Male partner treatment shows no significant effect on bacterial vaginosis recurrence or cure ratesTreating male partners may not prevent bacterial vaginosis recurrence

Bacterial vaginosis (BV) is the commonest vaginal infection globally, resulting from a shift from Lactobacillus-dominant microbiota to an overgrowth of anaerobes. Although standard antibiotic therapy achieves short-term cure, recurrence remains high. Recent evidence suggests that male genital microbiota is a potential reservoir for BV-associated bacteria (BVAB), prompting investigation into the role of concurrent male partner treatment (MPT). We conducted a systematic review and meta-analysis of randomized controlled trials to assess the effect of MPT on BV recurrence and cure. The study followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and was registered in PROSPERO (CRD420251132582). Embase, Scopus, Google Scholar, and PubMed databases were searched independently, from 1980 to September 2025. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated using random-effects models. Risk of bias and certainty of evidence were assessed using RoB 2 and GRADE. Eight randomized controlled trials were included. MPT showed no significant effect on BV recurrence (RR 0.92; 95% CI 0.69-1.23; I2 = 64%) or cure rate (RR 1.01; 95% CI 0.94-1.07; I2 = 46%). Adverse events were mild and similar across groups (RD 0.04; 95% CI 0.02-0.11). However, lower recurrence was observed among fully adherent couples, particularly in a recent trial using combined oral and topical therapy. While the overall pooled effect of routine partner treatment is neutral, a benefit may exist among fully adherent couples receiving intensive regimens. Targeted approaches that optimize regimen intensity and adherence warrant further investigation.