Trichomoniasis: causes, symptoms, diagnosis and treatment

Trichomoniasis is a common sexually transmitted infection caused by a parasite. In women, trichomoniasis can cause foul-smelling vaginal discharge, genital itching, and painful urination.

Men who have trichomoniasis usually have no symptoms. Pregnant women who have trichomoniasis may be at higher risk of having their babies prematurely.

The treatment for trichomoniasis consists of taking an antibiotic: metronidazole (Flagyl), tinidazole (Tindamax) or secnidazole (Solosec). To avoid re-infection, all sexual partners should be treated at the same time. You can reduce the risk of infection by using condoms correctly every time you have sex.

Most people with trichomoniasis have no signs or symptoms. However, symptoms may appear over time. When the signs and symptoms appear, they are different in men and women.

In women, the signs and symptoms of trichomoniasis include the following:

A copious amount of thin, often foul-smelling vaginal discharge that may be clear, white, gray, yellow, or green Redness, burning, and itching of the genitals Painful urination or sexual intercourse Discomfort in the lower stomach

In men, trichomoniasis rarely causes symptoms. However, when these do appear, they are usually the following:

Itching or irritation inside the penis Burning sensation when urinating or after ejaculation Discharge from the penis

See your health care provider if you have symptoms of trichomoniasis or if you know your sexual partner is infected.

Risk factors for trichomoniasis include the following:

Multiple sex partners History of sexually transmitted infections History of trichomoniasis Sex without a condom

Your health care provider can diagnose trichomoniasis through genital examination and lab tests.

The healthcare provider may also examine a sample of vaginal secretions for women or a swab from inside the penis (urethra) for men under a microscope. If the parasite can be seen under a microscope, no further testing is needed.

If no parasites are found during the test, but the health care provider thinks you might have trichomoniasis, further tests may be done. The health care provider may order further tests on a sample of vaginal secretions, a urethral swab from the penis, or sometimes urine. The tests include a rapid antigen test and a nucleic acid amplification test.

If you have trichomoniasis, your healthcare provider may also test for other sexually transmitted infections (STIs) in order to treat them.

Treatment of trichomoniasis requires an oral antibiotic medication that is effective against infections caused by this parasite. Treatment can be done during pregnancy. Options include the following:

Megadose.

Your healthcare provider may recommend a high dose (megadoses) of metronidazole (Flagyl), tinidazole (Tindamax), or secnidazole (Solosec). These oral medications are taken only once.

Various dosages.

Your healthcare provider may recommend several lower doses of metronidazole or tinidazole. In this case, the pills are taken twice a day for seven days. To help clear up the infection completely, you should keep taking this medicine for as long as your healthcare professional tells you, even if you start to feel better after a few days. If you stop taking it too soon, the infection may not go away completely.

All sexual partners require treatment at the same time. This prevents you from getting the infection again immediately (re-infection). Also, you should avoid sexual intercourse until the treatment is over and the symptoms are gone. These often go away within a week of finishing the last dose of the antibiotic. Tell your healthcare provider if you continue to have symptoms after treatment.

Drinking alcohol during and for a few days after treatment can cause severe nausea and vomiting. Do not drink alcohol within 24 hours of taking metronidazole, 48 hours after taking secnidazole, or 72 hours after taking tinidazole.

Your healthcare provider will usually repeat the trichomoniasis test after treatment. A new test between two weeks and three months after treatment can check if the infection is gone and if you have not reinfected yourself.

Even if you have already received treatment to get rid of trichomoniasis, you can catch it again if you come into contact with an infected person.