When Are You No Longer Contagious with Bacterial Vaginosis After Taking Flagyl?
Bacterial vaginosis is not considered a contagious or sexually transmitted infection, so the concept of being "contagious" does not apply to BV in the traditional sense. 1
Why BV Is Not Treated as a Contagious Condition
Male sex partners of women with BV are not symptomatic, and the CDC explicitly states that preventing transmission to men is not a goal of therapy. 1
Treatment of male partners has been shown in clinical trials to have no effect on either the clinical course of BV in women during treatment or the relapse/reinfection rate. 1 Therefore, routine treatment of sex partners is not recommended. 2, 3
The primary goal of treating BV with metronidazole is to relieve vaginal symptoms and signs of infection in the affected woman, not to prevent transmission. 1
When Treatment Is Complete and Symptoms Resolve
After completing a standard 7-day course of oral metronidazole 500 mg twice daily, follow-up visits are not necessary if symptoms resolve. 1, 2
The CDC reports cure rates of 95% for the 7-day metronidazole regimen, with relief of symptoms and improvement in clinical course and vaginal flora disturbances. 1
No specific "contagious period" exists because BV represents an imbalance of normal vaginal flora rather than transmission of a pathogen. 1
Important Clinical Context
BV is characterized by an overgrowth of polymicrobial bacteria that normally exist in the vagina, not by acquisition of a new infectious agent from a partner. 4
Recurrence of BV is common (approaching 50% within 12 months), but this represents relapse or recolonization with the woman's own flora rather than reinfection from a partner. 2, 4, 5
Sexual activity may influence BV recurrence through changes in vaginal pH and flora, but abstinence or protected sex during and after treatment is associated with better cure rates—not because of preventing "contagion" but because of maintaining vaginal flora balance. 5
Common Pitfall to Avoid
- Do not counsel patients that they need to wait a specific period after treatment to avoid "spreading" BV to partners, as this misrepresents the nature of the condition. 1 The focus should be on symptom resolution and maintaining vaginal health rather than infectivity concerns.