Trichomoniasis: Understanding Symptoms, Causes, Treatment, and Prevention

Duly Care
Jun 20
8 min read

Trichomoniasis is a common sexually transmitted infection (STI) caused by the parasite Trichomonas vaginalis. Despite its prevalence, trichomoniasis remains under-discussed, often leading to confusion and misinformation about its symptoms, treatment, and prevention.

This blog aims to provide a comprehensive guide to understanding trichomoniasis, addressing common myths, and equipping readers with the knowledge to take charge of their health.

Key Takeaways

Trichomoniasis is a treatable STI caused by the parasite Trichomonas vaginalis.
It can affect both men and women, with women often experiencing more noticeable symptoms.
Regular testing and safe sexual practices are essential for prevention and early detection.
Effective treatment is available, typically involving a single dose of antibiotics.

What Is Trichomoniasis?

Trichomoniasis, often referred to simply as “trich,” is a sexually transmitted infection (STI) caused by the protozoan parasite Trichomonas vaginalis. The infection is one of the most common STIs worldwide and can affect both men and women. It primarily targets the genital tract, but it can also affect the urethra and prostate in men, as well as the vagina in women.

In spite of being quite common, trichomoniasis is frequently underdiagnosed, as many people, especially women, may not experience noticeable symptoms.

In women, trichomoniasis can cause irritation and inflammation of the vagina, leading to discomfort and potential complications if untreated. In men, while symptoms are typically less severe, they can still experience discomfort and may unknowingly spread the infection to their sexual partners.

Causes of Trichomoniasis

Trichomoniasis is caused by Trichomonas vaginalis, a single-celled parasitic organism. It is primarily transmitted through unprotected sexual contact with an infected individual. This includes vaginal, anal, or oral sex, as the parasite thrives in the moist environments of the genital tract.

The infection is highly contagious and can spread even if an infected person shows no symptoms, making it easy for the parasite to pass between sexual partners.

Though sexual transmission is the primary mode of infection, non-sexual transmission is considered rare but theoretically possible. The parasite can survive for a short period outside the human body in moist environments, such as on towels, bathing suits, or other shared personal items. However, it does not live long outside the body, and the likelihood of transmission via this route is low compared to direct sexual contact.

Risk Factors for Trichomoniasis Spread

Unprotected Sexual Activity: The most significant risk factor for contracting and spreading trichomoniasis is having unprotected sex (vaginal, anal, or oral) with an infected person. Without the barrier protection of condoms, the Trichomonas vaginalis parasite can be easily transmitted from one partner to another.
Multiple Sexual Partners: Having multiple sexual partners increases the likelihood of exposure to Trichomonas vaginalis, especially if those partners are not regularly tested for STIs. This raises the chances of encountering someone with an undiagnosed infection, which can then be passed on.
Having a New Sexual Partner: Entering into a new sexual relationship with someone who has not been tested for STIs or who has multiple partners also raises the risk of contracting trichomoniasis. Even if symptoms aren’t immediately noticeable, an infected person can still spread the parasite.
Lack of Regular STI Testing: For sexually active individuals, particularly those with multiple partners, not undergoing regular STI screenings increases the risk of undiagnosed infections like trichomoniasis. As the infection can be asymptomatic or have mild symptoms, people may unknowingly pass it to others.
Previous or Existing STIs: If someone has a history of STIs, including trichomoniasis, they are more likely to contract and spread infections. Having other STIs can make genital tissues more susceptible to infections like trichomoniasis, and can also increase the risk of acquiring other STIs, such as HIV.
Douching and Vaginal Hygiene Products: While douching or using certain vaginal hygiene products may not directly cause trichomoniasis, they can disrupt the natural balance of bacteria in the vagina, making it more prone to infections. Disrupting the vaginal environment can increase the chances of catching or spreading infections.
Not Completing Treatment: Failure to complete the full course of antibiotics for trichomoniasis can lead to persistent infection. Incomplete treatment may result in a relapse of the infection, and untreated individuals can continue to spread the parasite to their sexual partners.

Symptoms of Trichomoniasis

Trichomoniasis may not always cause noticeable symptoms, but when they do occur, they vary between men and women. It is important to seek medical advice if symptoms appear, as untreated infections can lead to complications like infertility and pelvic pain.

In Women:

Women are more likely to experience noticeable symptoms, typically appearing within 5 to 28 days after infection.
One of the most common signs is frothy, yellow-green vaginal discharge, often accompanied by a strong, unpleasant odour.
Vaginal irritation or itching is common, which can make everyday activities uncomfortable.
Pain during sex or urination is frequently reported, causing discomfort.
Some women may experience vaginal bleeding or spotting, especially after sexual intercourse.
Without treatment, complications like pelvic inflammatory disease (PID) can occur, potentially leading to fertility issues.

In Men:

Many men with trichomoniasis show few symptoms and may not even realise they are infected.
When symptoms occur, they are typically mild and may include a clear or whitish discharge from the penis, which can become more noticeable over time.
A burning sensation during urination or after ejaculation is also a common symptom.
Some men may feel irritation inside the penis, particularly around the urethra.
Although less common, complications like prostatitis or urethritis may develop if the infection is left untreated.

Trichomoniasis is treatable with antibiotics, and prompt diagnosis and treatment can prevent long-term complications. Regular STI screening is essential for those who may be at risk, and both partners should be treated to prevent reinfection.

Testing of Trichomoniasis

Accurate diagnosis is key to effectively treating trichomoniasis and preventing complications. If you have symptoms or believe you've been exposed, it is essential to get tested for early detection and treatment.

The following diagnostic tests are simple and typically involve analysing samples from the affected area.

Microscopic Examination

A sample of vaginal or penile discharge is examined under a microscope to identify the Trichomonas vaginalis parasite. While it is a common method, it is not always the most reliable if the parasite is in low numbers.

Rapid Antigen Test

This test detects proteins produced by the parasite, offering quicker and more accurate results than a microscopic examination. It can often provide results within hours.

Nucleic Acid Amplification Test (NAAT)

This is the most sensitive test, identifying the parasite’s DNA. It is highly accurate and preferred for a definitive diagnosis, though it may take a little longer to return results.

Treatment of Trichomoniasis

Trichomoniasis is easily treatable with antibiotics, typically a single dose of metronidazole or tinidazole. Both are effective in clearing the infection. Adhere to the following guidelines to

Complete the Full Course: Even if symptoms disappear quickly, it is crucial to finish the entire course of antibiotics to ensure the infection is fully eliminated and reduce the risk of it returning.
Treat Both Partners Simultaneously: To prevent reinfection, both partners should receive treatment at the same time. It is important to avoid sexual activity until both are treated.

Can Trichomoniasis Resolve Without Treatment?

Rarely Resolves on Its Own: Trichomoniasis usually doesn’t clear up without treatment. It can last for months or years if left untreated.
Potential Complications: In women, untreated infection may lead to pelvic inflammatory disease (PID), which can cause fertility issues. It can also increase the risk of other STIs, including HIV.
Seek Treatment Promptly: It is essential to seek treatment to avoid complications and prevent spreading the infection to others.

How to Prevent Trichomoniasis

Preventing trichomoniasis involves several key precautions to reduce the risk of infection and transmission:

Practice Safe Sex

Using condoms during every sexual encounter is one of the most effective ways to reduce the risk of trichomoniasis. Condoms help prevent the spread of Trichomonas vaginalis and other sexually transmitted infections (STIs).

However, while they offer significant protection, condoms do not cover all areas, such as the vulva or the base of the penis, where transmission can still occur. For even better protection, consider using a dental dam during oral sex.

Regular Testing

Routine STI testing is essential for sexually active individuals, especially those with multiple partners. Since trichomoniasis can sometimes be asymptomatic or cause mild symptoms that are easy to overlook, regular screenings help ensure early detection. Many doctors recommend annual testing for sexually active individuals, or more frequently if at higher risk for STIs.

Testing not only protects your health but also helps prevent unknowingly spreading infections.

Mutual Monogamy

Being in a mutually monogamous relationship with a partner who has been tested for STIs can lower your risk of contracting trichomoniasis. Regular testing for both partners, especially before engaging in unprotected sex, ensures that both individuals are free of infections.

Open communication and a commitment to exclusivity, combined with routine testing, can greatly reduce the likelihood of exposure to trichomoniasis and other STIs.

Debunking Common Myths

Myth 1: Trichomoniasis only affects women.

Fact: While women often show more obvious symptoms like vaginal discharge and irritation, men can also get and spread the infection. Men may experience symptoms like a burning sensation during urination or penile discharge. Both genders should be tested and treated, even if symptoms aren’t visible.

Myth 2: You can only get trichomoniasis from sex.

Fact: Although sexual contact is the main way trichomoniasis spreads, it can also be contracted from contaminated objects like towels or bathing suits. However, this is rare since the parasite doesn’t survive long outside the body.

Myth 3: Once treated, you can’t get it again.

Fact: Treatment does not make you immune to trichomoniasis. Reinfection is possible, especially if your partner isn’t treated or if you have unprotected sex with someone infected. It is important for both partners to get treated and practice safe sex to avoid reinfection.

Conclusion

Trichomoniasis is a common, preventable, and treatable sexually transmitted infection that can affect both men and women. Recognising its symptoms, seeking timely testing, and adhering to prescribed treatments can help prevent long-term complications such as pelvic inflammatory disease (PID) or increased susceptibility to HIV.

If you suspect exposure or experience symptoms, it is important to consult a doctor for diagnosis and treatment. Taking precautions, such as using condoms and getting regular screenings, can help prevent trichomoniasis and keep you and your partner healthy.

Frequently Asked Questions

What is trichomoniasis discharge like?
Trichomoniasis discharge is often frothy, yellow-green, and accompanied by a strong odour, particularly in women.
Can trichomoniasis be cured?
Yes, trichomoniasis is treatable with antibiotics like metronidazole or tinidazole. Ensure both partners receive treatment to avoid reinfection.
Is trichomoniasis a serious disease?
While treatable, untreated trichomoniasis can lead to complications like pelvic inflammatory disease and an increased risk of other STIs.
How is trichomoniasis diagnosed?
Diagnosis involves laboratory tests like microscopic examination, rapid antigen tests, or NAAT, which detect the parasite’s DNA.

Important

This blog, including its text, images, and infographics, is for educational purposes only and not a substitute for professional medical advice. For personalised advice, always consult a doctor.

References

World Health Organization. Sexually Transmitted Infections. 2023. https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
Morbidity and mortality weekly report. Recommendations and reports. Sexually transmitted diseases treatment guidelines, 2015. 2015. https://pubmed.ncbi.nlm.nih.gov/26042815/
Clinical Microbiology Reviews. Trichomoniasis. 2004. https://pubmed.ncbi.nlm.nih.gov/15489349/
US Centers for Disease Control and Prevention. Trichomoniasis - CDC Fact Sheet. Accessed on 27 January 2025. https://stacks.cdc.gov/view/cdc/30965
Current Infectious Disease Reports. Epidemiology and Treatment of Trichomoniasis. 2015. https://pmc.ncbi.nlm.nih.gov/articles/PMC5030197/