A major international study is rewriting the script on treating bacterial vaginosis (BV), a common yet often overlooked vaginal infection that impacts one in three women worldwide, including many in Thailand. Latest research reveals that to truly tackle BV and prevent its frustratingly frequent return, it’s not enough to just treat the women affected—their male sexual partners should be treated too. The landmark findings challenge decades of medical dogma and offer hope for the millions of women who have endured repeated, uncomfortable cycles of this stubborn infection (New York Times; NEJM).
Bacterial vaginosis is the most common cause of abnormal vaginal discharge in reproductive-age women. In Thailand, as in much of the world, many women are only vaguely aware of the condition, despite its strong links to increased risk of sexually transmitted infections including HIV and heightened danger of premature birth in pregnancy (Wikipedia). The infection is caused by an imbalance in the normal population of vaginal bacteria—Lactobacilli, the “good guys,” are replaced by other bacteria, often leading to a thin, fishy-smelling gray or white discharge. Classic treatments can relieve symptoms but, frustratingly, up to 60% of women see BV return within months (USA Today).
For decades, BV has been viewed as a condition that is not sexually transmitted—unlike chlamydia or gonorrhea—so treating male partners was not part of routine care. But a game-changing study, published in early 2025 in the New England Journal of Medicine, dismantles this view (NEJM). Led by Dr. Catriona Bradshaw and colleagues at the Melbourne Sexual Health Center, researchers conducted the first successful trial of a strategy targeting both partners. The study found that when men were given a course of oral and topical antibiotics alongside their female partners, the recurrence of BV in women dropped significantly within 12 weeks—far lower than with standard treatment alone.
“We saw a clear benefit when treating male partners concurrently,” Dr. Bradshaw stated. “This approach gets at the root of the cycle of reinfection that so many couples experience.” (NEJM commentary)
The implications for Thai women are substantial, particularly given cultural shyness, taboos around discussing intimate health, and the importance of holistic family care. In Thailand, BV remains under-discussed, both due to embarrassment surrounding gynecological concerns and a lack of knowledge among both patients and some healthcare workers. Yet, the infection’s impact is anything but minor—recurrent BV can produce discomfort, marital strain, and downstream effects on fertility and maternal health (Wikipedia).
The research is also relevant for public health goals in Thailand. As Dr. Nattapong, a reproductive health specialist at Chulalongkorn Hospital, notes: “Reducing BV recurrence could play a role in lowering HIV transmission rates and improving pregnancy outcomes among Thai women.” He sees opportunities to incorporate this approach in national sexual health education and support outreach programs targeting both men and women in partnerships.
Historically, dissatisfaction has simmered globally over why BV returns so often, even after diligent use of prescribed antibiotics like metronidazole or clindamycin (Wikipedia). Studies found that women who resumed sex with untreated partners after treatment had high relapse rates, hinting at transmission and reinfection cycles. However, the medical establishment hesitated to recommend treating men due to inconsistent evidence and a lack of proven strategies. The new studies shatter that hesitation: by treating both partners, the relentless cycle of BV is broken (The Guardian).
The science behind the shift is compelling. The vaginal microbiome—a collection of bacteria living in the vagina—becomes unbalanced during BV, allowing “bad” bacteria to thrive. Research now shows that these bacteria are present in the penile microbiome of male partners as well, setting the stage for back-and-forth reinfection (NEJM). New studies used both oral antibiotics and topical (applied) treatments for the male partners, finding better outcomes than with either approach alone.
On a global scale, up to 30% of women between ages 14 and 49 are affected by BV at any time (Wikipedia). Rates are even higher in some regions of Africa and Southeast Asia. In Thailand, as social norms shift and sexual behaviors become more open, experts caution that candid discussions and comprehensive couple-based treatment could drive healthier outcomes, especially in urban settings like Bangkok and Chiang Mai.
Yet, barriers remain. Dr. Suwanna, a gynecologist at Siriraj Hospital, points out that: “Many Thai women are reluctant to talk openly about vaginal symptoms or ask their partners to join in treatment. There’s a cultural resistance to involving men in what has traditionally been seen as a ‘women’s health’ issue.” Education campaigns, she argues, need to specifically address this by destigmatizing both the infection itself and couple-based treatment.
The new research also comes at a key time as Thailand’s healthcare system looks for evidence-based strategies to reduce maternal and child health risks and lower rates of preventable infectious diseases. Enhanced approaches to BV treatment align closely with the government’s goals for sexual and reproductive health under the Universal Coverage Scheme (Portside; MedCity News).
Looking forward, experts anticipate growing use of couple-based BV treatment, with telehealth providers already rolling out male partner treatment packs (MedCity News). For Thai health services, integrating this research means not only updating clinical guidelines, but also ensuring that pharmacists, general practitioners, and community health workers are trained to address the infection in the context of couples—and in a culturally sensitive way.
So, what practical steps should Thai women (and couples) take? First, women experiencing symptoms such as abnormal discharge or persistent irritation should seek prompt medical attention. If diagnosed with BV, women should not hesitate to ask their healthcare provider about the possibility and safety of partner treatment—especially if recurrences are a problem. Couples should understand that treating both parties can now be seen as a modern, sensible way to protect each other and prevent frustration down the road.
Finally, health authorities and NGOs working in sexual and reproductive health should take advantage of these new findings to update educational materials, encourage open discussions, and offer supportive environments where both women and men can participate in care. As recent research makes clear, “รักษาร่วมกันดีกว่า”—“treating together is better”—not only for overcoming BV but also for building stronger trust in Thai relationships.
For those with questions, further information is available in English and Thai via professional organizations such as the Thai Gynecological Society and international resources (NEJM), or seek advice at local primary care or women’s health clinics.