Trichomoniasis

Overview

Trichomoniasis (say: trik-oh-moh-NY-uh-sis) is a common sexually transmitted infection (STI) caused by a tiny parasite called Trichomonas vaginalis. It can affect both men and women, but symptoms are more common in women. The infection can be easily treated with medication.

Yes, trichomoniasis is very common. The World Health Organization estimates that about 156 million new cases occur each year worldwide. In the UK, it is less common than some other STIs but still affects thousands of people every year.

Anyone who is sexually active can get trichomoniasis, regardless of gender, age, or sexual orientation. It is more common in women, especially those aged 16 to 35. Men can also get it, but they often have no symptoms.

Symptoms

Common symptoms

• In women: frothy, yellow-green or gray vaginal discharge with a strong fishy smell
• In women: itching, burning, or redness around the vagina and vulva
• In women: discomfort during sex or when urinating
• In men: irritation inside the penis, mild discharge, or burning after urination or ejaculation
• Many people (especially men) have no symptoms at all

Symptoms in children

• Trichomoniasis in children is rare and usually suggests sexual abuse. Any case in a child must be reported to child protection services. Symptoms may include vaginal discharge, itching, or pain when urinating.

Symptoms in older adults

• Symptoms in older adults are similar to those in younger people. However, older adults may be less likely to suspect an STI, so they may not seek testing. Symptoms can be mistaken for other conditions like a urinary tract infection.

Causes

Main causes

• Infection with a tiny parasite called Trichomonas vaginalis
• Spread through sexual contact (vaginal, oral, or anal) with an infected partner
• The parasite can live for a short time on damp objects like towels or underwear, but this is not a common way to get the infection

Risk factors

• Having multiple sexual partners
• Not using condoms consistently
• Having a history of other STIs
• Having a partner who is infected with trichomoniasis
• Sex without a condom

When to see a doctor

See a doctor urgently if:

• Severe pelvic pain or fever – see a doctor or go to an urgent care centre on the same day
• If you are pregnant and have any symptoms of trichomoniasis – contact your midwife or doctor promptly

Book a routine appointment if:

• Any unusual discharge, itching, or irritation in the genital area
• Pain or burning during sex or when urinating
• If you think you have been exposed to trichomoniasis, even if you have no symptoms
• If you have a sexual partner who has been diagnosed with trichomoniasis

Diagnosis

Trichomoniasis is diagnosed by testing a sample of fluid from the vagina or penis. Your doctor or nurse will examine your genital area and take a swab (like a cotton bud) to collect a sample of discharge. In some cases, they may test a urine sample.

Tests that may be done

• Swab test of vaginal discharge in women
• Swab test of urethral discharge in men
• Urine test (less sensitive than swab but can be used)
• Rapid test that gives results in about 20 minutes (available in some clinics)

What to expect at your appointment

The test is quick and usually not painful, though you may feel a little discomfort. Your doctor or nurse will explain everything and answer your questions. It is important to tell them about any symptoms and recent sexual partners so they can offer the right tests. Results may take a few days, but some clinics give results on the same day.

Treatment

Trichomoniasis is treated with antibiotics. Usually a single dose is enough, but sometimes you may need to take medicine for several days. Your doctor will prescribe a medication that kills the parasite. It is very important to finish all the medicine, even if symptoms go away, and to avoid sex until both you and your partner(s) have finished treatment.

Self-care at home

• Avoid all sexual contact (oral, vaginal, and anal) until you and your partner(s) have finished treatment and any symptoms have gone
• Do not douche (rinse the vagina with water or other fluids) – it can make the infection worse
• Wear loose-fitting cotton underwear and avoid tight trousers to reduce irritation
• Do not use any vaginal creams, sprays, or wipes without talking to your doctor first

Medical treatments

Treatment involves a course of oral antibiotics. Your doctor will choose a medicine that is safe and effective. In some cases, a single dose is prescribed; in others, a longer course of several days. Pregnant women can be treated safely. It is important that all sexual partners are treated at the same time to stop the infection from spreading.

When is surgery considered?

Surgery is not needed for trichomoniasis.

Living with this condition

Once you have completed treatment, you should feel better within a few days. It is important to tell any sexual partners so they can get tested and treated too. After treatment, use condoms with any new partners until you are sure everyone is cured. You can get reinfected if you have sex with someone who still has the infection.

Lifestyle tips

• Use condoms every time you have sex
• Limit the number of sexual partners
• Have regular sexual health check-ups, especially if you have a new partner
• Wash underwear in hot water to kill any parasites

Diet and exercise

There is no special diet or exercise needed for trichomoniasis. Eating a balanced diet and staying healthy can support your immune system, but it will not cure the infection. Follow your doctor's treatment plan.

Mental health and emotional wellbeing

Being diagnosed with an STI can feel upsetting, embarrassing, or stressful. These feelings are normal. Remember that trichomoniasis is a medical condition like any other – it is not a sign of being 'dirty' or 'bad'. Talking to a trusted friend, partner, or a counsellor can help. Sexual health clinics often have support services.

Prevention

Yes, you can reduce your risk of trichomoniasis by using condoms correctly every time you have sex. Condoms are very effective but do not cover all skin, so they cannot guarantee 100% protection. Limiting your number of sexual partners and having regular STI tests also help.

Vaccines

There is no vaccine for trichomoniasis.

Screening programmes

Routine screening for trichomoniasis is not recommended for everyone. However, if you have symptoms or have had unprotected sex with a new or multiple partners, you should get tested. Pregnant women may be offered screening if they have symptoms or are at higher risk.

Complications

If left untreated

• In women: pelvic inflammatory disease (PID) – an infection of the uterus, fallopian tubes, and ovaries that can cause long-term pelvic pain and infertility
• In pregnant women: preterm labour, low birth weight, and increased risk of passing the infection to the baby during delivery
• In men: inflammation of the prostate gland (prostatitis) or urethra (urethritis)
• Both men and women: increased risk of getting or spreading HIV if exposed

Long-term outlook

The outlook is very good. Trichomoniasis is easily cured with antibiotics. Most people feel better within a week. Once treated, the infection goes away completely. However, you can get infected again if you have sex with someone who still has the parasite. That is why it is important to make sure all sexual partners are treated too.

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