Sex can be a risk factor for vaginal infections like bacterial vaginosis (BV), yeast infections, and urinary tract infections (UTIs). We hear from many people that sex is their #1 trigger of vaginal symptoms, which makes sense - unprotected penetrative sex can introduce new pathogens, change the vaginal pH and encourage the overgrowth of bad bacteria (learn more here). A new CDC report has finally recognized that BV can be sexually transmitted.

At Evvy, we are often asked whether or not male partners should be simultaneously treated for BV. Multiple studies have shown that BV-associated bacteria can be found in the penile microbiome (located on the surface of the penis) and in the urethra. As far as we know, BV-causing bacteria in the penile microbiome is not harmful to people with penises.

Unfortunately, right now there is no standard, effective strategy that doctors can use for partner treatment. Multiple studies have tried different methods of giving male partners with BV an oral antibiotic, and none of these studies indicated an effective benefit over a placebo. However, a recent promising pilot study suggests that a combination of oral and topical antibiotic treatments could lower BV-causing bacteria in both penile and vaginal microbiomes, and a larger study is actively enrolling patients. We are looking forward to seeing more research as it emerges!

Currently, the best way to prevent BV microbes that are introduced via sex from sticking around is to transition the vaginal microbiome to a protective state dominated by Lactobacilli. The vaginal microbiome should be acting as a localized immune system that can ward off temporary intruders! The best way to see the highest efficacy and impact while transitioning to a protective microbiome is avoiding unprotected sex.

Evvy does not offer partner testing or treatment at this time. That said, if you know that unprotected sex is a trigger and you've been dealing with recurrent infections, your male partner can talk to their provider about their options. MicrogenDX offers a MensKEY Complete Urine + Semen Test Service - this requires working directly with a provider who is best equipped to determine treatments and next steps from test results.

Receiving oral sex is also considered a risk factor for BV (you have an oral microbiome, too!) - companies like Bristle offer oral microbiome testing, which you and your male partner can discuss with a provider.

If you are doing a treatment protocol, with Evvy or your own provider, it is crucial to avoid unprotected sex during the full duration of the program to account for these risks, increase treatment efficacy, and alleviate symptoms.

Although rare, if a male partner is experiencing any unusual symptoms, he should consult a healthcare provider. Additionally, if you are diagnosed with BV and have multiple partners, it's a good idea to ensure that other STIs have been ruled out, as symptoms can be similar.