Metronidazole Gel for BV:
Your Questions Answered

Written by Kathleen Morrison
Medically Reviewed by Andrea Sleeth WHNP-BC, MSCP

Noticing changes in vaginal discharge or odor? You’re not alone—bacterial vaginosis (BV) is incredibly common and nothing to be ashamed of. It simply means the natural balance of bacteria in your vagina has shifted, and the good news is treatment is straightforward.

Metronidazole vaginal gel is a doctor-recommended option that targets BV at the source, helping to restore balance so you can feel like yourself again. It’s applied directly inside the vagina, helping people manage symptoms effectively.

Understanding how it works, its benefits, and how to use it correctly can help you decide if it’s the right choice for you. Wisp makes prescription BV management simple, discreet, and stress-free—because your sexual health should never feel complicated.

What is Metronidazole Gel?

Metronidazole (met-roh-nai-deh-zowl) gel is a prescription treatment for bacterial vaginosis (BV) that works by restoring balance to your vaginal microbiome. Unlike oral prescription antibiotics, it’s applied directly inside the vagina, targeting the source of BV while minimizing side effects like an upset stomach.

The gel contains metronidazole, an antibiotic that fights off harmful bacteria without disrupting any of the good ones. That means less odor, unusual discharge, and discomfort—without unnecessary guesswork. Since it’s a localized treatment, many find it gentler on the body while still being highly effective.

While metronidazole gel is a trusted go-to for BV, it won’t treat yeast infections or other vaginal conditions. If you’re dealing with recurring symptoms, a quick chat with a healthcare provider can help confirm the best approach for you.

How Does Metronidazole Gel Work?

BV happens when the bacteria in your vagina get out of balance, and metronidazole gel is designed to reset the vibe. It works by targeting anaerobic bacteria (the kind that overgrows when things are off balance) while leaving the good bacteria intact.

The result? A healthier vaginal environment and fast relief from symptoms like odor and unusual discharge.

Because metronidazole gel is applied directly inside the vagina, it gets to work right at the source. Many people find it works faster than oral BV antibiotics and with fewer side effects. Most treatment courses last 5–7 days, and while you might start noticing relief early on, completing the full course is important to keep BV from making a comeback.

Everyone’s body is different, so if your symptoms linger or return, a quick check-in with a healthcare provider can help fine-tune your treatment plan. When used correctly, metronidazole gel is a simple, effective way to stop BV in its tracks and keep your vaginal health in balance.

How to Use Metronidazole Gel

Using metronidazole gel the right way can make all the difference in getting the best results. Sticking to a simple routine helps ensure that the treatment does its job—so you can get back to feeling like yourself.

Dosage and Application

Most healthcare providers recommend applying metronidazole gel once or twice a day for about five days, though your prescription might vary. Typically, you’ll use the provided applicator to insert the gel into your vagina—often at bedtime—to help it stay in place while you sleep.

A few tips to make the application easier:

• Wash your hands before and after using the applicator to keep things clean.
• Use a panty liner if you’re worried about leaks, though the gel is designed to stay put.
• Stick to the instructions from your provider or medication guide—skipping doses or stopping early can make BV more likely to return.

While treating BV, it’s best to avoid vaginal douches or scented soaps, which can disrupt your natural balance. If you use other vaginal medications, check with your provider about spacing them out so they don’t interfere with each other.

Tips for Effective Use

• Set a reminder: Applying your gel at the same time each day (like right before bed) helps you stay consistent.
• Pause on sex: It’s best to avoid sex during treatment since friction can cause irritation and make the gel less effective. If you do engage in sexual intercourse, using barrier protection like a condom can help.
• Finish the full course: Even if your symptoms clear up early, stopping treatment too soon can allow BV to return.
• Listen to your body: If you notice intense itching, irritation, or worsening symptoms, check in with a provider for guidance.

A little planning goes a long way—whether that’s setting a calendar reminder or tracking symptoms in a notes app. By staying on top of your treatment, you can clear up BV and focus on what matters: feeling comfortable and confident in your body.

Potential Side Effects

Starting a new treatment can feel a little nerve-wracking, especially if you’re not sure how your body will react. The good news? Most people find metronidazole gel easy to use with little to no side effects. And when side effects do pop up, they’re usually mild and short-lived.

Here’s what you might notice:

• Mild vaginal irritation: Some people feel slight itching or burning after applying the gel, especially if BV has already caused sensitivity. This usually fades as the medication starts working.
• Metallic taste: Even though the gel goes in your vagina, metronidazole can sometimes cause a metallic taste in your mouth. Weird, but totally normal.
• Changes in discharge: You might see a shift in color or texture while using the gel. This is usually just the medication mixing with natural fluids and clearing out the infection.
• Mild nausea, headaches, or stomach upset: These side effects are more common with oral metronidazole but can occasionally happen with the gel.
• Allergic reactions (rare): If you notice intense itching, swelling, or hives, stop using the gel and check in with a provider.

The key is to pay attention to whether your BV symptoms—like odor or irritation—are improving. If they are, the gel is doing its job. If any side effects feel severe or just won’t go away, a quick chat with a provider can help you decide if switching treatments makes sense.

Keeping track of reactions (even just in your phone’s notes app) can help you find what works best for your body.

Most people find that any minor side effects are well worth the relief from BV!

Interactions with Other Medications

Mixing medications can sometimes lead to unexpected reactions, so it’s always a good idea to check with a doctor or pharmacist before starting metronidazole gel—just to be safe.

Here’s what to keep in mind:

• Metronidazole, in any form, has the potential to interact with other medications. That’s why it's important to share your full list of prescriptions, supplements, and vitamins with your provider. For example, blood thinners and seizure medications can sometimes be affected.
• Alcohol and metronidazole gel: While the oral version is known for causing nausea and flushing when mixed with alcohol, the gel has a lower risk. That said, many doctors still recommend avoiding alcohol use during treatment, just in case.
• Using other vaginal treatments? If you’re also using antifungal creams or other vaginal medications, space them out to avoid interference. Letting one absorb fully before applying another can help everything work better.

Keeping an updated list of your medications and checking for interactions before starting something new can help you stay in control of your sexual health—without the guesswork!

Why Use Metronidazole Gel?

When BV flares up, you want relief—fast. Metronidazole gel delivers exactly that, sending the antibiotic straight to the source so you can start feeling better ASAP. Plus, it comes with some major perks that make treatment simple, discreet, and easy to stick with.

One of the biggest advantages? Targeted application. No swallowing pills and a lower chance of full-body side effects—just direct relief where it’s needed. Since the gel is applied inside the vagina, it works on the root cause of BV but with a lower risk of an upset stomach or a weird metallic taste in your mouth (which both happen more often with oral antibiotics since they need to move through your digestive system).

Most people notice symptoms like odor or unusual discharge improving within a few days. Just remember: even if you’re feeling better, finishing the full course can help BV from coming back.

It’s also completely discreet and hassle-free. You can apply the gel in private, usually at bedtime, so it won’t disrupt your daily routine. You don’t need to time your doses around meals—just a quick, easy step before bed.

And let’s be real: confidence is everything. When BV symptoms fade, you can go about your day (or get intimate) without that nagging worry about odor or discomfort. Since BV has a habit of coming back, metronidazole gel also helps restore balance to your vaginal flora, which can mean fewer recurrences in the future.

Things to Know Before Using Metronidazole Gel

Starting a new treatment comes with questions, and that’s a good thing. Taking charge of your sexual health means knowing what’s right for your body. Metronidazole gel is a go-to for BV, but there are a few things to keep in mind before getting started.

First, if you have any allergies—especially to antibiotics—it’s worth double-checking the ingredients with a healthcare provider to make sure you’re in the clear. Metronidazole gel mostly works locally, but small amounts can enter the bloodstream, so if you have kidney or liver concerns, it’s smart to bring that up, too. A quick chat with a provider can help you feel confident about starting treatment.

Sex and Metronidazole Gel

Some healthcare professionals recommend avoiding sex while using the gel, and here’s why: friction from intercourse (or the presence of semen) could irritate sensitive tissue or interfere with how well the treatment works. Plus, latex condoms and diaphragms may not be as effective when they come into contact with certain ingredients in the gel. If you’re wondering how this applies to you, talking to a provider about alternatives—like non-latex options or temporary abstinence—can help you make the best choice for your body.

Who should skip it?

• If you’re allergic to metronidazole or similar antibiotics, this gel isn’t for you—there are other options that can work just as well.
• If you’re pregnant or breastfeeding, metronidazole gel is often considered safer than oral antibiotics, but it’s still worth discussing with your provider to make sure it’s the best fit for your situation.
• If you have epilepsy or certain blood disorders, you’ll want to check in with a healthcare professional before starting just to be sure it won’t interact with your current treatments.
  

When to Check In With a Doctor

Most people notice relief within a few days, but if your BV symptoms don’t improve after finishing the full course, it could mean the infection needs a different approach. A quick follow-up can help you figure out the next step, whether that’s another round of treatment or switching to a different option.

Other signs that deserve attention? Persistent pain, heavy bleeding, or severe irritation. If something doesn’t feel right, don’t wait—your body deserves care and answers. And if you ever experience swelling around your lips or throat (a possible allergic reaction), seek medical help right away.

Keeping track of how you feel during treatment—whether in a notes app or a journal—can make it easier to spot patterns and discuss any concerns with a healthcare provider. Your sexual health should feel empowering, not stressful, and Wisp is here to make sure you have the info you need to take care of yourself with confidence.

Metronidazole vs. Other BV Treatments: What’s Your Best Fit?

With so many BV treatments out there, figuring out the right one for your body can feel overwhelming. The good news? Understanding how metronidazole gel stacks up against other options can help you make an informed, confident choice.

Wisp treatment options are available only after consultation with a licensed medical professional. You should consult with your healthcare provider before starting a new supplement or treatment regimen. Individual results may vary.

Oral Antibiotics: Effective, but Not for Everyone

Oral antibiotics like metronidazole or tinidazole are go-to prescriptions for BV, working throughout the body to fight off disruptive bacteria. While they’re effective, they’re also more likely to bring along those common side effects like stomach upset or that notorious metallic taste than a gel or cream. If you’ve struggled with those in the past, switching to a gel that works directly at the source—without circulating through your whole system—might be a more comfortable option.

Clindamycin Cream: Another Prescription Alternative

Clindamycin cream is another vaginal treatment for BV. It works similarly to metronidazole gel, but if you’re sensitive to metronidazole, this could be a good alternative. That said, clindamycin is more likely to throw off your vaginal flora, potentially leading to a yeast infection or gut imbalances. If you’re weighing your options, talking to a provider can help you choose what makes the most sense for you.

Over-the-counter Treatments: Helpful or Hype?

Walk down any pharmacy aisle, and you’ll see tons of products promising to restore balance. The catch? Many of them are actually designed to treat yeast infections, not BV. Using the wrong treatment might offer temporary relief, but it won’t fix the root cause—kind of like slapping a bandage on a leaky pipe. If you’re unsure whether BV is the culprit, getting tested or consulting a provider is the best way to avoid frustration (and wasted money).

Lifestyle Adjustments: A Good Boost, but Not a Cure

Probiotics, diet changes, and good hygiene habits can help support vaginal health, but unfortunately, they aren’t enough to clear up an active bacterial vaginal infection. If you’re dealing with BV, you’ll need an antibiotic treatment first. After that, maintaining a balanced vaginal microbiome—by skipping douches, choosing breathable underwear, and considering probiotic support—can help keep future infections at bay.

Why Metronidazole Gel?

Metronidazole gel delivers medication exactly where it’s needed, helping to reduce the full-body side effects that sometimes come with oral antibiotics. Many people find it easier to use—no scheduling pills throughout the day, and fewer digestive issues to worry about. If you’re looking for an effective, straightforward BV treatment with less disruption to the rest of your body, metronidazole gel might be the perfect fit.

Can you Pee After Inserting Metronidazole Gel?

Wondering if you can pee after inserting metronidazole gel for BV? That’s a totally valid question, as it’s natural to want the medication to be as effective as possible. Luckily, peeing after inserting metronidazole gel is totally fine. Though some of the gel might leak out over time, most of the medication will stay inside your vagina. Using the bathroom won’t keep metronidazole gel from doing its job or impact its effectiveness. That said, it might be more comfortable to use the bathroom before inserting metronidazole gel—just make sure your external skin is clean and your hands are sanitized.

Can I Use Metronidazole Gel While on My Period?

BV and other infections often cause vaginal discharge. Add your period into the mix and things can get overwhelming! That’s why a common question is: can you use metronidazole gel while on your period? The answer is yes, you can. But you shouldn’t use tampons or menstrual cups at the same time–stick to sanitary pads instead.

If you start your period while using metronidazole gel, make sure to finish your whole treatment. And if you’d rather not use metronidazole gel for BV while on your period? Antibiotic tablets are another great option. Discuss your preferences and any concerns with a healthcare provider, and you’ll be good to go.

Is Metronidazole Gel Right for You?

If you want a targeted BV treatment with fewer full-body side effects, metronidazole gel could be a great fit. It works directly at the source to ease symptoms like odor and discharge—just be sure to complete the full course for the best results.

At Wisp, we make sexual health care simple, stigma-free, and accessible. If BV keeps coming back or you have questions about treatment, a quick check-in with a provider can help. You can also support vaginal balance by skipping douches, wearing breathable underwear, and considering doctor-approved probiotics.

Metronidazole gel is a reliable, low-maintenance option that fits into your routine—so you can get relief and get on with your life.

Frequently Asked Questions (FAQ):

How long does it take metronidazole gel to work for BV?

You’ll likely start noticing relief in about six days (and the fishy odor should be gone in about three), but completing the full course (or what your provider prescribes) gives you the best chance of kicking BV for good.

Is metronidazole gel good for BV?

Yes! It’s one of the most common and effective BV treatments because it directly targets the bacteria causing the infection.

What comes out after using metronidazole gel?

Some gel and fluids may come out of the vagina, which is totally normal. This is just your body clearing the infection and the medication doing its thing.

Does metronidazole gel address the fishy odor?

Yep! Since BV is caused by an imbalance of bacteria, metronidazole works to restore balance—often eliminating the odor that comes with it.