Trichomoniasis Symptoms in Women and Men

What trichomoniasis symptoms look like

In women, trich usually shows up, when it shows up at all, as a change in discharge – thin or frothy, yellow-green or gray, with a strong or fishy smell – along with itching, burning or redness of the vulva and vagina, discomfort when urinating and pain during sex. In men it is usually silent; when there are symptoms they are mild: irritation or itching inside the penis, a thin discharge, or burning after urinating or ejaculating. Symptoms, if any, start five to twenty-eight days after exposure and can come and go.

Why most people have no symptoms

Trich is caused by a tiny parasite passed during vaginal sex. The CDC estimates that about seven in ten people who have it have no symptoms, that it is the most common curable STD in the United States, and that it is one of the least tested for – it is not part of many standard panels, so people who have been “tested for everything” often have not been tested for this. A test is the only way to know. Symptoms do not shorten the time an infection takes to show up on a test, and having none does not mean you are clear.

What else causes the same symptoms

Discharge, itching and odor in women are more often bacterial vaginosis or a yeast infection, and burning when urinating is more often a urinary tract infection. The trich test looks only for trich; it does not diagnose yeast, bacterial vaginosis or a UTI. If it is negative and the symptoms continue, see a clinician for the other causes.

When to see a clinician rather than wait for a test

Some symptoms need a clinician, not just a lab. A sore, blister, ulcer or rash should be examined – and, where possible, swabbed – while it is there, because a blood or urine test cannot tell you what a sore is. Severe pelvic or lower-belly pain, pain or swelling in a testicle, a fever with pelvic pain, vision or hearing changes, a severe headache, or yellowing of the skin or eyes need prompt medical care. If you are pregnant, tell your prenatal provider about any symptom or exposure. And if you may have been exposed to HIV in the last 72 hours, go to an urgent care or emergency room today and ask about PEP, which can prevent infection only if it is started in time. If you are pregnant, tell your prenatal provider about symptoms: untreated trich in pregnancy is associated with early delivery and low birth weight, and it is treatable.

How trich is tested, and what the test cannot tell you

Our test is a nucleic acid amplification test (NAAT) from a small urine sample, which finds far more infections than the microscope examination that was standard for decades. No swab, no exam. It works whether or not you have symptoms and in both women and men. There is no formally defined window period for trich; the guidance we use is on our When to Get Tested page, or call (866) 872-1888. More about the test is on our trichomoniasis testing page.

After a positive result

Trich is treated with metronidazole or tinidazole – under current CDC guidance, a seven-day course for women and a single dose for men. A member of our care team calls you, explains the result, and arranges a consultation with a physician who sends the prescription to the pharmacy you choose. Avoid sex until you and your partners have finished treatment and symptoms have resolved; treating both partners is the only way to stop passing it back and forth. Women should retest about three months after treatment, because re-infection is common. Being in a long-term relationship does not protect against trich if either partner had it before – it can sit silently for years.