Is it safe to have an orgasm with a current csf leak, if not, how long after treatment should i wait before having an orgasm?

You should abstain sex in any acute medical condition. CSF leak is a serious complication so you should avoid sex for at least 2 weeks if you can.

Depends upon cause. If this is due to a post lumbar puncture leak, there would be no real issue, and a blood patch could reverse. If there is a rent elsewhere in the central nervous system, the source should be located and managed.