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. Sex can be a trigger for BV, so you need to be mindful of sexual activity when you’re treating bacterial vaginosis, especially if you're taking the antibiotic metronidazole.

So, can you have sex while taking metronidazole? 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 cause unusual vaginal discharge (often grayish-white and thin) and a strong fishy odor.

BV is more common among sexually active women. Researchers aren't exactly sure why BV develops, but there are a few known risk factors:

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 BV, 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 BV.

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

All of this is to say that if you’re taking medication to treat BV, 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 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 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 BV, 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 it. Boric acid is toxic when ingested, so you should also avoid receiving oral sex for a few days after finishing the treatment.

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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 tablets. 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. 

What not to do when treating BV

It’s a good idea to abstain from sexual intercourse (vaginal sex) and oral sex while treating bacterial vaginosis. Anal sex is technically a safer option (as long as you use a condom), but the friction caused by penetration still carries the risk of transmitting some unwanted bacteria from the anus to the vaginal opening. If you really can’t hold off from sex, your safest option is mutual masturbation.

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 BV 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 a week after finishing your medication.

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

You should wait at least a week after finishing a course of metronidazole treatment for bacterial vaginosis before having unprotected sex. This waiting period allows the medicine 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, but it may take a little longer. It's important to stick with the full course of treatment, which commonly lasts a week, to ensure the infection is completely gone. Even if you start feeling better quickly, finish all of the prescribed medicine to prevent the infection from returning. 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.

Can you have sex while on antibiotics? 

It depends on why you’re taking antibiotics. If you’re treating a sinus infection, for example, there’s no reason why you can’t have sex. But if you’re taking antibiotics because you’re treating BV or an STI, you should wait until you’ve finished the entire course and your symptoms have completely cleared.

Can I have sex with bacterial vaginosis? 

You can, but it’s better if you don’t. Having sex while you have bacterial vaginosis can make your symptoms worse, and potentially make the infection harder to treat. Not only does sex alter your pH balance and make your vaginal microbiome more susceptible to dysbiosis, but recent research suggests that BV can be sexually transmitted. 

What not to do while taking metronidazole? 

While taking metronidazole for BV, there are a few things you should avoid to ensure the medicine works effectively and to prevent any unpleasant side effects. First off, it's really important not to drink alcohol. Drinking while on metronidazole can lead to an unpleasant reaction that can make you feel nauseous, cause headaches, and lead to flushing. To be safe, stick to non-alcoholic beverages while you're on the medication and for at least 48 hours after you've finished it. Next, try to take all your doses as prescribed, even if you start to feel better. It’s essential to complete the full course of treatment to make sure the infection is completely gone and doesn’t come back. Also, avoid vaginal douches or scented vaginal products during your treatment. These can cause vaginal irritation and might interfere with how well the medicine works. It’s best to hold off on sex until you've finished your full course of antibiotics. Lastly, if you’re using metronidazole as a vaginal gel or cream, it's a good idea to skip applying it during your period (unless your doctor tells you otherwise) since menstrual blood can make it less effective. Remember to follow your healthcare provider's advice, and don’t hesitate to reach out if you have any questions or concerns during your treatment.