Trichomoniasis

Overview

What is trichomoniasis (trich)?

Trichomoniasis or “trich” is a common and curable sexually transmitted infection (STI). Trich spreads during sexual intercourse — in semen (cum) and vaginal fluids. Its name comes from the parasite Trichomonas vaginalis, which causes the infection.

You may have trich and not know it — most people don’t have symptoms from the infection. Trich is contagious, which means you might unknowingly infect others through sexual contact.

How common is trichomoniasis (trich)?

It’s the most common nonviral sexually transmitted infection globally. Anyone who has sex can get trich. Approximately 3.7 million people have the infection in the United States. Only about 30% of people have symptoms. Trichomoniasis is more common in Black women and people assigned female at birth (AFAB).

Symptoms and Causes

What are the symptoms of trichomoniasis?

One reason trich spreads so easily is that a large number of infected people — up to 70% — never have symptoms. You may infect others before you know you have the disease. When symptoms occur, they tend to appear within five to 28 days after exposure. Symptoms are more common in women or people AFAB. Researchers aren’t entirely sure why some people have symptoms and others don’t.

Signs of trichomoniasis in males and people assigned male at birth (AMAB)

Men and people AMAB rarely show signs of infection. In those who do, the most common are:

Signs of trichomoniasis in females and people AFAB

Women and people AFAB tend to have more noticeable symptoms than men. Some of them are:

  • Thin (or sometimes foamy) white, yellow or greenish vaginal discharge that has a bad odor.
  • Irritation, soreness or redness around the opening of your vagina.
  • Pain or discomfort during intercourse or when peeing.

What causes the condition?

A small parasite called Trichomonas vaginalis causes trich. Once you have the infection, you can give trich to someone else through:

  • Vaginal-penile or vaginal-vaginal intercourse.
  • Anal sex.
  • Oral sex.
  • Genital touching (skin-to-skin contact without ejaculation).

You can’t spread trich by sharing food and drinks, kissing, holding hands or through other nonsexual forms of contact.

In addition to affecting your genitals, trich can also infect your anus, mouth and hands.

Can trichomoniasis be caused by poor hygiene?

No. Poor hygiene won’t cause trichomoniasis. A parasite causes trich. The parasite spreads from partner to partner during sexual contact.

Can a UTI cause trichomoniasis?

No, a urinary tract infection (UTI) doesn’t cause trichomoniasis.

Is trichomoniasis (trich) contagious?

Yes, trich is contagious. Many people aren’t aware they have it and unknowingly spread it to their sexual partners.

Risk factors

Trich can affect anyone regardless of their assigned sex. Women and people AFAB are more likely to get trich. Your risk for trich increases if you:

  • Don’t use condoms while having sex.
  • Have multiple sexual partners.

Complications of this condition

Untreated trich increases your risk of becoming infected with the human immunodeficiency virus (HIV) if you’re exposed to the virus. Untreated HIV can lead to AIDS. Women and people AFAB who have trich and HIV are more likely to pass both diseases on to their partners. For this reason, the Centers for Disease Control and Prevention (CDC) recommends that HIV-positive women and people AFAB get tested for trich at least once a year.

Diagnosis and Tests

How is it diagnosed?

Your healthcare provider may perform the following tests to diagnose trich:

  • Physical exam: Your provider will examine your genitals and discuss any symptoms you’re having. For people AFAB, it may include a pelvic exam. Often, your provider will get a sample of your discharge using a cotton swab during this exam.
  • Lab test: Your healthcare provider examines a sample of your vaginal or penile discharge under a microscope to check for signs of infection. They may send the swab to the lab for further testing if they don’t see trichomonads under the microscope.

If you have trichomoniasis, your provider may want to test you for other STIs too.

In some cases, your provider may prescribe antibiotics without an exam. This is typically only the case if your sexual partner has the infection and you engage in sexual contact with them while they have it.

Management and Treatment

How is trichomoniasis treated?

Healthcare providers treat trichomoniasis with antibiotic medication to kill the parasite causing the infection. Without treatment, trich can last for months or even years. It won’t go away on its own. The entire time you’re infected, you can give the infection to your sexual partners. It’s important that all sex partners are treated to prevent re-infection.

What medication do you take for trichomoniasis?

Oral antibiotic medications kill trich. Your healthcare provider may prescribe metronidazole or tinidazole. It’s important to keep the following in mind while undergoing treatment:

  • People with vaginas should be prescribed metronidazole for seven days and a single dose of the same medication cures up to 95% of people with penises.
  • You and your sexual partners must get treatment for trich or you’ll continue to pass the infection back and forth.
  • You shouldn’t have sex for one week after finishing the medication to give the drug time to kill off the infection and for symptoms to clear up. Having sex too soon can lead to reinfection.
  • You should see your healthcare provider in three months to ensure you don’t have the infection anymore.

Complications/side effects of the treatment

You shouldn’t drink alcohol-containing beverages while taking metronidazole or tinidazole. The combination can cause severe nausea and vomiting and a rapid heart rate.

The medications may also cause these side effects:

Is trich 100% curable?

Yes, trich is curable. A healthcare provider treats trich infection with medication you take by mouth (swallow).

Can trichomoniasis go away on its own?

No, trich doesn’t go away on its own. You need an antibiotic to treat the infection.

Care at Cleveland Clinic

Prevention

Can trichomoniasis be prevented?

If you’re sexually active, you can take these steps to protect yourself against getting or spreading trich and other STIs:

  • Use condoms.
  • Get tested routinely for trich and other STIs.
  • Get treated if you have trich or other STIs.
  • Tell your sexual partners if you have trich so they can get tested and treated.
  • Engage in a monogamous relationship with one sexual partner.
  • Limit your number of sexual partners.

Outlook / Prognosis

What can I expect if I have this condition?

Trichomoniasis is a very common STI that goes away with proper treatment. It’s important that you and your sexual partners take antibiotic medication as prescribed and abstain from sex until the infection clears up (about one week). Trich rarely causes long-term problems, although an untreated infection makes you more susceptible to getting (or spreading) HIV, the virus that causes AIDS.

Can I get trichomoniasis (trich) more than once?

It’s possible to get trich multiple times. Approximately 1 in 5 people who get treatment for trich become infected again within three months. To prevent reinfection, you and your sexual partners should receive treatment at the same time. After finishing treatment, you should wait a week before having sex to give the medication time to work and for symptoms to go away.

Living With

When should I see my healthcare provider?

You should call your healthcare provider if you have trichomoniasis and you experience:

  • Unusual vaginal or penile discharge.
  • Foul-smelling discharge.
  • Genital irritation or itching.
  • Vaginal redness, soreness or swelling.
  • Painful intercourse.

How does trichomoniasis (trich) affect pregnancy?

If you’re pregnant or breastfeeding (chestfeeding) and have trichomoniasis, it’s generally safe to take metronidazole to treat it. Left untreated, trich increases your risk of:

  • Premature labor (childbirth before the 37th week of pregnancy).
  • Low birth weight (newborns who weigh less than 5 pounds, 8 ounces).

Frequently Asked Questions

Is trichomoniasis a female STD?

Yes, trich is an STI. While trichomoniasis is more common in women and people AFAB, men and people AMAB can also get it.

Is trichomoniasis a type of chlamydia?

No. Trichomoniasis and chlamydia are two different infections. A bacterium causes chlamydia, while a parasite causes trich.

A note from Cleveland Clinic

Trichomoniasis is an extremely common and treatable infection. Millions of people are diagnosed with trich every year. It spreads easily because most people don’t have symptoms and aren’t aware they’re contagious. Be sure to follow your healthcare provider’s directions when taking medications to treat the infection. Stopping treatment too soon or engaging in sexual contact before the infection is gone can lead to reinfection. Your healthcare provider can also offer suggestions for preventing future STIs.

Last reviewed by a Cleveland Clinic medical professional on 12/27/2022.

References

  • American Academy of Family Physicians (AAFP). Common Sexually Transmitted Infections (STIs). (https://familydoctor.org/common-sexually-transmitted-infections-stis/) Accessed 12/27/2022.
  • Centers for Disease Control and Prevention (CDC). Trichomoniasis — CDC Fact Sheet. (https://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm) Accessed 12/27/2022.
  • Kandamuthan S, Thambi R, Yeshodharan J. Trichomoniasis: Is it always sexually transmitted? (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553853/) Indian J Sex Transm Dis AIDS. 2014 Jul-Dec;35(2):166-7. Accessed 12/27/2022.
  • Merck Manual. Trichomoniasis. (https://www.merckmanuals.com/home/infections/sexually-transmitted-diseases-stds/trichomoniasis) Accessed 12/27/2022.
  • Planned Parenthood. Trichomoniasis (Trich). (https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/trichomoniasis) Accessed 12/27/2022.
  • U.S. Department of Health and Human Services (HHS) Office on Women’s Health. Trichomoniasis. (https://www.womenshealth.gov/a-z-topics/trichomoniasis) Accessed 12/27/2022.

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