Bacterial vaginosis breakthrough study

A recent groundbreaking study has unveiled a significant shift in our understanding and treatment of bacterial vaginosis (BV), a common vaginal infection affecting nearly one in three women. Traditionally, BV was viewed as an imbalance in vaginal bacteria, not classified as a sexually transmitted infection (STI). However, new research indicates that BV can be sexually transmitted, and treating both female patients and their male partners simultaneously leads to higher cure rates and reduced recurrence.

Understanding Bacterial Vaginosis

BV occurs when there's an overgrowth of certain bacteria in the vagina, disrupting the natural balance. This imbalance can cause symptoms like a fishy odour, unusual discharge, and discomfort, though some women may not experience noticeable signs. If left untreated, BV can lead to complications, including an increased risk of acquiring other STIs and issues during pregnancy.

The Landmark Study

Researchers from Monash University and Alfred Health conducted a study involving 164 heterosexual couples, where women diagnosed with BV were treated alongside their male partners. The men received a combination of oral antibiotics and topical antibacterial cream. The results were striking: BV recurred in only 35% of women whose partners were also treated, compared to 63% in the control group where only the women received treatment.

Implications of the Findings

This study challenges the previous notion that BV is not sexually transmitted and highlights the importance of treating both partners to prevent reinfection. The findings suggest that men can harbor BV-associated bacteria and transmit them back to their female partners, leading to recurrence. By treating both individuals, the cycle of reinfection can be broken, offering more effective management of BV.

What This Means for You

If you or someone you know is dealing with recurrent BV, it's essential to consider the role of sexual partners in treatment. Here are some steps to take:

• Consult Your Healthcare Provider: Discuss the possibility of simultaneous treatment for both you and your partner. This approach may significantly reduce the chances of BV returning.

• Practice Safe Sex: Using condoms can help reduce the transmission of BV-associated bacteria between partners.

• Maintain Vaginal Health: Avoid practices that can disrupt the natural balance of bacteria in the vagina, such as douching or using scented products.

Looking Ahead

While this study marks a pivotal step in understanding BV's transmission and treatment, further research is needed to develop comprehensive prevention strategies and update clinical guidelines. In the meantime, awareness of the potential for sexual transmission and the benefits of treating both partners can empower individuals to take proactive steps toward better vaginal health.

Vodstrcil, L. A., Plummer, E. L., Fairley, C. K., Hocking, J. S., Law, M. G., Petoumenos, K., Bateson, D., et al. (2025). Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis. New England Journal of Medicine, 392(10), 947-957. https://doi.org/10.1056/NEJMoa2405404

Which IUD should I choose?

If you're thinking about getting an intrauterine device (IUD) for contraception, you might be wondering which one is best for you. In Australia, there are three types of IUDs available: Mirena, Kyleena, and the Copper IUD. Each has its own benefits and drawbacks, so let's break it down to help you decide.

Three options

There are three IUDs to choose from in Australia:

1. Mirena - levonorgestrel 52mg

2. Kyleena - levonorgestrel 19mg

3. Copper IUD

Mirena

How long does it last?

Mirena can stay in place for up to 8 years.

Size

Mirena is larger than Kyleena but similar in size to the Copper IUD.

Procedure and discomfort

The Mirena is inserted in a similar way to the other IUDs. Some people experience cramping during and after insertion, but pain relief options can help.

Best suited for

Mirena is a good choice for both people who have had children (parous) and those who haven’t (nulliparous). Because it's slightly larger, some people who haven’t had children may find insertion more uncomfortable. If we can time the insertion during or just after your period, the insertion tends to be more straightforward. It is also one of the best methods to reduce or stop heavy menstrual bleeding or irregular cycles.

Effectiveness

Mirena is over 99% effective at preventing pregnancy.

Risks

• Irregular bleeding or spotting in the first 4-6 months

• Possible hormonal side effects like mood changes or breast tenderness ( though this is much less likely than other hormonal methods such as The Pill)

• Small risk of the IUD moving or being expelled

• Very low risk of infection at the time of insertion

Kyleena

How long does it last?

Kyleena can stay in place for up to 5 years.

Size

Kyleena is smaller than Mirena and the Copper IUD, making it a good option for people who prefer a smaller device.

Procedure and discomfort

Because it is smaller, Kyleena may be slightly easier and more comfortable to insert than Mirena, especially for people who haven’t had children.

Best suited for

Kyleena is often recommended for people who have never been pregnant (nulliparous) because of its smaller size. It is also a good option for those who want a lower dose of hormones than Mirena.

Effectiveness

Kyleena is over 99% effective at preventing pregnancy.

Risks

• Irregular bleeding or spotting, especially in the first few months

• Possible hormonal side effects (probably less than with Mirena)

• Small risk of the IUD moving or being expelled

• Very low risk of infection at the time of insertion

Copper IUD

How long does it last?

The Copper IUD can stay in place for 5 to 10 years, depending on the type.

Size

The Copper IUD is similar in size to the Mirena.

Procedure and discomfort

The procedure is the same as with hormonal IUDs, and some cramping is normal during and after insertion. The Copper IUD does not contain hormones, which can be a benefit for those who want a completely non-hormonal option.

Best suited for

The Copper IUD is suitable for both parous and nulliparous people. However, those who already experience heavy or painful periods may find that the Copper IUD makes this worse.

Effectiveness

The Copper IUD is over 99% effective at preventing pregnancy. It can also be used as emergency contraception if inserted within 5 days after unprotected sex.

Risks

• May cause heavier, longer, or more painful periods

• Small risk of the IUD moving or being expelled

• Very low risk of infection at the time of insertion

Which One is Right for You?

• If you want long-term contraception with light or no periods, Mirena might be the best choice.

• If you want a smaller IUD with fewer hormones, Kyleena is a great option.

• If you prefer a hormone-free method, the Copper IUD is your best bet.

All IUDs are highly effective, long-term contraception options, but the right one for you depends on your body and preferences. Talk to your doctor to discuss what suits you best!

What to Expect During an IUD Insertion

Thinking about getting an IUD (Intrauterine Device) but feeling a bit nervous about the procedure? You’re not alone! Many people have questions about what to expect, and it’s completely normal to have some concerns. The good news is that IUD insertion is a quick, routine procedure that provides long-term, highly effective contraception. In this post, we'll walk you through what happens before, during, and after the insertion so you can feel informed and prepared.

What is an IUD?

An IUD is a small, T-shaped device that sits inside the uterus to prevent pregnancy. There are two main types:

• Hormonal IUDs (Mirena or Kyleena) - These release a small amount of progestogen, which thickens cervical mucous and thins the lining of the uterus.

• Copper IUDs - These are hormone-free and work by creating and environment that is toxic to sperm.

Both types are over 99% effective and can last between 5-10 years, depending on the type you choose.

Before the Appointment

1. Consultation with Your Doctor

Before getting an IUD, you’ll have a chat with your doctor to discuss your medical history, contraception needs, and which IUD is best for you. They may also perform a pelvic exam or STI screening to ensure there are no infections before insertion.

2. Preparing for the Procedure

Here are a few tips to make your appointment smoother:

• Take ibuprofen and paracetamol about 30-60 minutes before your appointment to help with discomfort.

• Eat a light meal beforehand to avoid feeling lightheaded.

• Bring a pad or panty liner in case of light spotting afterward.

• Ideally, have someone drive you to and from the appointment (in case you feel a little crampy or lightheaded afterwards).

During the insertion

The actual procedure only takes a few minutes and happens in a standard GP or clinic room. Here’s how it works:

1. Positioning & Examination

You’ll lie on an examination table (similar to a Pap smear position). The doctor will insert a speculum to gently open the vagina, allowing them to see the cervix.

2. Measuring the Uterus

The cervix is gently grasped, which can cause a pinching feeling (although a lot of people don’t feel anything). A small instrument called a sound is used to measure the depth of your uterus to ensure proper placement of the IUD. This may cause a brief cramping sensation.

3. Inserting the IUD

The IUD is introduced via a thin tube, which is inserted through the cervix into the uterus. Once in place, the arms of the IUD open up, and the tube is removed. The doctor will trim the IUD strings, which stay inside the vagina so the IUD can be checked or removed later.

4. All Done!

The entire process usually takes 5-10 minutes.

After the procedure

1. How Will I Feel?

• Mild to moderate cramping (like period pain) is common for the first few hours.

• Light spotting or irregular bleeding may occur for a few weeks.

• Some people feel totally fine right away, while others may prefer to rest for a little while.

2. What to Watch For

While complications are rare, contact your doctor if you experience:

• Severe pain or heavy bleeding

• Fever or unusual discharge (possible infection)

• Inability to feel the IUD strings (which may indicate it has moved)

3. When Does It Start Working?

• Hormonal IUD: If inserted within the first 7 days of your cycle, it's effective immediately. Otherwise, use backup contraception for 7 days.

• Copper IUD: Works immediately, even as emergency contraception.

Getting an IUD is a safe, quick, and effective way to prevent pregnancy, and for many people, the benefits far outweigh any temporary discomfort. If you’re feeling anxious, remember that your doctor is there to support you and make the experience as comfortable as possible. If you have any concerns before or after the procedure, don’t hesitate to reach out to your GP.

Thinking about getting an IUD? Book an appointment today to discuss your options and find the best contraception for you!