Trichomoniasis

Trichomoniasis is a sexually transmitted infection (STI) caused by the parasite Trichomonas vaginalis. You may have trichomoniasis but have no symptoms which means you can pass on the infection without knowing you have it.

It’s most common in sexually active females between 16 and 35 years of age. Male partners always need to be treated even if they don’t have symptoms.

If you have trichomoniasis, it’s easy to treat with antibiotics and you need to tell anyone you’ve had sex with in the past 3 months to get tested and treated too. 

For those infected, there’s no need to feel embarrassed – trichomoniasis is very common. However, it’s important to get tested and treated, and to follow preventive practices to protect yourself and your partners.

Trichomoniasis is spread when you have unprotected sex and contact with genital fluids from the penis or vagina of someone who has the infection.

Ιt can also be passed on by sharing sex toys (eg, vibrators) if you don't wash them before use. You don’t need to have many sexual partners to get the infection. Trichomoniasis is not thought to be passed on through oral or anal sex, or through kissing.

A lot of people with trichomoniasis don’t have any signs or symptoms. Often females may notice symptoms while males can be symptom free. If you do have symptoms, you might have anything from a bit of irritation to severe inflammation. Some people get symptoms within 5 to 28 days of being infected, but others don’t develop symptoms until much later. Symptoms can come and go.

Females

• You may feel pain, swelling, burning or itching in your genital area.
• You may also feel pain or discomfort when passing urine (peeing) or having sex.
• You may notice a watery discharge (greeny-yellow and may be frothy) from your vagina.
• You may have a bad odour (a fishy smell) in your genital area.
• You may notice your genital skin and upper thighs are red and irritated.
• Many females don’t have any symptoms.

Males

• Μost males don’t have symptoms.
• You can still pass trichomoniasis on even if you don’t have symptoms.
• You may have discharge or fluid leaking from your penis.
• You may also have pain when passing urine (peeing) or during ejaculation (coming).
• You may have pain, swelling or redness around the head of your penis or foreskin.

Trichomoniasis can be difficult to diagnose because the symptoms are similar to other sexually transmitted infections (STIs). Your healthcare provider or sexual wellbeing clinic will ask you a few questions about your symptoms, and whether you have had any sexual contact with someone with trichomoniasis infection. They might also examine your genital area.

• For females, a swab will be taken from your vagina.
• For males, your healthcare provider may suggest a urine test or a swab depending on your symptoms.

If you’ve had sex with someone who has trichomoniasis or trichomoniasis is suspected, you may be offered treatment straight away without waiting for test results.

If you have trichomoniasis, your healthcare provider may also test for other STIs or do a sexual health check. Read more about sexually transmitted infections (STIs).

Trichomoniasis can be easily treated with an antibiotic such as metronidazole or ornidazole. You can take it as a single dose or as a 1-week course. Your healthcare provider will advise on what's best for you. You shouldn't take ornidazole if you're pregnant or breastfeeding. 

The antibiotic tablets can sometimes make you feel a bit nauseous (sick), but it helps if you take them with food. Don't drink alcohol while taking the tablets or for as least 24 hours after finishing your full course of antibiotics. 

So you don't pass the infection on, avoid sex for 7 days after you and your partner(s) have finished your antibiotic treatment, or use condoms if this isn't possible. 

It's common to get infected with trichomonas again. To reduce the chance of re-infection:

• make sure all your sexual partners get treated too even if they don’t have symptoms
• don’t have any unprotected sex (sex without a condom or oral dam) until a week after you and your sexual partner(s) have finished treatment. 

Make sure you get checked again if your symptoms come back. You should get retested after 3 months to check for re-infection.

Note: If you’ve had trichomoniasis and it’s been treated, you’re not immune to it and could get it again.

Trichomoniasis is unlikely to go away without treatment. 

• It can increase your risk of getting or spreading other STIs, such as HIV. Trichomoniasis can cause genital inflammation, which makes it easier to get infected with the HIV virus, or to pass the HIV virus on to a sex partner.
• It can increase your chances of a genital infection such as bacterial vaginosis.
• Both males and females are at increased risk of infertility.
• Trichomoniasis can cause pelvic inflammatory disease in females.
• It can also cause inflammation of the prostate gland in males (prostatitis).
• If you're pregnant, your baby is more likely to come early and to have a low birth weight. 

Practising safer sex can protect you from getting, or passing on trichomoniasis and other STIs. The following tips can help prevent STIs:

• Use condoms or oral dams during vaginal, oral or anal sex with every partner, every time.
• Keep sex toys clean, cover them with a condom when you use them and avoid sharing with others.
• Communicate openly with sexual partners about sexual health to help reduce the transmission (passing on) of STIs.
• Avoid having sex if you or your partner have any symptoms such as sores, ulcers, discharge or any pain around the genital area – get checked by a healthcare provider first.
• Have regular STI checks (every 3 months), especially if you have had any unprotected sex (sex without a condom) or have more than 1 partner.
• Wash your hands with soap and water before and after sex or sexual play.

Read more about safer sex.

If you think you have trichomoniasis or any other sexual health concerns, you can see or talk to your healthcare provider.

Other places you can get help or advice include sexual health clinics(external link) and Sexual Wellbeing Aotearoa clinics(external link).