[Question #3233] Male with Gardnerella vaginalis

37 months ago
Dear Doctor,

I am writing this to you in the hope that you can provide some insight into a recent diagnosis. I appreciate that is not an STI but it is effecting my penis. 

I am a 50 year old male in a monogamous relationship for the last 15 years. 

Recently I have undergone a significant battery of tests, urine, blood, MRI's, ultrasound on my stomach, colonoscopy etc etc.

Essentially, all possible blood and urine tests and cultures have been conducted. This includes all sexual health tests. 

All tests have been conducted in professional settings by professional medical doctors. 

All tests are negative apart from two things. 

The first is Diverticulitis (likely heredity) and I am in the hands of a specialist for this. 

The second is confounding and the reason that I write as I have been diagnosed with Gardnerella vaginalis.

Obviously I do not have a vagina. I least hope I do not. (Excuse my weak attempt of applying brevity to my situation).

My doctor has said it is highly unusual and has not come across my situation before. I was prescribed 2g of Metronidazole in one dose.

The NHS website pretty much says that men don't get Gardnerella Vaginalis. The CDC website only vaguely references men. Some websites say men do not suffer from this. Some say they do. Some say that men cannot pass this to women and women cannot pass this to men. 

I can find no reference of symptoms of this in men. However, I can relay the symptoms I have and have had on and off for some years which seem to be noticeably getting worse. 

Frequent need to urinate

Uncomfortable feeling inside and outside my penis. Kind of itchy, scratchy. 

Uncomfortableness/itchiness inside my scrotum/anus. 

Occasionally, the head of my penis seems blue. 

I have no pain when I urinate but the above symptoms seem to increase until I urinate and then abate when I urinate. 

I have discussed the findings with my wife and she is due to visit the doctor next week. She uses an IUD, has a history of thrush and identifies with the female symptoms and causes (IUD) on the NHS and CDC websites with respect to Bacterial Vaginosis. 

I hope that I have provided enough information. 

I have the following questions. 

Q1. The test was a Molecular DNA Test. How accurate are these tests and is it possible for this to be a misdiagnosis? 

Q2. If it is possible to be a misdiagnosis, then what else could it be? 

Q3. Is this really a highly unusual diagnosis? 

Q4. How long does the medication take to work? (It has been 20 hours since I took the Metronidazole. About 5 hours after the symptoms described above abated. 15 hours later they returned).

Q5. Was the medication prescribed the correct medication and dosage regime for a male?

Q6. Can Gardnerella Vaginalis infect any other parts of the body such as the mouth, scrotum, skin? 

Q7. Can Gardnerella Vaginalis bacteria be transmitted non-sexually?

Thank you in advance for your assistance.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Welcome to the forum. Thanks for your question.

The bottom line is that as best I can tell, you have no medical problem related to Gardnerella. As you seem to know, or at leat your doctor implies, molecular testing is not normally done in men. But in any case, G. vaginalis is an entirely normal bacteria. It causes no disease of any kind. In women with the condition called bacterial vaginosis, GV is one of many bacteria that overgrow in the vagina. At one time it was thought to be the actual cause of BV, but it is not. Just a normal bacteria carried in the gential tracts of both men and women. Accordingly, it is unlikely that it has anything to do with yoru symptoms. It also does not imply a need for your wife to be examined, tested, or treated.

And from your description, the only symptom you describe that could be related to an infection in your urethra or bladder is the increased frequency of urination. If infection is the cause (whether due to G vaginalis or other bacteria), you would expect to also have painful urination, perhaps abnormal discharge from the penis, and a urinalysis showing increased white blood cells and perhaps other abnormalities like elevated protein and maybe a trace of blood. Most likely your doctor has done a urinalysis. If it is normal, it is further evidence that the G. vaginalis isn't causing any problem.

Anyway, men your age often begin to have nonspecific genital symptoms due to enlarged prostate, overactive bladder, and similar issues, and these can cause frequent urination. So my bet is that this is more likely than infection due to GV or anything else. None of your other symptoms sound abnormal at all -- and certainly not due to any infection in the urinary tract, whether caused by GV or any other bacteria. I am suspicious that some or all your symptoms are the result of anxiety magnifying trivial symptoms or entirely normal body sensations that otherwise you would ignore or not even notice.

Those comments pretty well cover your specific questions, but to be explicit:

Q1. The test probably is accurate, i.e. G. vaginalis is in your urethra or urine. But for the reasons above, I doubt it is responsible for any symptoms or that it needs treatment.

Q2, Q3. Discussed above.

Q4. Metronidazole does not treat G. vaginalis. It is effective against bacterial vaginosis in women, but mostly because it inhibits a whole bunch of vaginal bacteria, but not necessarily GV. Since it is unlikely any of your symptoms are due to GV, I don't expect the metronidazole to have any effect on your symptoms.

Q5. No, it was not the correct treatment.

Q6. Neither GV nor other bacteria associated with BV in women are known to cause infection or symptoms of other body sites, including the ones you list.

Q7. Yes, it is sexually transmitted. But that applies to hundreds of normal bacteria in the genital tract. It should be no surprise that sexual partners share a whole bunch of genital bacteria. The appearance of GV in your test does not mean you have acquired it recently. I'm confident both you and your wife have had it for years, probably since your wife's childhood. (Most if not all babies acquire it from their mom's vaginas during birth, then carry it for life.)

All things considered, you (and apparently your doctor) have overreacted to a test result that really means nothing at all. If you have other evidence of a urinary tract infection (e.g. the urinalysis abnormalities noted above), further tests should be done to determine the cause and best treatment. Otherwise, ignore this test result and move on. There is nothing in any of this that implies any need for your wife to be examined or treated.

I hope this information is helpful. Let me know if anything isn't clear.


37 months ago
Dear Dr HHH,

Thank you for your response. 

Your response is clear and I understand everything you say. 

In essence, this is something that does not need worry or concern. The diagnosis of Gardnerella Vaginas serves no purpose, represents no danger or warning signals. The medication prescribed will not treat it. That GV is a fact of life and inconsequential. 

I have no pain when I urinate, no discharge. Every test I have had to date is negative. 

The reason for my full body health testing was mostly due to my age and symptoms associated to diverticulitis, which is confirmed. Additionally, moderately high blood pressure has also been confirmed and not unexpected. Any other symptoms are essentially a by product of age as well as stress and or anxiety associated to occasional pain from inflamed diverticulitis. 

Seems I was given the female full health screening package as an additional bonus which led us to this point. 

My wife will go for a check up anyway as she is due for her annual at this time. 

Many thanks for your help. I do not have any further questions at all. You have clarified this well for me. 

Best wishes. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Thanks for the follow-up comments. Perhaps this is a lesson learned about comprehensive health screenings. By and large, most medical experts recommend against them. There are some elements whose value is unquestioned, like blood pressure checks, lipid tests (cholesterol etc), colonoscopy, and others. But extended screening has the problem that things turn up at random. (If 100 tests are done, it's more or less guaranteed that a few will be "abnormal", usually not indicating any health problem at all.) I don't mean to lecture you, but a male having a "female" screening package??

Don't misunderstand, I'm not blaming you and I understand the lure of such comprehensive screening as people age and face their own mortality. Trust me, I know this personally. But this does seem a teaching moment, for you for sure and perhaps for others who might be visiting the forum.

Anyway, your statement above ("In essence,...) is exactly right and shows you get it. Let me know if you have any final questions.