Partner Treatment for BV: What New Research Means for Holistic Care

Andy Turner, ND
Jul 10
3 min read

Bacterial vaginosis (BV) is one of the most common vaginal health concerns I see in my practice. If you’ve dealt with it, you know the cycle: symptoms show up, you're prescribed antibiotics, they go away—only to return a few weeks or months later. Wash, rinse, repeat. And it’s not just antibiotics. Even with natural therapies—which are often gentler and less disruptive to your microbiome—the same story can play out. Relief, recurrence, and the emotional toll of not knowing what’s going wrong.

A recent study in The New England Journal of Medicine offered a new and important piece of the puzzle: maybe it’s not just you. Maybe it’s time we start treating your partner, too. As I read this study, I felt both validated and encouraged. This is something many naturopathic doctors have been doing for decades—because we’ve seen firsthand how often symptoms only truly resolve when both partners are treated.

What the StepUp Trial Found

The StepUp trial looked at heterosexual couples where the female partner had BV. All women were treated with standard oral antibiotics, and in half the couples, the male partner was also treated—with oral antibiotics plus a topical antimicrobial cream.

The difference was striking:

Among women whose partners were not treated, 63% experienced BV recurrence within 12 weeks.
When partners were treated, that number dropped to 35%.

That’s a nearly 50% reduction in recurrence. For a condition known for being stubborn and persistent, this is a meaningful breakthrough.

Why This Matters in Holistic Care

The idea that BV might be passed back and forth between partners isn’t new to many of us in integrative medicine. I—and many other naturopathic doctors—have been treating partners for years, because we saw how often our patients’ symptoms would return unless their partners were addressed, too. But until now, the research didn’t support that approach. Earlier studies—mostly from the 1980s and early 2000s—didn’t show consistent benefit from treating male partners. However, those studies had major limitations: small sample sizes, poor adherence, and the use of only oral treatment in men, without attention to topical therapies or the male genital microbiome.

The StepUp trial is the first research to show that yes, treating both partners can make a meaningful difference. It validates what we’ve long observed in holistic care: healing happens in context—not in isolation.

A Naturopathic Lens: Supporting Your Whole Ecosystem

In conventional medicine, BV is usually managed with antibiotics that aim to kill off overgrown bacteria. But in naturopathic care, we go deeper. We ask: Why did the imbalance happen in the first place? And what does your body need to truly restore balance and resilience?

In my practice, I often incorporate a combination of:

Boric acid suppositories, which can help normalize vaginal pH and reduce overgrowth of bacteria or yeast
Oral and vaginal probiotics, to repopulate healthy flora and support long-term microbiome health
Botanical antimicrobials like berberine (from herbs such as Oregon grape or goldenseal), which gently support the immune system and address overgrowth
Nutritional and lifestyle counseling, focused on gut health, blood sugar balance, stress, sleep, and sexual hygiene

And when symptoms continue to return despite good care, partner treatment becomes part of the conversation.

Why I Take a Partner-Inclusive Approach

Whether you're using herbs or antibiotics, it doesn’t matter how effective your treatment is if you’re being re-exposed to the same microbial imbalance. BV may not be classified as a sexually transmitted infection, but in many cases, it behaves like one. So yes, we can use probiotics, berberine, and boric acid. We can support your immune system and nourish your body’s natural defenses. But if your partner’s microbiome is contributing to the problem—and we don’t address that—you may find yourself stuck in a frustrating cycle. The StepUp trial bridges the gap between holistic experience and conventional research. It gives us not only permission but also evidence to treat the full ecosystem—yours, your partner’s, and the space between.

You Deserve Better Than “Wait and See”

If you’ve been stuck in the cycle of recurrent BV, you are not alone—and it’s not your fault. There is a path forward, and it starts by looking at the bigger picture.

In my practice, we’ll work together to figure out what your body needs to rebalance and heal. We’ll use natural therapies to support your microbiome, tailor a plan to your unique needs, and yes—talk honestly about the role of your partner and whether co-treatment makes sense.

Because real healing happens when we stop isolating symptoms and start supporting the whole system—body, mind, relationships, and all.

Ready to feel better in your body again? Schedule a visit and let’s build a plan that supports true, lasting healing.

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