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Trichomoniasis is an
infection with a tiny parasite spread by sexual contact (sexually transmitted infection (STI)). It is sometimes
called a Trichomonas infection or trich (say "trick").
and women can get a trich infection, but it is more commonly detected in women. Trich in
pregnant women can cause problems with the pregnancy.
Trich is caused by a one-cell
Many women and most men do
not have any symptoms of trich. But when you do have symptoms, they usually
start within 1 week after you were infected.
In women, symptoms include:
In men, symptoms include:
The time from contact with the trich parasite until you
get symptoms can range from 5 to 28 days.1 This is
incubation period. You can spread trich to others
during this time and until you finish the prescribed medicine. You should avoid
all sexual contact until you finish taking your medicine and the symptoms are
Your doctor can tell if
you have trich by asking about your past health and doing a physical exam. He
or she may order lab tests to find the parasite that causes trich. In women,
the parasite may sometimes be found during a routine
Pap test. This test is done as part of a regular
Your doctor will prescribe
medicine called metronidazole or tinidazole to treat trich. These kill the
parasite that causes the infection. The medicine is usually taken by mouth as
pills, tablets, or capsules. Medicine given in the vagina will not cure
It is important to treat trich. Treatment can:
Trich is spread when a person has unprotected sex with an infected
partner. Some people carry the parasite that causes trich, but they do not have
symptoms. So it is important to practice safer sex to prevent getting trich.
Using a condom each time you have sex may reduce your chance of getting an
In rare cases, it may be possible to get trich from contact
with personal items, such as a wet towel, that a person with trich has just
used. The trich parasite cannot live on objects for long, so it isn't usually
spread this way.
Trich may be spread from a mother to her baby
during a vaginal delivery, but this is also rare.
Symptoms of a
trich infection in young children may be a sign of sexual abuse. They need to
be checked by a doctor.
Learning about trichomoniasis:
Trichomoniasis (trich) is caused by a
parasite (a one-celled protozoan) that most commonly
is sexually transmitted from an infected person.
women, trich organisms usually infect the vagina and cervix,
bladder, and glands in the genital area, such as the
Bartholin's and Skene's glands.
infections develop in the urethra or under the foreskin of an uncircumcised
Up to 50 out of 100 women and men infected with
trichomoniasis (trich) do not have symptoms.2 If symptoms develop, they usually appear within 1 week after a person is infected. But symptoms can develop months later.
Symptoms may be worse during pregnancy
or right before or after a menstrual period. Symptoms in women may
Men rarely have symptoms but still need
treatment. If symptoms are present, they may include:
Trich can have symptoms similar to those of other
sexually transmitted infections such as
(trich) infection is spread when you have unprotected sex with an infected partner.
Many women and most men do not have any symptoms of trich. If symptoms appear,
they usually start within 1 week after a person is infected. But it may take up to a month for symptoms to appear. In most cases, trich should be treated to prevent
transmitting this sexually transmitted infection (STI) to others and to prevent some problems that can happen if
you are pregnant. You and your sex partner(s) should be treated for trich at
the same time, to avoid reinfecting each other.
Trich during pregnancy raises the risk of premature rupture of membranes
(PROM) and premature delivery. Treating the infection doesn't appear to reduce
this risk.3 If you are pregnant and have trich, talk
to your doctor about the pros and cons of treatment.
Trich may be
transmitted from a mother to her baby during a vaginal delivery, but this is
Those most affected by
trichomoniasis (trich) are sexually active women ages 16
to 35. It is thought that 1 out of 5
women in this age group will become infected at some time.4
Behaviors that will increase your risk of
getting trich include:
You can get other STIs, such as
syphilis, at the same time you get a trich infection.
If one STI is diagnosed, testing for other STIs should be done so that all
infections can be treated at the same time.
Some infections that
can be spread through sexual contact, such as the
human immunodeficiency virus (HIV) infection, are
life-threatening. Studies show that trich infection may increase the risk of
transmitting HIV infection.5 Health professionals
around the world are concerned about the increased risk of trichomoniasis and
Women who have trich may also be at risk for other vaginal
infections. About 20% of women with trich also have a
yeast infection and many also have
Call your doctor immediately if you:
Call your doctor for an appointment within 1
week if you:
Watchful waiting is a period of time during
which you and your doctor observe your symptoms or condition
without using medical treatment. Watchful waiting isn't appropriate if you
think you have trichomoniasis (trich). In most cases, trich should be treated
to prevent transmitting this sexually transmitted infection to others and to
prevent some problems that can happen if you are pregnant.
Note: Trich during pregnancy raises the risk of premature
rupture of membranes (PROM) and premature delivery. Treating the infection doesn't appear to reduce this risk.3 If you are pregnant
and have trich, talk to your doctor about the pros and cons of
Health professionals who can diagnose and treat a
trichomoniasis (trich) infection include:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
(trich) is diagnosed by using:
People can get other
sexually transmitted infections (STIs), such as
syphilis, at the same time they get a trich infection.
If one STI is diagnosed, you will likely be tested for other STIs so that all
infections can be treated at the same time.
In women, the trich
parasite may also be identified by a routine
Pap test done as part of a regular gynecologic exam.
Expert opinions vary on the accuracy of a Pap test for diagnosing trich. But if
a Pap test shows trich, your doctor will probably talk to you about treatment
or maybe other tests.
(trich) is treated with an oral
antiprotozoal medicine, such as metronidazole or
tinidazole. The medicine is taken either as a single dose or as
partner(s) should be treated at the same time you are being treated. This increases
the cure rate and reduces the possibility of further transmission or
reinfection. Sexual intercourse should be avoided during treatment until
symptoms are gone and until partners have been treated. It is
best to avoid sex for 1 week after treatment with a single dose of
metronidazole. Male partners may not have symptoms but still need
People who are infected with
HIV receive the same treatment for trich as those who
during pregnancy raises the risk of
premature rupture of membranes (PROM) and premature
delivery. Treating the infection doesn't appear to reduce this risk.3 If you are pregnant and have trichomoniasis, talk to your
doctor about the pros and cons of treatment.
suppositories and creams aren't effective in curing
trich, but they may reduce discomfort and swelling in the genital area.
If trich goes untreated or isn't properly treated,
complications can develop, such as
pelvic inflammatory disease (PID) in women or
conditions that contribute to
infertility in men.6
Take measures to reduce your risk of
becoming infected with
trichomoniasis (trich) or other
sexually transmitted infections (STIs), such as
syphilis. You can also reduce the risk of transmitting
an STI to your sex partner(s).
Preventing an STI is easier than
treating an infection after it occurs.
Using condoms may reduce the risk of
becoming infected with an STI. Condoms must be put on before beginning any
sexual contact. Use condoms with a new partner until you are certain he or she
does not have an STI. It is important that
you use a condom properly to prevent the risk of trich infection.
Even if you are using a birth
control method to prevent pregnancy, you may wish to use female condoms to reduce your
risk of getting an STI.
There is no home treatment for
trichomoniasis (trich). But you can lower your chances
of getting trich or other
sexually transmitted infections (STIs) by making careful
choices about sex. For example, you can make sure to always use condoms during
sex. For more information, see the topic
Trich is not usually
transmitted by contact with objects. But avoid using objects
such as washcloths or wet towels that a person with trich may have used.
It is safe for a woman to use tampons while she has a trich infection,
but it may be uncomfortable.
Avoid douching. It does not help
relieve symptoms, and it can even make them worse.
(trich) is usually treated with a medicine called metronidazole. The cure rate
in treating trich using metronidazole is 90% to 95%.5
Tinidazole has been shown to be this useful too.
Antiprotozoals, such as metronidazole or tinidazole,
are medicines that kill the tiny
parasite that causes trich.
Trich during pregnancy raises
the risk of premature rupture of membranes (PROM) and premature delivery.
Treating the infection doesn't appear to reduce this risk.3 If you are pregnant and have trich, talk to your doctor about
the pros and cons of treatment.
suppositories or creams aren't recommended, because
oral metronidazole is much more effective. Vaginal medicines cure trich in less
than 50% of cases.5
gel, which is used to treat
bacterial vaginosis, is not recommended for treatment
The mission of the American Social Health Association is
to improve the health of individuals, families, and communities, with a focus
on sexual health and preventing sexually transmitted diseases.
American Academy of Pediatrics (2009). Trichomonas
vaginalis infections (Trichomoniasis). In LK Pickering et al., eds.,
Red Book: 2009 Report of the Committee on Infectious Diseases, 28th ed., pp. 674–675.
Elk Grove Village, IL: American Academy of Pediatrics.
British Association of Sexual Health and HIV (2007).
Management of Trichomonas Vaginalis Infection. Available
American College of Obstetricians and Gynecologists
(2006, reaffirmed 2011). Vaginitis. ACOG Practice Bulletin No. 72. Obstetrics and Gynecology, 107(5): 1195–1206.
American Public Health Association (2008). Trichomoniasis. In DL Heymann, ed., Control of Communicable Diseases Manual, 19th ed., pp. 625–627. Washington, DC: American Public Health Association.
Centers for Disease Control and Prevention (2010). Trichomoniasis section of Sexually transmitted diseases treatment guidelines 2010. MMWR, 59(RR-12): 58–61. Also available online: http://www.cdc.gov/std/treatment/2010/default.htm.
Hobbs MM, et al. (2008). Trichomonas vaginalis and
trichomoniasis. In KK Holmes et al., eds., Sexually Transmitted Diseases, 4th ed., pp. 771–793. New York:
U.S. Department of Health and Human Services (2006).
Sexually Transmitted Diseases Treatment Guidelines, 2006
(CDC Publication Vol. 55, No. RR-11), pp. 52–54. Atlanta: U.S. Department
of Health and Human Services. Also available online: http://www.cdc.gov/STD/treatment/2006/rr5511.pdf.
Other Works Consulted
McCormack WM (2010). Trichomoniasis section of Volvovaginitis and cervicitis. In GL Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practices of Infectious Diseases, 7th ed., vol. 1, pp. 1498–1500. Philadelphia: Churchill Livingstone Elsevier.
August 7, 2012
Sarah Marshall, MD - Family Medicine & Jeanne Marrazzo, MD, MPH - Infectious Disease
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