Systematic Review Finds No BV Recurrence Reduction With Male Partner Treatment

BACKGROUND: Bacterial vaginosis (BV) is the most common cause of vaginal discharge and shows high recurrence rates despite effective initial therapy. Emerging evidence suggests that reinfection from untreated male partners may contribute to recurrence. OBJECTIVE: To evaluate whether treating male sexual partners of women with BV reduces recurrence compared with treating women alone. METHODS: This systematic review and meta-analysis was prospectively registered in PROSPERO (CRD420251006378). Five databases (PubMed/MEDLINE, Embase, ScienceDirect, Web of Science, and Scopus) were searched from inception to April 2025 without language restrictions. Randomized controlled trials including adult women with BV and comparing combined female and male partner treatment versus female-only treatment were included. Data extraction and risk of bias assessment were performed independently by two reviewers. Recurrence rates were pooled using a random-effects model, with heterogeneity assessed by the I statistic. Sensitivity analyses and funnel plots were conducted. MAIN RESULTS: Six randomized controlled trials, including 953 couples, were included. Pooled analysis showed no significant reduction in BV recurrence with male partner treatment compared with standard female-only therapy (RR = 0.97; 95% CI 0.76-1.22; p = 0.78; I = 59.9%). Sensitivity analysis excluding the study by Vodstrcil et al., 2025, the only trial that implemented combined oral and topical male therapy, eliminated heterogeneity (I = 0%) and yielded a neutral effect (RR = 1.08). CONCLUSION: Male partner monotherapy is unlikely to reduce bacterial vaginosis recurrence, confirming current evidence. However, combined oral and topical therapy may improve female cure rates, highlighting the need for further high-quality studies to evaluate its effectiveness in preventing recurrence.