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Trichomoniasis is a widespread sexually transmitted infection that is more common in females than males. Testing for trichomoniasis can be challenging as many people have no symptoms.

Trichomoniasis is a type of sexually transmitted infection (STI) with symptoms that include irritation around the genitals. This article discusses trichomoniasis symptoms, when to see a doctor, testing, and treatment.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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The Centers for Disease Control and Prevention (CDC) estimate that 2 million people had trichomoniasis infections in 2018, making it the most common STI in the United States. The CDC also states that only about 30% of people with the infection had symptoms.

Trichomoniasis is more prevalent than chlamydia, gonorrhea, and syphilis combined. Females are more likely to have trichomoniasis than males, and older people are more susceptible to the infection.

Causes

The Trichomonas vaginalis parasite causes trichomoniasis. The disease is transmissible through sex, typically through penile-vaginal contact but also through vagina-to-vagina contact and shared sex toys.

Symptoms

There is no clear reason why some people who have the infection show symptoms and others do not. Symptoms usually appear 5–28 days after contracting the infection. Symptoms can be mild or severe and can come and go in cycles.

Symptoms for females typically include:

  • irritation, itching, and inflammation of the genitals
  • discomfort during urination
  • a discharge from the vagina that can appear white, yellow, or greenish and have an unpleasant odor

Learn about other STIs that cause itching.

Symptoms for males typically include:

  • irritation or itching inside the penis
  • a burning sensation following urination or ejaculation
  • abnormal discharge from the penis

Trichomoniasis can spread from asymptomatic individuals who have the infection to others.

Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.

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Doctors typically prescribe antibiotics to treat trichomoniasis. For example, someone may take metronidazole, which is generally highly effective for treating the condition.

Metronidazole

Doctors usually prescribe metronidazole in pill form as either a single dose of 2 grams (g) or multiple 500 milligrams (mg) over 7 days. It is safe to take these drugs during pregnancy.

One study found that females who took the 7-day dose were less likely to test positive for trichomoniasis after treatment than those who took a single dose. Studies also found people who took the single tablet were more likely to have side effects, such as nausea and vomiting.

If applicable, people should not consume alcohol when they are taking medication to treat trichomoniasis. They should also not drink alcohol for 24 hours after their last dose of metronidazole and 72 hours after completing tinidazole treatment.

Learn more about metronidazole here.

Boric acid

Some people are allergic to metronidazole. Doctors may prescribe 600–mg doses of boric acid as a vaginal suppository twice a day for 60 days instead of metronidazole.

Doctors do not typically prescribe this treatment for trichomoniasis, and people should not use it as an alternative to antibiotics unless a doctor advises it.

Learn more about boric acid here.

Nausea and vomiting are some possible side effects of antibiotic treatment for trichomoniasis. These are more common with a single-dose antibiotic treatment than the typical 7-day dose.

It can be difficult to diagnose trichomoniasis even where symptoms exist because they typically resemble those of other STIs. A person who believes they have trichomoniasis should speak with a doctor, who will recommend various tests to ensure an accurate diagnosis.

Home tests are available, making it possible for people to connect with certified labs from the privacy of their homes. Some options include:

LetsGetChecked

This company offers three sexual health tests, including trichomoniasis.

Individuals take their samples at home, send them off with a prepaid mailing label, and check their results 2–5 days later at a secure online location. Doctors review the test results, and a nursing team will provide a consultation.

The standard package testing for the six most common STIs costs $119.

Learn more about LetsGetChecked here.

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EverlyWell

One of the 30 tests this company conducts is a urine test for trichomoniasis.

Users send their urine samples in a prepaid biohazard bag that comes with the test kits. A board certified doctor contacts people to discuss the next steps if their test results are positive.

The test costs $49.

Learn more about EverlyWell here.

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People should always speak with a doctor if they receive positive or uncertain test results.

Learn more about trichomoniasis testing here.

Abstinence from vaginal, anal, and oral sex is the only certain way to prevent STIs, including trichomoniasis.

Those who choose to engage in sexual activity can minimize their risk of infection by:

  • being in a mutually monogamous relationship with both partners regularly testing negative for STIs
  • using latex condoms during sexual interaction

Those who are sexually active should consider regular testing for STIs. Many people might experience no trichomoniasis symptoms, but treatment is necessary because the infection may increase the risk of:

  • contracting or transmitting HIV
  • problems with pregnancy, including premature delivery and low birth weight
  • contracting or transmitting herpes

People who notice symptoms should see a doctor for testing. They may have trichomoniasis or another condition that requires treatment.

People should also see a doctor if they test positive for another STI or a sexual partner tests positive for trichomoniasis or another STI.

People getting tested for trichomoniasis do not need to make any special preparations.

Testing for females usually involves a visual examination of the genitals. A healthcare professional will then use a small brush or swab to take a sample of vaginal discharge and tissue cells, which a laboratory technician will examine under a microscope. Females may also provide a urine sample.

When testing males, a healthcare professional conducts a visual examination of the penis and uses a swab to collect a cell sample from the urethra. Males also need to conduct a urine test.

People with trichomoniasis should follow a full course of antibiotic treatment as prescribed by a healthcare professional.

They should keep in mind that they can become reinfected with trichomoniasis. The CDC reports that 1 in 5 people who complete trichomoniasis treatment become infected again within about 3 months.

The best way for people to avoid reinfection is to notify sexual partners of their infection diagnosis so that they can also seek antibiotic treatment.

Those who have had trichomoniasis should get retested for the infection 3 months after completing treatment or sooner if symptoms emerge.

Trichomoniasis and pregnancy

Trichomoniasis can cause complications with pregnancy. People with trichomoniasis may experience preterm labor and deliver babies before their due dates. There is also a risk of birthing an infant with a low birth weight of fewer than 5.5 pounds.

The following are common questions and answers about trichomoniasis treatment:

Which antibiotics treat trichomoniasis?

Doctors usually prescribe metronidazole, tinidazole, or secnidazole to treat trichomoniasis.

How long does it take for trichomoniasis to go away after treatment?

Trichomoniasis symptoms usually clear in 7–10 days with treatment.

What will happen if trichomoniasis is left untreated?

Trichomoniasis infections are unlikely to clear on their own. Without treatment, trichomoniasis infections can increase a person’s risk of contracting HIV and herpes and cause problems with pregnancies.

The majority of people with trichomoniasis do not have symptoms. However, the disease can lead to significant health problems without proper treatment. These include a greater risk of getting or transmitting HIV and pregnancy issues.

Treatment with antibiotics is the standard approach to trichomoniasis and is generally effective.