A groundbreaking new study conducted by researchers in Australia is reshaping how we think about one of the most common vaginal infections worldwide. Bacterial vaginosis (BV), long recognized as a frequent and sometimes stubborn issue affecting millions, may, in fact, be a sexually transmitted infection (STI)—at least according to new evidence published in the prestigious New England Journal of Medicine. Although BV is not currently classified as an official STI, the latest research suggests it may fit the criteria, sparking important discussions in both the medical community and the public sphere.
According to the Cleveland Clinic, around 35% of people with vaginas will experience BV at some point in their lives. This makes it one of the most common vaginal conditions, second only to yeast infections. BV occurs when the natural balance of bacteria in the vagina is disrupted, allowing harmful bacteria to outnumber the beneficial ones. Typically, the vagina maintains a healthy population of “good” bacteria—primarily lactobacilli—which produce substances that keep the environment slightly acidic and prevent overgrowth of other microorganisms. However, when the balance tips in favor of harmful bacteria, symptoms such as off-white vaginal discharge, a noticeable “fishy” odor, and occasional irritation can occur. It’s important to note, though, that not everyone with BV experiences symptoms, which can make it tricky to detect and treat.
The Australian researchers’ findings are particularly significant because they challenge the traditional view of BV. If BV is indeed sexually transmitted, it means that treating only one partner might not be enough. Recurrent infections, which are a frustrating reality for many people dealing with BV, might be better understood—and more effectively managed—if healthcare providers also consider treating sexual partners. Current treatments usually involve antibiotics like metronidazole or clindamycin, but recurrence rates are high, often because the underlying transmission cycle remains unbroken.
The study draws attention to how STIs are generally defined: infections that are primarily transmitted through sexual contact. BV seems to fit this definition better than previously thought. Past research has hinted that sexual activity, particularly with new or multiple partners, increases the risk of developing BV. Furthermore, women who have sex with women are at a heightened risk of recurring BV, pointing again to a potential sexual transmission pattern.
This reclassification could have profound impacts—not only for medical protocols but also for public health messaging and the way society views sexual health. Education campaigns might need to address BV alongside more well-known STIs like chlamydia, gonorrhea, and HPV. Additionally, removing the stigma surrounding conditions like BV could encourage more individuals to seek prompt treatment without shame or fear.
Ultimately, whether or not BV becomes formally recognized as an STI, the study emphasizes the importance of open dialogue, early intervention, and comprehensive care. It also underscores how much we still have to learn about the human microbiome, sexual health, and the intricate ecosystems within our bodies. For now, the takeaway is clear: awareness and preventive care are key. If you experience symptoms of BV—or if you have questions about vaginal health—it’s essential to consult a healthcare provider for accurate diagnosis and effective management.
Only doctors can diagnose BV (Getty Stock Photo)
How can you develop BV?
What the researchers found was that the cure rates were higher when both couples were treated, as would be the case with an STI.
Commenting on the findings, per BBC News, one of the lead researchers, Prof Catriona Bradshaw, said: “Our trial has shown that reinfection from partners is causing a lot of the BV recurrence women experience, and provides evidence that BV is in fact an STI.”
Bradshaw added that the researchers faced difficulties in establishing whether BV is sexually transmitted because they don’t know precisely which bacteria are the cause, but she added that advances in genomic sequencing may help them figure it out.
As a result of the findings, the Melbourne Sexual Health Centre has now changed its clinical practice to routinely treat both partners.
How is BV treated?
Only a doctor can diagnose BV, and if diagnosed they may prescribe antibiotics in the form of a gel or cream you insert into your vagina. Antibiotics may also come in the form of pills.