How Long to Wait for Sex After BV Treatment?

There’s nothing like bacterial vaginosis (BV) to ruin your chances of getting lucky, especially because sex is usually off the table while you’re treating a vaginal infection. Although BV isn’t a sexually transmitted infection (STI), sex can be a trigger — so you need to be mindful of sexual activity when you’re treating bacterial vaginosis.

Below is everything you need to know about treating bacterial vaginosis if you’re sexually active, including how long to wait for sex after BV treatment. 

What is bacterial vaginosis?

Bacterial vaginosis is a common vaginal infection that occurs when there’s an imbalance in the normal bacteria found in the vaginal microbiome. 

Your vagina naturally hosts a variety of bacteria, both good and bad, but when the bad bacteria multiply too much, it can lead to bacterial vaginosis symptoms like unusual vaginal discharge (often grayish-white and thin) and a strong fishy odor.

Bacterial vaginosis isn’t an STI, but it is more common among sexually active women. Researchers aren't exactly sure why BV develops, but there are a few known risk factors:

• Sex (specifically, with multiple sex partners or a new sex partner)
• Hormonal fluctuations (e.g. birth control, pregnancy, and menopause)
• Your period
• Smoking cigarettes
• Chronic stress‍
• Douching and using vaginal hygiene products.

It’s important to treat BV because, if left untreated, it can increase the risk of developing other health issues, including pelvic inflammatory disease (PID), increased susceptibility to STIs, infertility, and pregnancy complications (such as premature delivery). 

Does sex trigger BV?

Sex itself doesn’t directly cause bacterial vaginosis, but it can contribute to the conditions that make BV more likely to develop. Unprotected sex, especially with a new partner or multiple partners, can introduce new bacteria into the vagina, disrupting the balance of good bacteria and potentially leading to bacterial vaginosis.

Additionally, semen has a higher pH than the vaginal environment, which can alter the vaginal flora and promote the growth of bacteria that cause bacterial vaginosis. Some women also find that lubricants, spermicides, or certain types of contraceptives can irritate the vaginal lining, making it more susceptible to bacterial vaginosis.

All of this is to say that if you’re taking medication to treat bacterial vaginosis, having unprotected sex before the infection has cleared up may throw a spanner in the works. 

Sex after BV treatment: How long should you wait?

The short answer is that it’s best to wait until you’ve completed your treatment and your symptoms have fully resolved. 

The medications used to treat BV, such as antibiotics like metronidazole or clindamycin, need time to kill BV-causing bacteria. Having sex too soon could reintroduce bacteria into the vagina, potentially causing a recurrence of BV.

Even after starting treatment, it may take a few days for symptoms like discharge and odor to completely disappear. Waiting until these symptoms are gone is a good indication that the infection has been successfully treated.

The general recommendation is to wait at least seven days after completing your BV treatment before having sex again. This time frame allows the medication to do its job and gives your body a chance to restore its natural balance and allow good bacteria to grow back.

However, every woman is different. If your symptoms persist beyond the seven-day mark, or if you’re still experiencing discomfort, it’s best to hold off on sex and consult your healthcare provider. They may need to reassess your treatment or explore other underlying issues.

Although antibiotics are the first-line treatment for bacterial vaginosis, in some cases your healthcare provider may recommend boric acid suppositories. If you're taking boric acid for bacterial vaginosis, it's worth mentioning that it can be irritating for male partners, so you should abstain from penetrative sex for a few days after taking them. Boric acid is toxic when ingested, so you should also avoid receiving oral sex for a few days after finishing the treatment.

How to prevent bacterial vaginosis from coming back

Once your treatment is complete and you’re ready to resume sexual activity, there are steps you can take to reduce the risk of recurrent BV:

• Use protection: Using barrier methods like condoms and dental dams can help reduce the introduction of new bacteria into the vagina. Research shows that consistent condom use decreased the risk of bacterial vaginosis by 45%.
• Clean your sex toys: Wash (and dry!) your sex toys before and after each use.
• Don’t cross-contaminate: After anal play, make sure to change your condom or wash your sex toy before vaginal penetration.
• Consider partner treatment: Given that partners may harbor the bacteria that can cause symptoms and lead to infection, it may be worthwhile for both parties to be treated — especially if your partner is also a woman. Talk to your doctor about if this may be a useful approach for you.
• Practice good hygiene: Wash the genital area with mild soap and water, and avoid douching, which can disrupt the natural balance of bacteria.
• Limit multiple sexual partners: Having multiple partners puts you at an increased risk of developing BV. Reducing the number of sexual partners can lower the risk of bacterial imbalance.

FAQ

Can I have sex while treating BV?

You can, but that doesn’t mean you should. It's best to avoid sex while you're treating BV. Having sex during treatment can reduce the effectiveness of the medication and may prolong your recovery. It's also possible that it could make your symptoms worse or cause discomfort. To give your body the best chance to heal, it’s best to finish the full course of treatment and wait until your symptoms have fully resolved before resuming sexual activity, usually at least seven days after finishing your medication.

What happens if I had sex while taking metronidazole?

If you had sex while taking metronidazole for BV, it could potentially reduce the effectiveness of the treatment — whether you’re taking metronidazole gel or oral metronidazole. Sex might reintroduce bacteria into the vagina, which can prolong the infection or cause it to return after you've completed your medication. Additionally, some women experience increased irritation or discomfort during sex while on treatment. There's also a risk that the infection could be passed back and forth between partners (especially if you have female partners), making it harder to fully clear the BV. 

How long should you wait to have unprotected sex after metronidazole?

You should wait at least seven days after finishing a course of metronidazole treatment for bacterial vaginosis before having unprotected sex. This waiting period allows the medication to fully clear the infection and gives your body time to restore its natural bacterial balance. Having unprotected sex too soon could increase the risk of reinfection or could disrupt the healing process. 

How long does BV take to heal after treatment?

Most women start feeling better within a few days of beginning treatment, and their symptoms usually improve significantly within two to three days. It's important to stick with the full course of treatment, which commonly lasts seven days, to ensure the infection is completely gone. Even if you start feeling better quickly, finish all of the prescribed medication to prevent the infection from returning. Sometimes, it might take about a week or a little longer for all the symptoms to go away completely. BV also has a nasty habit of being stubborn, so if your symptoms don't go away after initial treatment, or if they come back soon after, it's best to talk to your healthcare provider for further advice. They may recommend a stronger dose or a different antibiotic treatment.