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Sex and Lyme Disease Transmission in Lyme disease treatment

Can Lyme Be Sexually Transmitted? Yes.

Lyme can be sexually transmitted. In this article I review the science behind this statement and the risk that I believe exists. I also answer the following questions:

Q: Should I have my healthy sexual partner tested for Lyme disease?

Q: But shouldn’t I have my sexual partner tested to prevent him or her from transmitting the germ back to me during or after treatment?

Q: Should I tell my new sexual partner that I have Lyme? Should we use condoms?

How We Know Lyme Disease is Sexually Transmitted

The Lyme infection, borrelia, can be sexually transmitted. However we do not know the actual rate or chance of transmission. There is limited science around this topic, but here it is.

  • Studies do show borellia in vaginal fluid and male ejaculate of those who have positive testing with Lyme disease (1, 2).
  • In one recent study, 13 people with lyme were studied. Of the 13 studied 3 were sexual partners. All 13 had evidence of Lyme in the genital secretions. The sexual partners in each of these studies had identical strains of borrelia (Lyme) detected in the male ejaculate and vaginal fluid. However the researchers did not clarify the length between sexual activity of each couple and when the specimens were obtained. Nor is there scientific evidence indicating how long borrelia can persist in the vaginal fluid after male ejaculation. Thus it is possible the detection of identical strains in the female partner could be from male secretions in the vaginal fluid rather than her own vaginal secretions. In addition, it is possible each person in the couple were independently bitten by ticks which each carried the same strain. Furthermore this study only included 13 people. Small studies of this nature often do not reflect what happens in the general population.
  • Lyme is a spirochete like syphilis which is well know to be sexually transmitted.
  • Most Lyme Literate Medical Doctors (LLMD) treat married and other committed partners who both have Lyme disease.
  • The actual sexual transmission rate is not known.

On a positive note, in my experience most who get a Lyme infection through sexual transmission do not develop Lyme disease. I believe most people have immune systems that are able to rid the body of the Lyme infection or keep it under control.

Marty Ross MD Discusses Lyme Disease and Sexual Transmission

The video is a recording from Conversations with Marty Ross MD on 10/22/14

 

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Q:  Should I have my healthy sexual partner tested for Lyme disease?

A:  I recommend against testing. Even if testing is positive, I would not treat in this situation. I believe the majority of people, children or adult, who have Lyme infection do not develop Lyme disease. Lyme disease is the medical mess that sometimes results from a Lyme infection but does not always occur. Our immune systems do have the ability to get rid of the infection or to keep it under control. There are no animal or human studies that show what percent of the time Lyme disease develops in those with positive testing.

There are no outcome studies to show what happens when antibiotics are given to the healthy adult who does not have symptoms of Lyme disease. It is possible using antibiotics in this situation could trigger a more virulent form of the Lyme germ or treatment resistant infection causing Lyme disease to develop down the road. I take an “if it is not broken do not fix it” approach. One other point it is possible to have false positive testing too. The ability of a test to truly predict a disease is increased if symptoms of the illness are present. For more information about testing and false postive results see A Review of Lyme Infection Tests. Pass or Fail.

Q:  But shouldn’t I have my sexual partner tested to prevent him or her from transmitting the germ back to me during or after treatment?

A:   I do not think so. During treatment it is highly unlikely that your partner will transmit Lyme to you because the herbal or prescription antibiotics you take will prevent this from happening.

At the end of treatment a person should take the steps outlined in Finished? to prevent a Lyme relapse. I also believe these same steps that support the immune system will prevent the Lyme germs from a sexual partner to take hold. However, if I have a patient who has a relapse, I am likely to recommend they follow all of the steps outlined in Finished? including the recommendations about preventive herbal or prescription antibiotics. Even if a healthy sexual partner is treated for Lyme infection, there is no proof that the germ is eradicated at the end of his or her treatment. So it is best to follow the steps in outlined in Finished?.

Q:  Should I tell my new sexual partner that I have Lyme? Should we use condoms?

A:  First I recommend condoms for any sexual relationship that is not monogamous to prevent contracting a variety of sexual transmitted infections. Regarding Lyme, the choice on this topic is quite personal. As I discuss above, not all who contract a Lyme infection develop Lyme disease. It is not clear what the transmission rate is. Furthermore most who do get Lyme disease are likely easily treated. If you choose to tell your sexual partner then I suggest you both share this article together to make the best choice for you and your relationship.

References:

1) Middelveen MJ, Burke J, Sapi E et al. Culture and identification of Borrelia spirochetes in human vaginal and seminal secretions  F1000Research 2014, 3:309.

2) Recovery of Lyme spirochetes by PCR in semen samples of previously diagnosed Lyme disease patients. Gregory Bach, DO, International Scientific Conference on Lyme Disease, April 2001.

by Marty Ross MD

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