Trichomoniasis, commonly referred to as trich, is 1 of the 10 most common sexually transmitted infections (STIs) in the UK. Left untreated, it increases the risk of infertility in women.
Here, we’ll explore the symptoms and complications of trich, as well as trichomoniasis diagnosis and treatment.
What is trichomoniasis?
Trichomoniasis, or trich, is caused by infection with a parasite called Trichomonas vaginalis. Globally, it’s the most common STI that isn’t caused by a virus. In the UK, there are around 6,000 cases diagnosed every year.
How can you get trichomoniasis?
Trichomoniasis is spread through intimate contact with the genitals, anal, oral or vaginal sex, and sharing sex toys that have not been cleaned properly.
It can be spread even if you’re infected but have no symptoms.
Trichomoniasis symptoms
Trich does not always cause symptoms. When it does, they can appear 5–28 days after being infected, or much later. In women, who more commonly develop symptoms than men, the most common symptom is a yellow–green, foul-smelling discharge from the vagina.
Other symptoms in women include:
- Itchy skin around the vagina
- Redness, swelling and/or soreness in and around the vagina
- Pain when urinating
- Pain when having vaginal sex
Men infected with trichomoniasis are less likely to develop symptoms. This is because the parasite is better adapted to living within the environment of the vagina. In women, it can also infect the opening of the womb (cervix), outer genitals (vulva) and the tube through which urine leaves the body (urethra).
In men who develop symptoms, the parasite has infected the urethra.
Symptoms in men include:
- Discharge from the penis
- Pain or soreness in the penis
- Pain or soreness in the area between the anus and scrotum (perineum)
- Pain when ejaculating and/or urinating
- Urinating more often than usual
If you notice any of these symptoms, you should see your GP or visit a sexual health clinic for sexual health testing.
Who is at risk of trich infection?
Your risk of infection with trichomoniasis is higher if you have multiple sexual partners, unprotected sex and/or have previously been infected with trichomoniasis or other STIs.
For women, the risk of trich infection is also higher if practicing vaginal douching. This involves washing your vagina with water or other liquids. This disturbs the bacteria that naturally live in your vagina, which help create a protective, acidic barrier against infections.
Trichomoniasis complications
Trichomoniasis infection has long-term health consequences for men and women. In women, it increases the risk of cervical cancer, while in men, it increases the risk of prostate cancer.
In women, there’s also a higher risk of infertility. In men, the risk of prostate gland inflammation (prostatitis) and inflammation of the tube that stores and transports sperm (epididymitis) increases.
In both men and women, it increases the risk of bladder inflammation (cystitis).
Trichomoniasis and HIV risk
Trichomoniasis infection causes inflammation of the genitals. This makes the genitals more vulnerable to any kind of infection.
Trich infection, in particular, increases the risk of HIV infection in women and men if exposed to this virus. This is because inflammation causes certain immune cells to travel to the genitals. These are the same immune cells that HIV targets and infects.
However, trichomoniasis can be effectively treated and is curable.
Trichomoniasis and pregnancy
If you’re pregnant and become infected with trichomoniasis, you are more likely to give birth before your baby is full-term. This is called a preterm birth. Your baby is also more likely to have a low birth weight.
Both preterm birth and low birth weight can have a long-term impact on your baby’s health.
If you have a vaginal delivery while infected, there is also a risk that you will pass the infection on to your baby.
Getting a diagnosis of trichomoniasis
If you’ve noticed symptoms of trichomoniasis or are concerned that you may be infected, visit your GP or a sexual health clinic.
They will ask you about any symptoms, as well as your medical and sexual history. If you have symptoms, they may ask to examine your genitals and may use a swab to collect a sample of discharge for testing in a lab.
If you do not have symptoms, you can still be tested with a urine test. Even if you do have symptoms, such as discharge, a healthcare professional may still ask for a urine sample.
You may also be asked to get tested for other STIs.
Telling sexual partners
If you test positive for trich, you will need to tell all current and recent sexual partners. This can be done on your behalf without mentioning your name — this can be arranged via a sexual health clinic.
Trichomoniasis treatment
Trich is treated with a course of antibiotics. This is usually metronidazole tablets taken twice a day for 7 days. You need to complete the course for treatment to be effective. Your recent sexual partners will also need to be treated if they’ve tested positive.
You should not have any type of sex or intimate contact until you and any partners have finished your treatment.
Preventing trichomoniasis infection
You can reduce your risk of trichomoniasis infection by reducing the number of sexual partners you have, always using a barrier contraceptive such as a condom, and washing any sex toys thoroughly before using them.
If you have multiple sexual partners, it’s also important to have regular sexual health testing to help prevent the spread of STIs.
Sources
Masha SC, Cools P, Sanders EJ, Vaneechoutte M, Crucitti T. 2019 Feb. Sex Transm Infect. Trichomonas vaginalis and HIV infection acquisition: a systematic review and meta-analysis. doi: 10.1136/sextrans-2018-053713
Morniroli D, Tiraferri V, Maiocco G, De Rose DU, Cresi F, Coscia A, Mosca F, Giannì ML. 2023 Jul. Front Pediatr. Beyond survival: the lasting effects of premature birth. doi: 10.3389/fped.2023.1213243
https://www.nhs.uk/conditions/trichomoniasis/
https://www.cdc.gov/trichomoniasis/about/index.html
https://www.sticlinic.co.uk/blog/most-common-stis-uk-stats-trends
