Trichomoniasis (trich, trichomonas or TV) is a common sexually transmitted infection (STI) caused by an organism known as a protozoan. This parasite – trichomonas vaginalis – lives inside the body, binding itself to the vaginal or urethral lining in women, and the urethral passage in men.
Having unprotected sex or sharing sex toys with an infected partner will transmit it but you can’t catch it from oral or anal sex or kissing.
Trichomoniasis Symptoms in Women
If you suspect you may have an STI consult your GP or nearest sexual health clinic for proper diagnosis. Many STIs have similar symptoms, and in half of the reported cases of trichomoniasis* there are no symptoms. If you have had unprotected sex with a new partner then ask for a full STI check. Sometimes a routine cervical screening test will pick up traces of the infection but this isn’t 100% accurate so you will still need to have a proper test done.
If symptoms do occur they are likely to manifest within a month of infection and include the following:
An itchy or swollen genital area – the vulva, vagina and inner thighs. Internal and external swelling can also cause discomfort during sex.
Stomach pains and cramping.
Vaginal discharge – pay attention to your normal patterns of discharge and if you notice anything unusual get it checked, however scant. It will be yellowish in colour, thick or thin consistency, and may smell fishy.
These symptoms are similar to those caused by thrush and bacterial vaginosis so a test is essential for accurate diagnosis so that it can be treated. Your GP or local sexual health service will do this for free, although you may have to pay the prescription charge if you see your GP.
Trichomoniasis Symptoms in Men
Men will experience a whitish discharge from the tip of the penis, may find it painful to urinate, or have slightly inflamed foreskin. As the parasite also affects the prostate gland it can cause painful sex.
It is tempting to try and self-diagnose STIs using information from the internet but it’s not advisable as the symptoms can be similar to other infections. If you’re worried you may have an STI it’s not necessary to wait for symptoms – simply book yourself in for a full check at your local sexual health clinic.
You will be asked to undress from the waist down and your doctor will examine the genital area, taking a swab (small cotton bud) sample of any discharge from the vagina or urethra. This will then be sent to a lab for analysis. Having a swab taken is momentarily uncomfortable but not painful. The testing and treatment process is fast and will indicate whether an infection is present but it won’t be able to tell you how long you’ve had it (or whom you got it from). If your doctor suspects you have it then she or he will suggest treatment straight away (i.e. before you receive the test results) so there’s no need to wait.
You will be given antibiotics to treat it – a single dose of metronidazole once a day, or 400mg twice a day for up to a week. Antibiotics are 95% effective if you finish the course and will clear up any symptoms within a few days. Tinidazole is sometimes offered as an alternative if a patient can’t take metronidazole.
Tell your GP if you are pregnant or breastfeeding as this means treatment needs to be adapted to protect the baby, as a single dose of antibiotics will be too strong. A clotrimazole pessary can be used internally as a type of anti-fungal medication but it isn’t as strong as antibiotics so may not clear up the infection completely.
Whilst you’re having treatment for any STI it’s important not to have sex as you risk reinfection or transmitting the infection to a partner. Antibiotics also interfere with hormonal contraceptives containing estrogen and progestogen (the mini pill or patch). Avoid alcohol too, as this can trigger side effects.
How to Protect Yourself From STIs
Practice safe sex. If you’re with a new partner use condoms until you’ve both been screened for STIs. Clean sex toys thoroughly and cover them with a condom if you’re sharing them. Use a dental dam (or condom cut in half) for oral sex or frottage. Trichomoniasis can’t be caught through oral sex but it may be passed on from genital to genital contact.
STIs can live in the body for long periods without causing any symptoms so having one doesn’t mean that a partner has been unfaithful. Tell any ex-partners that they may have been exposed to an STI and need to be tested. If this is a worry then the clinic can do it for you, keeping your details anonymous.
The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.