When it comes to STIs, trichomoniasis, or trich as it is commonly called, is the most common curable sexually transmitted infection. It’s spread through vaginal fluids and semen during sexual intercourse. The complicated sounding name comes from the parasite, Trichomonas vaginalis.
The reason it’s so common is that most people (up to 95%) don’t have symptoms of the infection and unknowingly spread it back and forth. Researchers don’t know why some people get symptoms while others don’t, but it’s likely due to overall health, genetics, and age. In the U.S., the Centers for Disease Control (CDC) estimate more than two million infections occur annually.
What are the Symptoms of Trichomoniasis?
For men, they include:
- Mild or severe itching inside the penis
- Burning with urination or ejaculation
- Penile discharge
For women, they include:
- Itching, burning, redness, or soreness in and around the vagina
- Pain or discomfort with urination
- Vaginal discharge that may be clear, white, or greenish and have a fishy odor
- Occasional abdominal pain
If trichomoniasis isn’t treated, it can last for years in women, and it increases the risk of spreading other sexually transmitted infections, like HIV, due to genital inflammation. It can also complicate pregnancy for women, causing low birth weight babies, premature labor, pelvic inflammatory disease, and a premature rupture of membranes. Men are less likely to harbor the infection chronically, however, it is far from benign. In men, the infection can cause chronic inflammation in the male urethra and prostate. Trichomoniasis may also be responsible for infertility in both men and women and can affect the anus, mouth, and hands.
Getting Diagnosed
For women, your healthcare provider will perform a pelvic exam and take fluid samples that will be sent to the lab to look for the parasite under a microscope. A blood test can also detect the parasite. In men, the doctor will collect samples from the urethra, and the lab will study them under the microscope. It can be more difficult to detect the parasite in men.
Trichomonas is often not routinely tested for (unlike chlamydia and gonorrhea, which are frequently tested for at a well-woman visit.) As a woman may not have symptoms, and these infections may be present for years, a sudden positive test can lead to great confusion and even lead the patient to question marriage infidelity. A positive trichomonas test is NOT a marker of infidelity, or even a recent infection.
Treatment for Trichomoniasis
If you test positive, your healthcare provider will prescribe a course of antibiotics, typically metronidazole, unless you are pregnant. You’ll take the antibiotic for one week and both partners must be treated at the same time. Metronidazole does have side effects, such as abdominal cramping, nausea, and vomiting, and should not be taken with alcohol since headaches and flushing along with an increase of side effects can occur. Reinfection of trich occurs in about one in five people one to three months after treatment. You can prevent reinfection by making sure your partner was treated at the same time, not having sex until one week after you and your partner finish treatment, and by being retested three months after your treatment ends to ensure the infection has cleared.
Preventing Trichomoniasis
The only definitive way to avoid trich is not to have vaginal, anal or oral sex. Otherwise, you can decrease your odds of contracting the STI by being in a mutually monogamous relationship, limiting your partners and ensuring you and your partner(s) are regularly tested for STIs. You should also use a condom correctly every time you have sex. Talk with your partner about preventing STIs, and ask a new partner about testing before having sex for the first time. Some STIs can occur even in long-term monogamous relationships, so be sure to test regularly. Remember, trich doesn’t go away on its own; you must take an antibiotic, but it is 100 percent curable.
