BV After Treatment: What to Expect Next (Real Stories & Clinician Guidance)

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The Short Answer at a Glance

After treatment for bacterial vaginosis (BV), most people notice odour improving within 2–3 days and discharge settling over about a week, although mild changes can continue for a little longer. It’s common for symptoms to fluctuate, especially around sex or periods, and for BV to come back; around half of people experience recurrence. Simple aftercare habits and understanding your personal triggers can make a big difference to comfort and how often BV returns.

Who this guide is for

This guide is for people in the UK who have recently finished BV treatment (or are about to) and want to know what’s normal, what isn’t, and what to do if symptoms come back.

Finishing a course of BV treatment can bring relief, but also new worries. You might be asking yourself: “Is it supposed to smell like this?”, “Why has my discharge changed again?” or “Has the BV actually gone or is it coming back?”

BV is incredibly common and frustrating. Symptoms don’t always disappear overnight, and many people experience flare-ups again after sex, periods, or using certain products. This doesn’t mean you’re dirty or have poor hygiene. BV is about vaginal pH and bacteria balance, not how clean you are.

In this guide, we’ll walk through real experiences, what’s normal after treatment, when to be concerned, and simple steps to support your vaginal microbiome (the community of helpful and unhelpful bacteria in the vagina) as it settles.


Key Takeaways

  • BV symptoms often start improving within 2–3 days of treatment
  • Odour and discharge can take up to a week to fully settle
  • Recurrence is common up to 1 in 2 people experience BV again
  • Sex, periods, tight clothing, and perfumed products can disrupt vaginal pH
  • Simple aftercare habits can reduce flare-ups and improve comfort
  • If symptoms don’t improve in 7 days, or keep coming back, it’s worth a review


1. Real Experiences of BV Treatment

BV rarely feels straightforward. Even when treatment works, symptoms can shift day to day, and it’s easy to worry you’ve done something wrong.

 “BV went away within two days but the smell came back after sex. I felt like I’d done something wrong.”


“Metronidazole cleared the symptoms, but thrush hit straight after. It’s like a cycle.”

These stories are very common. BV is caused by a change in the balance of vaginal bacteria and pH (how acidic or alkaline things are), not a lack of cleanliness. Everyday things like sex, semen, period blood, sweating, and some products can nudge that balance again, even after successful treatment.

BV is about bacterial balance and pH; not poor hygiene or something you “did wrong”.

Simply knowing this can ease some of the shame and worry that often come with recurrent symptoms.


2. How BV Treatment Works (and How Fast)

BV treatment consists of antibiotic tablets, vaginal gel, or cream.  They target the overgrowth of bacteria that cause the classic BV odour and discharge. It doesn’t instantly “reset” the whole vaginal microbiome, but it reduces the bacteria driving your symptoms, so balance can return.

Most people notice:

  • Odour improving within 2–3 days
  • Discharge improving over 3–7 days

From clinical experience and guidance from bodies like BASHH (the British Association for Sexual Health & HIV), it can take 1–2 weeks for the vaginal microbiome to fully settle after BV treatment. During that time, sex, periods, sweating, or tight underwear can temporarily shift your pH and cause brief ups and downs.

Treatment usually starts working within days, but full rebalancing can take a week or two.

A small wobble in discharge or odour during this period doesn’t always mean BV has fully returned.


3. What’s Normal After BV Treatment?

Mild, short-lived changes are common while your body recovers. You might notice:

Mild discharge changes
A slightly thinner, wetter, or lighter discharge for a few days as the vagina clears out the treatment gel or responds to pH changes.

Temporary odour after sex or periods
Sexual fluids and period blood are more alkaline and can shift pH. A brief change in smell after sex or your period can happen, then settle again.

Watery discharge after gels
If you’ve used lactic acid gels or products such as pH-balancing vaginal gels, a bit of watery leakage is expected as the product works and moves out.

“I was worried at first, but the watery discharge eased after a few days and things felt normal again.”

Short-term changes in discharge and odour are common as your vagina settles after treatment.

If things are gradually improving, even with small ups and downs, that’s usually reassuring.


4. When BV Might Not Be Fully Resolved

Sometimes treatment doesn’t fully clear BV, or another condition (like thrush) appears afterwards. It’s worth seeking review if you notice:

  • Strong BV-like odour still present after 7 days
  • Clumpy white discharge (more like thrush, which is a yeast infection not a bacterial one)
  • Ongoing burning, itching, or soreness
  • Lower tummy or pelvic pain, especially with fever or bleeding

“The BV seemed better, but the itching became unbearable; it turned out to be thrush from the antibiotics.”

If symptoms haven’t shifted in a week, or feel different or worse, it may not just be BV.

In these cases, a clinician can help check whether you’re dealing with BV, thrush, both together, or something else that may need specific treatment.


5. Aftercare Checklist (Simple & Effective)

You can’t control everything that affects BV, but you can support the vaginal environment while it settles. Many patients find these steps helpful:

  • Avoid sex or use condoms for 3–5 days- Sexual fluids can briefly disrupt pH, so giving things a short break can help recovery.
  • Choose breathable cotton underwear- Cotton and looser clothing help reduce moisture and irritation.
  • Skip vaginal washes and perfumed products- Stick to washing the vulva (external area) with warm water only. Internal washes and fragranced products can upset the natural balance.
  • Consider probiotics if advised- Some people find that certain oral or vaginal probiotics help with recurrent BV, especially when suggested by a clinician.
  • Keep a simple symptom log- Note when flare-ups happen for example, after sex, your period, a new product, or a particular activity.

“Once I tracked it, I realised my BV kept flaring right after my period and after using a specific wash.”

Gentle aftercare and spotting patterns make it easier to prevent or manage future flare-ups.

These habits don’t “replace” treatment, but they can reduce the number and intensity of recurrences.


6. Why BV Sometimes Comes Back

Recurrent BV is unfortunately common. Studies and guidance from organisations like the CoSRH (College of Sexual and Reproductive Healthcare) suggest that around half of people treated for BV experience it again within a year.

BV can return due to:

  • Sex (especially without condoms)
  • Semen in the vagina
  • Period blood
  • Hormonal shifts
  • Sweating and very tight clothing
  • Other antibiotics (which may disrupt bacterial balance)
  • Scented soaps, bath products, or wipes

“It felt like a pattern, better after treatment, then back again after my period or sex.”

Recurrence is common and linked to natural pH changes, not poor hygiene.

Understanding your personal triggers can help you and your clinician choose the best long-term plan.


7. Next Steps if BV Symptoms Return

If your BV seems to be back, or never fully cleared,  it’s worth taking a step-by-step look:

  • Reassess recent triggers-Did symptoms flare after sex, your period, sweating, tight clothing, or another medication?
  • Consider a repeat treatment- A second course is common and often effective, especially if symptoms clearly match BV.
  • Check for thrush-Thrush often appears after BV treatment and needs a different treatment (usually antifungal, not antibiotic).
  • Rule out STIs if symptoms feel unusual-Pain, bleeding after sex, fever, or pelvic pain can sometimes suggest sexually transmitted infections or other causes that need checking.
  • Seek a review if symptoms persist beyond 7 days- A clinician can examine your history, symptoms, and any patterns to decide on the safest and most appropriate next step.

“Once I told my clinician how often it came back, we made a longer-term plan instead of just repeating short courses.”

If BV keeps returning, it’s a signal to review triggers and explore a longer-term plan with a clinician.


Frequently Asked Questions

How long should BV symptoms take to settle after treatment?

Most people find odour improves within 2–3 days, with discharge settling over about a week. Mild ups and downs are common during this time.

Is it normal for BV to come back after sex?

Yes, it can be. Semen and friction can temporarily disrupt vaginal pH, which is why some people see a pattern after intercourse.

Why did I get thrush after BV treatment?

Antibiotics can disturb the normal balance of bacteria and yeast, sometimes leading to thrush, which is a yeast overgrowth. Thrush needs a different type of treatment.

Can I do anything to stop BV coming back?

You can’t control everything, but you can support your vaginal balance with breathable underwear, avoiding perfumed products, using condoms if advised, and tracking patterns around your period and sex.

When should I seek urgent help?

Seek urgent medical advice if you have severe pelvic or tummy pain, fever, bleeding after sex, or symptoms that feel unusual, severe, or worrying.

Safety Section

BV itself is usually mild but uncomfortable. However, it’s important to seek further advice if:

  • Symptoms haven’t improved after 7 days of treatment
  • You develop new pain in your lower tummy or pelvis
  • You notice bleeding after sex or between periods
  • You feel unwell with fever or general flu-like symptoms

You should seek urgent medical help if:

  • Pain is severe or worsening
  • You have heavy bleeding
  • You feel very unwell, faint, or feverish

Guidance from organisations such as the NHS, BASHH, and the World Health Organisation (WHO) emphasises the importance of ruling out other causes if symptoms are persistent, severe, or unusual.

SwiftMedi clinicians will always take your symptoms seriously and review your history carefully before recommending any treatment.


Safety Disclaimer

This article provides general information and is not a substitute for medical advice. Always speak with a healthcare professional about your personal situation. SwiftMedi only provides treatment following a clinical assessment, and completing a consultation does not guarantee a prescription. Seek medical help if your symptoms worsen or you are worried about your health.


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