Everything you need to know about trichomoniasis

You’ve probably heard about sexually transmitted infections (STIs). You may have first been introduced to chlamydia, herpes, and gonorrhea in your sex education classes. But what about trichomoniasis, or “trich,” as it’s often called?

While it isn’t often talked about, trichomoniasis is a fairly common, often symptomless, and completely curable STI. Looking after your sexual health is such an important self-care step, but it can be hard to know every little thing about every STI. So if you’ve never heard about trichomoniasis, you’re not the only one, and we’ve got you covered. Here, Flo experts explain what trichomoniasis is, how it can manifest differently in men and women, and perhaps most importantly, how it can be treated. 

What is trichomoniasis, and how common is it?

In a nutshell, trichomoniasis is a common STI caused by a parasite called trichomonas vaginalis (TV). Sounds a little bit like sci-fi, right? Interestingly, Dr. Renita White, obstetrician and gynecologist at Georgia Obstetrics and Gynecology, US, says that the fact that trichomoniasis is caused by a parasite sets it apart. “This is different from other STIs that are caused by bacteria — [like] gonorrhea, chlamydia, or syphilis — or viruses like the human immunodeficiency virus (HIV), herpes, and genital warts,” she explains.

And when we say it’s common, we mean it. Trichomoniasis is the most common curable STI around these days. In 2018, it was estimated that more than 2 million people were infected with trichomoniasis in the US alone. However, only about 30% of them develop any symptoms. This might put you on edge, but it shows just how important it is to be regularly tested for STIs. 

You might be curious as to how a parasite can find its way into your body and where it lives once you have trichomoniasis. The condition is usually spread during sexual activity (when you come into contact with the sperm, precum, or vaginal fluids of someone with trichomoniasis). Barrier protection (such as condoms and dental dams) are the only methods of contraception that can protect you from STIs like trichomoniasis, so it’s important to keep that in mind when you’re having sex with someone new. Like other STIs, including herpes and chlamydia, trichomoniasis can infect other parts of your body (like your mouth, hands, or anus), but it’s fairly uncommon for this to happen. 

In women and people with a vagina, trichomoniasis can be found in the vulva (the part of your genitalia you can see on the outside), in your vagina (the internal passage that connects your vulva to your cervix), and your cervix (that’s at the top of your vaginal passage, connecting it to your uterus). You might contract trichomoniasis in your urethra (the tube that you pee out of), too. In men and people with a penis, the infection is often found in the urethra, and in some cases, it can be found in the prostate gland, which produces the fluid that helps to transport sperm (called seminal fluid).

Trichomoniasis symptoms

Now that you know what trichomoniasis is and where it comes from, you’ll likely be curious about the symptoms. Most of us will only ever be tested for STIs if we notice a new itch, burn, or pain. However, while some STIs come with clear symptoms and signs, trichomoniasis isn’t one of them. In fact, only around 30% of people experience symptoms associated with trichomoniasis. This is why, if you’ve had sex without using barrier protection, it’s important to go to your doctor for an STI test.

If you have trichomoniasis, any symptoms you do get will occur within around one month, and it can show up differently among genders. 

Trichomoniasis symptoms in women

The symptoms associated with trichomoniasis are fairly similar to other conditions. In fact, trichomoniasis is among the three most common vaginal infections that are seen in women’s health offices (alongside bacterial vaginosis and yeast infections). While they share similar symptoms, signs of trichomoniasis include: 

• More vaginal discharge than usual — You might also notice your discharge has a fishy smell. 
• A change in the texture and color of your discharge — It may be thin, thick, or frothy and look yellow-green. Learn more about your discharge and what to expect by using an app like Flo. 
• Swelling, soreness, and itchiness around the vulva and sometimes itchiness in the inner thighs, too
• Discomfort or pain when you’re having sex, peeing, and general pelvic pain

Trichomoniasis symptoms in men

Trichomoniasis can look a little bit different in men. Symptoms include: 

• Having to pee more than normal
• Noticing thin, watery, white discharge from your penis
• Feeling pain during ejaculation or when you pee
• Experiencing swelling, redness, and soreness at the head of the penis and around the foreskin

It’s worth noting, however, that you might have experienced one or more of these symptoms before and never had trichomoniasis. Changes in discharge and pain when you pee or during sex can also indicate a number of conditions (more on this in the section below), so it’s important to speak to your doctor if you get any of these symptoms. They’ll be able to examine you and offer any tests to help find the cause. 

Can you have trichomoniasis symptoms and test negative? 

You might have noticed a change in your discharge or a burning sensation when you pee. But when you went to see your doctor for an STI test, it came back negative. As we now know, just like many other STIs, the symptoms associated with trichomoniasis can be linked to many other conditions. 

A change in the consistency and smell of your discharge could be a sign of bacterial vaginosis, gonorrhea, chlamydia, or yeast infections. Pain during sex is associated with vulvodynia. This is a condition that’s defined by persistent pain in your vulva that lasts longer than three months and isn’t caused by another medical issue. 

Another reason why you might notice a change in the amount of discharge you’re producing is because of pregnancy. When you’re pregnant, you produce more discharge to protect your body from infection. This is totally normal. However, it shouldn’t have a strong smell and will be creamy white or translucent in color. If you notice any changes in the color of your discharge or the way it smells while you’re pregnant, this could be a sign of an infection. 

The best thing to do if you notice any change in your sexual health is to reach out to your doctor. It might feel embarrassing, but please don’t let that stop you: they have seen it all before. It’s much better to explain what you’re experiencing so they can help you to take the next step than to worry at home and do nothing. 

Myths about trichomoniasis 

Like other STIs, there are a few misconceptions that surround trichomoniasis. And while you might not feel like talking about your sexual health with your friends over brunch, this is one way you can get rid of these myths once and for all. Plus, it may help you to spot when something isn’t quite right. 

So, it’s time for some myth busting! For starters, trichomoniasis can’t be spread by:

• Hugging or kissing
• Sitting on a toilet seat
• Sharing cutlery, plates, or cups

Another myth is that trichomoniasis can only be spread during penetrative vaginal sex with someone with a penis. The reality is that the parasite can be spread during vagina-to-vagina sex and even during solo sex if you’re using a sex toy that has been used with someone who has trichomoniasis. So even if you haven’t had sexual contact with with someone with a penis, it’s important to get tested regularly.  

You might think that because trichomoniasis is so common and curable (more on that below), it shouldn’t be treated as a “serious” STI. However, if left untreated, the parasite can cause other health complications. This can include increasing your risk of becoming infected with HIV if you’re exposed to it, pelvic inflammatory infection, and infertility. 

Untreated trichomoniasis during pregnancy has also been linked to delivering a baby early, your water breaking early, lower birth weights, and passing the parasite on to the baby in the birth canal. This isn’t meant to scare anyone; it just shows how crucial it is to book an STI test with your doctor if you have a new sexual partner and have had sex without using a condom. A lack of symptoms isn’t always a sign that you’re in the clear, so it’s best to be sure. 

Trichomoniasis treatment: When to see your doctor 

Changes to your reproductive health can be scary, but it’s so important to keep your doctor in the loop — especially if your current partner (or a previous sexual partner) reaches out to you to say they’ve been diagnosed with trichomoniasis. But to stay on top of your sexual health more generally, Dr. White says the best thing to do is to be tested regularly. 

“You should get routine STI testing at least once per year or anytime you change sexual partners,” she says. “Trichomoniasis can last for months or years if you do not get tested.”  Testing is usually done via a swab of your vagina. 

Is trichomoniasis curable? 

While STI tests might not be anyone’s idea of a good time, there is good news: Trichomoniasis is one of the most common, curable STIs. So there’s no need to be scared.

If you are diagnosed with trichomoniasis, it can be effectively treated with an antibiotic called metronidazole. This is usually taken as a pill twice a day for five to seven days. Other antibiotics that can be used include tinidazole and secnidazole. Remember, it’s important to finish the course of antibiotics and to avoid having sex until you’ve finished treatment. 

Once you’ve completed your course of antibiotics, you should be in the clear. However, it’s still important to let the people you’ve had sexual contact with know that they need to be tested too. It might feel like an awkward conversation to have, but so many people have them every day, and it’s important to prevent any further spread because reinfection is still a risk.

“Reinfection occurs in 1 in 5 people within 3 months of treatment,” says Dr. Ruth Arumala, obstetrician and gynecologist in Texas, US. “To prevent this, your partner and whoever your partner is having intercourse with should be treated. You should also be retested in three months even if your partner is treated.”

Tips to prevent trichomoniasis

Dr. Arumala explains that there’s only one way to protect yourself 100% from getting any STIs — “abstaining from any vaginal, oral, or anal sex.” But obviously — for many of us — not having sex just isn’t realistic. 

So, there are a few things you can do to reduce the risk of getting trichomoniasis. These include: 

• Only having sex with one person at a time or being open with your partners about the last time you were both tested for STIs
• Using barrier protection correctly — If you aren’t sure how to apply a condom, learn more here. 
• Using condoms when you use sex toys and washing your sex toys with warm water after every use

Trichomoniasis symptoms: The takeaway 

While it may not be the most talked about STI, trichomoniasis is actually one of the most common — and one of the most curable. Most people don’t have any symptoms, which is why routine STI testing is a good way to make sure you stay on top of your sexual health. But one of the best ways to prevent getting it in the first place is using barrier protection like condoms. 

If you do test positive for trichomoniasis, it’s generally easy to treat. Both you and any of your sexual partners should complete a course of antibiotics. Practicing safe sex is the best way to ensure that you don’t become infected again and is an easy way to help you feel more empowered about your sex life. You want to understand what’s going on in your body, right? So why wouldn’t you prioritize it?