcision has been shown to reduce detection of BV-associated genera in males[ 32 ] and to reduce the risk of BV acquisition in women[ 33 , 34 ], providing further evidence that cutaneous carriage of BV-associated bacteria plays an important role in the pathogenesis of BV acquisition and recurrence.
The primary objective of this pilot study was to assess the acceptability and tolerability of combined topical and oral antimicrobial therapy in male partners of women with BV. Our secondary objective was to investigate the impact of dual-partner treatment i. There are no published data on the effect of antimicrobials used for BV treatment on the penile skin and urethral microbiota.
Tolerability and microbiota data are needed to provide an evidence base to inform larger clinical trials of combined topical and oral therapy in males. Women presenting with vaginal symptoms were routinely tested for BV by the Nugent and Amsel methods. Women diagnosed and treated for BV who had a regular male partner and expressed interest in the study were referred to a research nurse who screened them for eligibility. Women were eligible if they were 18 to 55 years old, were being treated for symptomatic BV and had a single regular male sexual partner who was willing to be enrolled in the trial women were asked to confirm if it was likely that their male partner would agree participate.
A regular partner was defined for the purpose of this study as someone who was considered by the female to be a boyfriend or partner. Women were ineligible if they were HIV positive, pregnant or breast feeding, diagnosed with current PID, if they were allergic to study medication, or had other concurrent sexual partners. Male partners of eligible women were recruited either in clinic following onsite consultation, or during a phone consultation with a clinician and research nurse; an electronic medical record for these male participants was created.
Where possible, the male partner started treatment on the same day as his female partner; however, treatment could be commenced within a week of the female commencing therapy. Before commencing treatment, women completed a questionnaire recording demographic, behavioural, clinical and contraceptive information.
Women provided two self-collected high-vaginal swabs using Copan flocked swabs for Nugent scoring and microbiota analysis. Males completed a questionnaire recording demographic and behavioural information, and provided a self-collected penile swab and a urine swab for microbiota analysis. The penile swab was obtained by rubbing a Copan flocked swab moistened with sterile water around the coronal sulcus and over the glans of the penis.
Males were instructed to rub the swab firmly twice around the coronal sulcus before using the same swab to rub the glans of the penis. If the male was uncircumcised he was instructed to pull pack his foreskin before collecting the swab.
For the urine swab, males urinated the first 20 mL of urine into a urine pot and dipped a Copan flocked swab into the collected urine to facilitate return of specimens by post. Participants returned weekly questionnaires and self-collected genital specimens for four weeks following completion of treatment 8, 14, 21 and 28 days post treatment. At each time point females provided a vaginal swab and a vaginal smear for Nugent scoring; males provided a penile swab and a urine swab. Questionnaires and specimens were returned by mail.
Participants were asked to either abstain from penile-vaginal sex or to have protected sex during the treatment period days 0 to 7. The primary outcome was to assess male participant acceptability and tolerability of treatment. Adherence and side effects to treatment were self-reported on day 8 at the end of the treatment period, providing a measure of acceptability of the trial.
Couples were included in the analysis of the primary outcome if both the male and female partner completed the day 8 questionnaire. The secondary outcome was the impact of dual-partner treatment on the genital microbiota of couples, assessed at baseline i. Although this study was not powered to measure BV recurrence, vaginal smears underwent blinded Nugent Scoring[ 35 ] by an experienced microscopist so that we could record whether or not BV recurred within the 28 day follow-up period.
Specimens with insufficient DNA for amplification were re-extracted using an alternate methodology S1 File. Twenty negative control samples were included to facilitate identification of reagent contaminants S1 Table. Tagcleaner standalone v0. Initially, unassigned reads and OTUs with less than three sequences were discarded. The OTU table was then screened for contaminants.
OTUs were flagged as contaminants and filtered from the OTU table if they were present in all control specimens or previously reported as common sequencing contaminants and were not expected in the clinical context.
Similar approaches have been discussed previously[ 49 , 50 ] S2 Table. A total of 6,, reads remained after post-processing and contaminant removal. Specimens were rarefied to an even sampling depth 1, reads prior to analysis. Two cutaneous penile and thirteen urine specimens did not produce an adequate number of reads and were excluded from further analysis. As a result, there were insufficient urine specimens to enable paired comparisons before and after treatment for participants and between couples.
Using R Studio [V0. The 30 most abundant bacterial taxa for each specimen type were included in the heatmap analysis. The proportion of females and males who were retained in the study and who adhered to medication was calculated. Adherence was calculated as number of tablets taken or doses applied as a proportion of the total number of tablets or doses prescribed.
Bray-Curtis scores were calculated using the vegan package between paired specimens from each participant to investigate the immediate day 0 and 8 and sustained day 0 and 28 effect of treatment on the composition of the vagina and cutaneous penile microbiota.
Scores were given a value from zero substantial change in the presence or abundance of bacterial taxa to one minimal change. Alpha diversity was expressed as the effective number of taxa i. Changes in alpha diversity were assessed by the Wilcoxon signed-rank test.
Prevalence of each taxon was calculated as the number of specimens positive for a specific taxon at time point A for specimen type X as a proportion of the total number of specimens available at time point A for specimen type X.
Abundance of each taxon was calculated as the number of sequences for a specific taxon in specimen A as a proportion of the total number of sequences in specimen A ; abundance of taxa was summarised by specimen type and time point using descriptive statistics mean, median, range and interquartile range [IQR]. The 30 most abundant bacterial taxa for each specimen type were included in prevalence and abundance analyses. We measured the impact of sexual partnerships on the genital microbiota of sexual partners by: 1 comparing the similarity of the genital microbiota of partners to non-partners, and 2 investigating the correlation of prevalent taxa in the vaginal and cutaneous penile microbiota of partners.
We used the approach of Zozaya et al[ 23 ] to compare the similarity in bacterial communities of sexual partners to non-partners, with the following modifications: Bray-Curtis scores were used as the distance measure as described above and the Wilcoxon signed-rank test was used to measure statistical significance. Written informed consent was obtained from all participants. Forty-one women were referred to the research nurse, 14 women declined and three were deemed ineligible.
Two male partners declined participation after the female had been screened Fig 1. Participant flowchart detailing number of women screened for eligibility, resulting number of couples recruited to study and their progression through the study period. LTFU, lost to follow up.
The mean age at baseline was The median duration of relationship between couples was nine months IQR, 3—12 months. One couple was positive for chlamydia and was prescribed azithromycin single 1g oral dose ; one female was positive for gonorrhoea and she and her male partner were prescribed azithromycin single 1g oral dose and ceftriaxone mg intramuscular injection.
Of the 16 couples who provided adherence and tolerability data, 14 women received oral metronidazole and two requested vaginal clindamycin; all males received both oral metronidazole and topical clindamycin.
For 15 of the 16 couples, the male and female partner started treatment within four days of each other 10 started simultaneously , and for one couple, the male partner started treatment a week following the female. Study medications were well tolerated by participants. One male experienced a mild body rash involving trunk and limbs not involving the penis on day six of treatment and was advised not to take the final day of study medication. The women who received clindamycin reported no adverse effects.
During the treatment period day 0 to 7 six of 16 couples reported unprotected vaginal sex, one couple reported unprotected anal sex and five couples reported oral sex Table 4.
All 16 couples reported unprotected vaginal sex between day 8 and 28, with one couple reporting unprotected anal sex during this time.
Can You Give BV To Your Male Partner?
Bacterial vaginosis BV is the most common cause of unusual vaginal discharge. One in three people with a vagina get it at some time. People who have bacterial vaginosis have:. Hormonal changes during the menstrual cycle, receiving oral sex, semen in the vagina after sex without a condom, an intrauterine contraceptive device IUD and genetic factors may also play a part. If you think you may have it, talk to a doctor or nurse who might recommend a test if you have signs and symptoms.
Monogamy May Up Chances a Vaginal Infection Will Recur
Bacterial vaginosis BV is an infection caused by having too much of a certain type of bacteria in the vagina. The vagina naturally maintains a balance of lactobacilli, which are beneficial bacteria. These are often referred to as the vaginal flora or microbiota. When vaginal flora is out of balance, harmful anaerobic bacteria take over. Read on to learn more about whether men can pass bacterial vaginosis on to their partners and the kinds of conditions that can cause similar symptoms in men. But sexually active women do have a higher risk of developing bacterial vaginosis. Women are also more likely to develop BV when having sex with women. Still, some research suggests that men can spread BV or similar bacterial infections to female partners. A study involving uncircumcised men concluded that participants who had one or more female sexual partners, aside from their spouse, were more likely to carry bacteria associated with BV on their penis. Another study from involved heterosexual men.
Bacterial Vaginosis (BV)
Visit coronavirus. Bacterial vaginosis is the most common vaginal infection in women ages The exact cause of BV is unknown. Doctors and scientists do not completely understand how sex contributes to BV or how it is spread. BV rarely affects women who have never had sex.
Bacterial vaginosis BV is an infection in the vagina. Males cannot develop bacterial vaginosis, but they can spread the infection. People with BV can get symptoms that include excess and discolored discharge from the vagina. It can cause a burning or itching sensation around the vagina, especially when urinating.
Bacterial Vaginosis (Gardnerella Vaginitis)
Having multiple sex partners increases the risk of bacterial vaginosis — an imbalance of vaginal bacteria that can cause pain and itching in women — but a new study suggests that being faithful to one partner may cause the infection to recur. Women in the study who were treated for bacterial vaginosis BV were about twice as likely to experience a recurrence if they had sexual intercourse with the same partner before and after treatment, compared to women who had a new sexual partner, or no partner, after treatment. Antibiotics can cure symptoms of BV in about 80 percent of women.
He seemed a little upset and told me that he thought she was cheating on him. BV is caused when the environment inside the vagina is out of balance. In a healthy vagina there are millions of micro-organisms keeping things in perfect balance. One of these organisms, Lactobacillus, creates lactic acid and hydrogen peroxide which keep the vaginal pH slightly acidic and help prevent harmful bacteria from getting out of hand. She can also keep a supply of Balance Activ at home to help treat it straight away and to prevent recurring if she knows what sets it off. For example if you both notice a fishy smell after having sex, it could be that sex triggers her BV.
Bacterial Vaginosis – CDC Fact Sheet
Bacterial Vaginosis BV is a common vaginal infection. It affects one of every five women of childbearing age. A normal, healthy vagina has mostly healthy or "good" bacteria and very few unhealthy or "bad" bacteria. BV develops when the pH balance or level of acidity in your vagina is upset. This change allows the "bad" bacteria to increase to 1, times more than normal.
Recurrence following recommended treatment for bacterial vaginosis is unacceptably high. While the pathogenesis of recurrence is not well understood, recent evidence indicates re-infection from sexual partners is likely to play a role. The aim of this study was to assess the acceptability and tolerability of topical and oral antimicrobial therapy in male partners of women with bacterial vaginosis BV , and to investigate the impact of dual-partner treatment on the vaginal and penile microbiota. Couples provided self-collected genital specimens and completed questionnaires at enrolment and then weekly for 4-weeks. Genital microbiota composition was determined by 16S rRNA gene sequencing.
Bacterial vaginosis BV is a mild infection in the vagina. BV happens when there are more "bad" bacteria than "good" bacteria in the vagina. BV is the most common vaginal infection affecting young women. Itching and burning are not common signs of bacterial vaginosis.
What's hard to diagnose, hard to treat, affects 10 to 15 per cent of Australian women — and could turn out to be sexually transmissible? While this is early research, circumcision appears to be linked to a reduction of these bacteria in men. Studies also suggest that women who are treated for BV may have high rates of recurrence because they are re-infected after sex with their partner after treatment. BV is distressing for women on many counts.
Bacterial Vaginosis, typically referred to as BV, is a bacteria infection that occurs in the vagina. Women get BV when there is an imbalance in the natural PH levels of your vagina. It occurs when there is a high presence of gardnerella bacteria and less lactobacillus bacteria, causing PH levels to become less acidic. Actions such as douching, using scented products and deodorants around the vagina, wearing tight non-breathable clothing, or using irritating products can all contribute to ph imbalance.
Bacterial vaginosis is a common vaginal infection that can be caused by a bacterial imbalance in the vagina or transmitted through sexual contact. And it's surprisingly prevalent among pregnant women: Sixteen percent of expectant mothers in the United States have bacterial vaginosis. There's a careful balance between the good and bad bacteria that live in the vagina, and when that balance is disrupted, bacterial vaginosis can occur. What causes this bacterial imbalance isn't exactly known, but there seems to be some evidence that it can be a sexually transmitted disease. But, says Dr.
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