Trichomoniasis

Overview

What is trichomoniasis (trich)?

Trichomoniasis is the most common non-viral sexually transmitted disease (STD) in the world. Most people call the condition trich. Its name comes from the parasite Trichomonas vaginalis that causes the disease.

You may have trich and not know it —the infection rarely causes symptoms. Trich is contagious, which means you might unknowingly infect others through sexual contact. You may also hear STDs like trich referred to as sexually transmitted infections (STIs).

How common is trichomoniasis (trich)?

Trichomoniasis is the most common curable STD affecting both men and women in America. Approximately 3.7 million people have the disease.

Who might get trichomoniasis (trich)?

Trich affects all genders. Women (especially older women) are more likely than men to get the disease. Black women are more prone to the disease. Your risk for trich increases if you:

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

Is trichomoniasis (trich) contagious?

Yes, trich is very contagious. In addition to affecting the genitals, trich can also infect the anus, mouth and hands.

Symptoms and Causes

What causes trichomoniasis (trich)?

A parasite called Trichomonas vaginalis causes this STD. Once you’re infected, 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).

What are the symptoms of trichomoniasis (trich)?

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. In fact, men rarely show any signs of infection. When symptoms occur, they tend to appear within five to 28 days after exposure. You may experience:

Diagnosis and Tests

How is trichomoniasis (trich) diagnosed?

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

  • Physical exam: For women, this exam includes a pelvic exam.
  • Lab test: Your healthcare provider examines a sample of the genital discharge under a microscope to check for signs of infection. The vaginal swab collected may be sent to the lab for further testing if trichomonads are not seen under the microscope.

Management and Treatment

How is trichomoniasis (trich) managed or treated?

Without treatment, trich can last for months or even years. It doesn’t go away on its own. The entire time you’re infected, you can give the STD to your sexual partners.

Oral anti-infective medications kill trich. Your healthcare provider may prescribe metronidazole (Flagyl®) or tinidazole (Tindamax®). It’s important to keep the following points in mind while undergoing treatment:

  • A single medication dose cures up to 95% of infected women. Men and women may need to take the medication for five to seven days.
  • You and your sexual partners must be treated for trich or you will 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’re no longer infected.

What are medication side effects?

You shouldn’t drink alcohol 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:

Can I get trichomoniasis (trich) more than once?

It’s possible to get trich multiple times. Approximately one in five people who are treated for trich become infected again within three months. To prevent reinfection, you and your sexual partners should take anti-infective medications 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.

What are the complications of trichomoniasis (trich)?

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 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 get tested for trich at least once a year.

How does trichomoniasis (trich) affect pregnancy?

If you become infected with trich while pregnant or breastfeeding, it’s generally safe to take anti-infective medication. 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).

Prevention

How can I prevent trichomoniasis (trich)?

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

  • Use condoms.
  • Get tested routinely for trich and other STDs.
  • Get treated if you have trich or other STDs.
  • 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 is the prognosis (outlook) for people with trichomoniasis (trich)?

Trichomoniasis is a very common STD that goes away with proper treatment. It’s important that you and your sexual partners take 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.

Living With

When should I call the doctor?

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.

What questions should I ask my doctor?

If you have trichomoniasis, you may want to ask your healthcare provider:

  • What is the best treatment for me?
  • Will this condition come back?
  • What’s the best way to prevent getting trich or another STD again?
  • How can I protect my partner from getting trich?
  • What are the medication side effects?
  • Should I look out for signs of complications?

A note from Cleveland Clinic

If you’re diagnosed with trichomoniasis, you’re not alone and shouldn’t be embarrassed. Millions of people are diagnosed with this STD 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 disease. 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 STDs.

Last reviewed by a Cleveland Clinic medical professional on 06/05/2020.

References

  • American Academy of Family Physicians (AAFP). Common Sexually Transmitted Infections (STIs). (https://familydoctor.org/common-sexually-transmitted-infections-stis/) Accessed 6/11/2020.
  • Centers for Disease Control and Prevention (CDC). Trichomoniasis — CDC Fact Sheet. (https://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm) Accessed 6/11/2020.
  • Merck Manual. Trichomoniasis. (https://www.merckmanuals.com/home/infections/sexually-transmitted-diseases-stds/trichomoniasis) Accessed 6/11/2020.
  • U.S. Department of Health and Human Services (HHS) Office of Population Affairs. Trichomoniasis. (https://www.hhs.gov/opa/reproductive-health/fact-sheets/sexually-transmitted-diseases/trichomoniasis/index.html) 6/11/2020.
  • U.S. Department of Health and Human Services (HHS) Office on Women’s Health. Trichomoniasis. 6/11/2020.

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