Overview
-Trichomoniasis
Contents
Overview
Diagnosis
Treatment
Prevention
Trichomoniasis is a sexually transmitted infection (STI) caused by a parasite called Trichomonas vaginalis (TV).
Symptoms of trichomoniasis
Symptoms of trichomoniasis usually develop within a month of infection.
But up to half of all people will not develop any symptoms (though they can still pass the infection on to others).
The symptoms of trichomoniasis are similar to those of many other sexually transmitted infections (STIs), so it can sometimes be difficult to diagnose.
Symptoms in women
Trichomoniasis in women can cause:
abnormal vaginal discharge that may be thick, thin or frothy and yellow-green in colour
producing more discharge than normal, which may also have an unpleasant fishy smell
soreness, swelling and itching around the vagina – sometimes the inner thighs also become itchy
pain or discomfort when passing urine or having sex
Symptoms in men
Trichomoniasis in men can cause:
pain when peeing or during ejaculation
needing to pee more frequently than usual
thin, white discharge from the penis
soreness, swelling and redness around the head of the penis or foreskin
When to get medical advice
See a GP or go to your local sexual health clinic (sometimes called a GUM clinic) if you develop any of the symptoms of trichomoniasis or you think you may be infected.
Trichomoniasis can usually be diagnosed after an examination of the genitals and a laboratory test carried out on a swab taken from the vagina or penis.
If the test shows you have trichomoniasis, it’s important that your current sexual partner and any other recent partners are also tested and treated.
How do you get trichomoniasis?
Trichomoniasis is caused by a parasite called Trichomonas vaginalis.
In women, this parasite mainly infects the vagina and the urethra (the tube that carries urine out of the body).
In men, the infection most commonly affects the urethra, but the head of the penis or prostate gland – a gland near the bladder that helps produce semen – can become infected in some cases.
The parasite is usually spread by having sex without using a condom.
It could also be spread by sharing sex toys if you do not wash them or cover them with a new condom before use.
You do not have to have many sexual partners to catch trichomoniasis. Anyone who’s sexually active can catch it and pass it on.
Trichomoniasis is not thought to be passed on through oral or anal sex.
You also cannot pass on trichomoniasis through:
kissing or hugging
sharing cups, plates or cutlery
toilet seats
The best way to prevent trichomoniasis is to have safe sex. This means always using a condom when having sex, covering any sex toys you use with a condom, and washing sex toys after use.
Treating trichomoniasis
Trichomoniasis is unlikely to go away without treatment, but it can be effectively treated with antibiotics.
Most men and women are treated with an antibiotic called metronidazole, which is usually taken twice a day for 5 to 7 days.
It’s important to complete the whole course of antibiotics and avoid having sex until the infection clears up to prevent reinfection.
Your current sexual partner and any other recent partners should also be treated.
Complications of trichomoniasis
Complications of trichomoniasis are rare, although some women with the infection may be at an increased risk of further problems.
If you’re infected with trichomoniasis while you’re pregnant, the infection may cause your baby to be born prematurely or have a low birthweight.
Trichomoniasis can sometimes be difficult to diagnose because symptoms are similar to those of other sexually transmitted infections (STIs).
If you think you may have trichomoniasis, you should visit a GP or your local sexual health clinic (genitourinary medicine (GUM)) clinic.
Some GP surgeries offer an enhanced sexual health service for diagnosing and treating STIs. It may be better to visit a GUM clinic because these clinics can carry out accurate tests more quickly.
In some cases, the GP may refer you to a GUM clinic for tests and treatment if they think you have trichomoniasis.
Important:Using sexual health clinics during coronavirus (COVID-19)
Call a sexual health clinic if you need help or advice. Only go to a clinic if you’ve been told to.
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Examination
If your doctor or nurse suspects you have trichomoniasis, they’ll usually carry out an examination of your genital area.
In women, trichomoniasis may cause abnormal vaginal discharge or red blotches on the walls of the vagina and on the cervix (the neck of the womb).
If you are a man with suspected trichomoniasis, your doctor or nurse will examine your penis for signs of inflammation or discharge.
Laboratory testing
After a physical examination, your doctor or nurse may need to take a swab from either the vagina or penis. The swab will be analysed in a laboratory to check for signs of the trichomoniasis infection. It may take several days for the results to come back.
In men, a urine sample can also be tested for trichomoniasis.
If trichomoniasis is suspected, you may be advised to begin a course of treatment before your results come back. This ensures the infection is treated as soon as possible and reduces the risk of it spreading.
See treating trichomoniasis for more information.
Notifying sexual partners
If the test shows you have trichomoniasis, it’s very important that your current sexual partner and any other recent partners are also tested and treated. The staff at the clinic or GP surgery can discuss with you which of your sexual partners may need to be tested.
If possible, tell your sexual partner and any ex-partners so they can get tested and treated as well. If you do not want to do this, the clinic can usually do it for you (it’s called partner notification and the clinic will not reveal who you are).
If you’ve had trichomoniasis and have been cured, there’s no need to tell any future partners.
Trichomoniasis is unlikely to go away without treatment. The infection may cure itself in rare cases, but you risk passing the infection on to someone else if you are not treated.
Antibiotics
Trichomoniasis is usually treated quickly and easily with antibiotics.
Most people are prescribed an antibiotic called metronidazole, which is very effective if taken correctly. You’ll usually have to take metronidazole twice a day, for 5 to 7 days.
Sometimes this antibiotic can be prescribed in a single, larger dose. However, this may have a higher risk of side effects and it’s not recommended for pregnant or breastfeeding women as a precaution.
Metronidazole can make you feel sick, be sick and cause a slight metallic taste in your mouth. It’s best to take it after eating food. Contact your doctor for advice if you start vomiting, because the treatment will not be effective if you’re unable to swallow the tablets.
Do not drink alcohol while taking metronidazole and for at least 24 hours after finishing the course of antibiotics. Drinking alcohol while taking this medicine can cause more severe side effects, including:
a fast heartbeat or heart palpitations
skin flushing
nausea and vomiting
A specialist can recommend alternative treatments if metronidazole is unsuitable for you (for example, if you’re allergic to it).
Follow-up
If you take your antibiotics correctly, you will not normally need any follow-up tests or examinations for trichomoniasis.
However, you may require further testing to see whether your symptoms are being caused by a different sexually transmitted infection (STI) if your symptoms remain or reoccur after treatment.
If you have unprotected sex before your treatment is finished, you need to return to your GP surgery or sexual health clinic. You may have become reinfected. You must also return if you:
did not complete your course of antibiotics
did not take your antibiotics correctly (according to the instructions)
vomited shortly after taking your antibiotics
You may need more antibiotics or a different form of treatment.
Sexual partners
You should avoid having sex while you’re being treated for trichomoniasis, as you may become reinfected.
If you were prescribed a single dose of antibiotics, you need to avoid having sex for 7 days after taking the medicine.
It’s very important that your current sexual partner and any other recent partners are also tested and treated. If your sexual partner is not treated, this increases the risk of reinfection.
Prevention
If you’ve had trichomoniasis and it’s been treated, you will not be immune to the infection and could get it again.
Like any sexually transmitted infection (STI), the best way to prevent trichomoniasis is to have safe sex. This means always using a condom.
The following measures will help protect you from trichomoniasis and most other STIs, including chlamydia and gonorrhoea. They’ll also help prevent you passing it on to your partner:
use condoms (male or female) every time you have vaginal or anal sex
if you have oral sex, cover the penis with a condom or the female genitals with a latex or polyurethane square (a dam)
if you’re a woman and rub your vulva against your female partner’s vulva, one of you should cover your genitals with a dam
avoid sharing sex toys – if you do share them, wash them or cover them with a new condom before anyone else uses them
If you’re not sure how to use condoms correctly, you can read about how to use a condom.
If you’ve been diagnosed with trichomoniasis, make sure both you and your partner are treated, and that any sex toys you’ve used are cleaned.
Getting tested
If you’re sexually active, go for regular sexual health check-ups. You can get an appointment by visiting your local genitourinary medicine (GUM) clinic.
Find a sexual health clinic
If you notice any signs or symptoms of an STI, avoid having sex and visit a GP or GUM clinic as soon as possible.