Trichomoniasis - Symptoms and Treatment - Candida Overgrowth & Gut Health Solutions

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What Is Trichomoniasis?

Trichomoniasis is caused by the protozoan (a parasite) Trichomonas vaginalis. This common but often overlooked sexually transmitted infection (STI) is commonly referred to as trich. It primarily affects the urogenital tract and is transmitted through vaginal, oral, or anal sexual contact. Due to its frequent lack of symptoms, especially in men, many individuals remain unaware they are infected, contributing to its widespread prevalence.

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Women Of Child-Bearing Age Most Affected

According to the World Health Organisation, in 2020 there were are an estimated 374 million new infections in people 15–49 years with 1 of 4 curable STIs: chlamydia, gonorrhoea, syphilis and trichomoniasis.

Yet despite its high global occurrence—156 million new cases were reported in 2020—trichomoniasis is often disregarded in public health discussions.

Women of reproductive age are the most affected, with men often serving as asymptomatic carriers. In women, symptoms can include abnormal vaginal discharge, discomfort during urination, or pain during intercourse, while men may only experience mild urethral irritation or discharge. (Schumann et al., 2023).

Left untreated, the infection can lead to serious complications such as poor pregnancy outcomes, pelvic inflammatory disease, and a heightened risk of acquiring HIV (Davis et al., 2016).

Fortunately, trichomoniasis is both preventable and curable with medicines like metronidazole or tinidazole. Increasing awareness, promoting routine STI screenings, and encouraging safe sexual practices are key strategies for reducing its impact (CDC).

Key Points

Caused by Trichomonas vaginalis, a protozoan (a parasite).
Affects the urogenital tract and spreads through vaginal, oral, or anal sex.
Often asymptomatic*, especially in men, making it an easily overlooked condition.
Associated with poor pregnancy outcomes, pelvic inflammatory disease, and increased HIV risk.
Treatable with antibiotics such as metronidazole or tinidazole.
Most common in women of reproductive age and disproportionately affects certain populations.
( * asymptomatic is someone affected by a disease but producing or showing no symptoms of it.)

Trichomoniasis Symptoms

Symptoms typically appear within 5–28 days of exposure, but can varu from person to person. Women may experience more noticeable symptoms, such as frothy, greenish-yellow vaginal discharge with a strong odour, itching, discomfort during intercourse, and irritation in the vaginal area. (Schumann et al., 2023).

In contrast, men rarely show symptoms or may have mild irritation or discharge from the penis. The lack of symptoms in men can facilitate the infection’s transmission, since carriers may be unaware of their status.

Trichomoniasis in Women

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Studies show that trichomoniasis disproportionately affects women and black individuals, highlighting significant health disparities associated with this STI (Van Gerwen et al., 2023).

This prevalence emphasises the need for increased awareness, prevention strategies, and accessible treatment options, especially for at-risk populations.

Symptoms of Trichomoniasis in Women

Trichomoniasis often causes noticeable symptoms in women, although some may remain asymptomatic.

Here’s a detailed list of trichomoniasis symptoms in women:

Abnormal vaginal discharge:
Thin, frothy discharge that may be white, yellow, or greenish.
Often accompanied by a strong, unpleasant, or “fishy” odor.
Vaginal irritation and discomfort:
Redness, soreness, or itching around the vaginal opening.
Swelling or inflammation of the vulva (vulvovaginitis).
Painful urination (dysuria):
A painful, burning or stinging sensation during urination.
Painful intercourse (dyspareunia):
Discomfort or pain during sexual activity, sometimes due to vaginal inflammation.
Spotting or bleeding:
Light vaginal bleeding or spotting after intercourse, though less common.
Increased urinary frequency:
Feeling the need to urinate more often, which can be confused with a urinary tract infection (UTI).

Importance of Symptom Recognition

Recognising symptoms early is critical to diagnosing and treating trichomoniasis. Women experiencing any of these signs should consult a doctor or a healthcare provider for testing, as untreated infections can lead to complications like pelvic inflammatory disease (PID) and increase susceptibility to other STIs.

Studies including what causes trichomoniasis, how it spreads, and who this STI affects in any given population, show that trichomoniasis is most prevalent among women and black individuals, making societal-level health disparities of this STI clear (Van Gerwen et al., 2023).

Trichomoniasis In Men

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Trichomoniasis in men often presents with subtle or no symptoms, making it easy to overlook or misdiagnose. Some men may present with symptoms including penile discharge, testicular pain, pain when urinating, increased urinary frequency, or cloudy urine (Schumann et al., 2023).

Frothy discharge from the penis, a burning sensation after ejaculation, or painful urination are common indicators of STIs. Irritation or itching inside the penis can also occur, adding to the discomfort.

While these symptoms may seem mild or intermittent, untreated trichomoniasis can lead to complications such as increased susceptibility to other sexually transmitted infections, including HIV, and potential issues with a man’s prostate health. Early diagnosis and treatment are essential to avoid long-term health consequences and to prevent transmission to sexual partners.

Symptoms of Trichomoniasis in Men

Here’s a detailed list of trichomoniasis symptoms in men:

Penile discharge (can be frothy)
Testicular discomfort of pain
Burning sensation after ejaculation
Painful urination
Increased urination
Cloudy urine
Irritation or itching inside the penis.

Trichomoniasis Causes

How Do You Get Trichomoniasis?

It is important to point out that trichomoniasis is a common sexually transmitted infection caused by a small parasite called Trichomonas vaginalis. The infection is transmitted primarily through unprotected sexual contact. Any sexually-active individual can contract and spread trichomoniasis, male or female, making safe practices and awareness vital for prevention.

Vaginal, anal, and oral sex are the main routes of transmission, but it can also spread through close genital contact without ejaculation. In rare cases, the trich parasite may survive in moist environments like wet towels for a short time, leading to indirect transmission, although this is less common.

The infection affects both men and women, though women tend to experience more pronounced symptoms. Men may carry the parasite without showing clear signs, increasing the likelihood of unknowingly passing it to partners. Importantly, trichomoniasis cannot spread through non-sexual contact, such as sharing food, drinks, or toilet seats, nor is it caused by poor hygiene.

Risk Factors for Trichomoniasis

Certain behaviours and conditions increase the risk of contracting trichomoniasis. These include:

A history of sexually transmitted infections (STIs).
Having a new or multiple sexual partners.
Sexual contact with an infected partner.
Engaging in unprotected sex without barrier methods.
Intravenous drug use or other risky behaviours.

While trichomoniasis is most commonly transmitted through direct sexual contact, rare cases of transmission via damp towels or other moist objects demonstrate the parasite’s resilience in certain conditions.

Key Points About Trichomoniasis Transmission

Trichomoniasis spreads primarily through unprotected vaginal, anal, or oral sex.
Genital skin-to-skin contact without ejaculation can transmit “trich”.
The infection may rarely spread via moist objects like wet towels but not through toilet seats or casual contact.
Poor hygiene does not cause trichomoniasis, and urinary tract infections (UTIs) are unrelated to its development.
Trichomoniasis can infect the genitals, anus, mouth, or hands.

Trichomoniasis Is Not Spread Through:

Sharing food or drinks
Kissing or holding hands
Toilet seats
Non-sexual forms of contact

Take-Aways

Always practice safe sex by using barrier methods like condoms to reduce the risk of transmission.
Limit the number of sexual partners and have open communication with partners about STIs.
Get regular STI screenings, especially if you are sexually active with multiple partners.
Seek immediate medical attention if you notice unusual symptoms such as discharge, itching, or burning.
Avoid sharing wet towels or personal items to minimise rare indirect transmission risks.
Follow your healthcare provider’s advice for treatment and ensure both you and your partner complete the prescribed course of medication to prevent reinfection.

By understanding the causes and modes of transmission, it is possible to take proactive steps to prevent and manage trichomoniasis effectively.

Trichomoniasis Test

Testing and Diagnosis of Trichomoniasis

Accurate diagnosis of trichomoniasis is most essential for effective treatment and preventing the spread of this common STI. Healthcare providers use a combination of physical exams and laboratory tests to confirm the trichomoniasis infection.

Prompt testing is particularly important if symptoms such as unusual discharge, itching, or burning occur. Let’s now look a the common ways this condition is diagnosed and tested:

Diagnostic Methods

Physical Examination:
The provider examines the patient’s genitals and discusses any symptoms.
Females will most likely undergo a pelvic exam. During the exam, providers may notice signs like a “strawberry cervix“, which is a hallmark of trichomoniasis. (see image from Archives of Obstetrics and Gynaecology)
A sample of discharge is collected using a cotton swab for further testing.
Lab Tests:
Microscopy: A sample of vaginal or penile discharge is examined under a microscope to detect trichomonads.
Advanced Testing: Samples may be sent to a lab for testing, such as “nucleic acid amplification tests” (NAAT), which are highly sensitive and considered a gold standard for trich testing in many healthcare settings (Craig-Kuhn et al., 2019).
Testing for Co-Infections:
If trich is confirmed, healthcare providers often test for other STIs, such as HIV or syphilis.
Partner Notification:
Partners of individuals diagnosed with trich should be notified and treated to prevent reinfection.

Key Points About Diagnosis

Physical exams and lab tests are the most common diagnostic methods.
NAAT is the most accurate test but may not be available in all healthcare settings.
Trichomoniasis diagnosis often includes screening for other STIs.
In some cases, antibiotics may be prescribed without an exam if a sexual partner is known to have the infection.

Take-Aways

Seek medical attention promptly if you notice symptoms of trichomoniasis, such as unusual discharge or itching.
Diagnostic methods include physical exams, microscopy, and molecular testing.
Notify sexual partners immediately if you test positive to ensure they receive treatment.
Regular STI screenings are critical for sexually active individuals to detect infections early.
Ensure all partners complete treatment simultaneously to prevent reinfection.
Consider testing for other STIs if trichomoniasis is confirmed.

Clear and accurate testing, combined with open communication and prompt treatment, helps control the spread of trichomoniasis and ensures better overall sexual health.

Trichomoniasis Treatment

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Can Trichomoniasis Be Cured?

Yes, trichomoniasis is curable with proper treatment. Patients treated with antibiotics such as metronidazole or tinidazole have a high cure rate, typically between 90% and 95%. These rates are even higher when both the infected individual and their sexual partner(s) are treated simultaneously, as this helps to prevent reinfection.

However, recurrent infections are common in sexually active individuals, particularly if partners are not treated or safe sexual practices are not followed.

Why Prompt Treatment Is Important

Trichomoniasis is not just an isolated infection; it is strongly associated with other sexually transmitted infections (STIs). Individuals with trichomoniasis are at an increased risk of contracting and transmitting infections such as HIV, gonorrhea, human papillomavirus (HPV), herpes, and chlamydia. This makes early diagnosis and treatment critical for protecting overall sexual health.

For pregnant women, untreated trichomoniasis can lead to severe complications, including:

Preterm delivery.
Low birth weight infants.
Premature rupture of membranes.

Trichomoniasis increases the risk of developing pelvic inflammatory disease (PID), a serious condition that can cause long-term reproductive health issues, including infertility (Van Gerwen et al., 2023).

Take-Aways

Trichomoniasis is curable with antibiotics like metronidazole or tinidazole.
Treating sexual partners simultaneously is essential to avoid reinfection.
Recurrent infections are common without safe sexual practices.
Trichomoniasis increases the risk of contracting and transmitting other STIs.
Pregnant women with trich face serious risks, including preterm delivery and low birth weight.
Early treatment reduces the risk of complications like pelvic inflammatory disease.

Addressing trichomoniasis promptly and adopting preventative measures can help ensure better long-term sexual and reproductive health.

Trichomoniasis Medication

Trichomoniasis is a curable sexually transmitted infection, but it requires prompt and proper treatment to eliminate the protozoan parasite causing the infection. While I’m not a fan of antibiotics in general, in cases of STIs there is no arguing that antibiotics are the most intelligent and effective solution.

Without treatment, trichomoniasis can persist for months or even years, during which time it can be transmitted to one or more sexual partners. Treating all sexual partners simultaneously is crucial to prevent reinfection.

The drug of choice is often metronidazole, which is highly effective in most all cases. I’ve also found it the drug of choice in hard to treat cases of the parasite called blastocystis hominis.

How Is Trichomoniasis Treated?

Antibiotics:
The primary treatment for is oral antibiotic medication, typically metronidazole or tinidazole.
A single large dose or a 7-day course is prescribed depending on the severity of the infection.
Treatment Instructions:
Take the medication with food to minimise side effects like nausea.
Avoid alcohol during treatment and for 24 hours after completing metronidazole (or 72 hours after tinidazole) to prevent adverse reactions.
Partner Treatment:
All current and recent sexual partners will need to be informed so they can be tested and treated, even if they have no symptoms.
Both partners must complete treatment to avoid passing the infection back and forth.
Sexual Activity:
Refrain from sexual contact (even with a condom) for at least 7 days after starting treatment or until symptoms completely resolve—whichever is later.
Follow-Up:
If symptoms persist after treatment, consult your healthcare provider for further evaluation.
A follow-up test 3 months after treatment is recommended to ensure the infection is cleared.

Key Points About Treatment

Antibiotics like metronidazole or tinidazole effectively kill the parasite.
Resistance is uncommon, but treatment failure may occur in some cases, requiring second-line regimens.
Women treated for vaginal discharge may also receive medications for bacterial vaginosis or candidiasis if symptoms overlap.
Avoid alcohol during and shortly after treatment to prevent side effects.
Reinfection can be prevented by ensuring all partners are treated and avoid sex during treatment.

Take-Aways

Take prescribed antibiotics as directed, and avoid skipping doses.
Inform and ensure treatment for all sexual partners, even if they have no symptoms.
Refrain from sexual activity for 7 days or until symptoms are fully resolved to prevent reinfection.
Avoid alcohol during treatment to minimise adverse effects from the medication.
Schedule a follow-up test 3 months after treatment to confirm the infection is cleared.
Consult your healthcare provider if symptoms persist or if reinfection occurs.

Effective treatment combined with proper precautions can eliminate trichomoniasis and prevent its spread, ensuring better overall sexual health.

Natural Approaches to Trichomoniasis Care

While antibiotics like metronidazole or tinidazole are necessary for curing trichomoniasis, natural approaches can support the body’s healing process, reduce the risk of reinfection, and promote overall reproductive health.

After completing antibiotic treatment, restoring the balance of the vaginal and gut microbiomes is crucial, as antibiotics can disrupt these ecosystems.

Probiotics, particularly strains like Lactobacillus, can help re-establish healthy microbial balance, reducing the likelihood of future infections and supporting immune function.

Additionally, maintaining a healthy vaginal pH and reducing sugar intake can play a significant role in creating an environment that is less conducive to the overgrowth of pathogens like Trichomonas vaginalis.

Incorporating anti-inflammatory and immune-boosting foods into the diet can further aid the recovery process. Foods rich in antioxidants, like berries, leafy greens, and cruciferous vegetables, can help reduce inflammation and support the body’s natural defense systems. Herbs such as garlic, oregano oil, and thyme are known for their antimicrobial properties and may help protect the body from additional infections.

Furthermore, a holistic approach to managing stress through practices like yoga, meditation, or deep breathing can help support the body’s immune system, as chronic stress can weaken immune function and make the body more susceptible to infections.

To further optimise complete and deep recovery, it’s beneficial to avoid irritants like douches, scented products, or harsh soaps that can disrupt the vaginal microbiome. Adopting a nutrient-dense, low-sugar diet and focusing on good hygiene practices can also reduce the chances of reinfection, ensuring the body has the best conditions to heal and maintain balance.

Key Natural Approaches

Probiotics: Replenish beneficial bacteria (Lactobacillus) to restore the vaginal and gut microbiomes.
Anti-inflammatory Foods: Incorporate antioxidant-rich foods such as berries, leafy greens, and cruciferous vegetables to reduce inflammation.
Nutrient-Dense Diet: Consume fruits, vegetables, and other natural whole foods that are full of nutrients.
Immune Supportive Herbs: Use garlic, oregano, and thyme for their natural antimicrobial properties.
Stress Management: Practice yoga, meditation, or other stress-reducing techniques to enhance immune function.
Dietary Adjustments: Reduce sugar intake to prevent imbalance in the vaginal pH and discourage pathogenic growth.
Avoid Irritants: Avoid douches, scented products, and harsh soaps that may disrupt the natural microbiome.

This holistic approach can be a valuable complement and adjunct to conventional treatments, helping to maintain long-term reproductive health and prevent future infections. Once your trichomoniasis treatment has successfully cured the condition, consider our vaginal cleansing and balancing program, it is primarily used to treat chronic vaginal thrush (yeast infection), but is also very good after trich treatment:

4-Steps to Vaginal and Gut Cleansing and Balancing

Our 4-step yeast infection treatment protocol combines the latest scientific research with over three decades of clinical expertise, offering a highly effective and practical alternative to conventional pharmaceutical treatments for vaginal yeast infections.

The methods we recommend are not only scientifically validated to be as effective as, or even more effective than, drug-based interventions, but they have also been clinically proven over 30 years of practice. By focusing on the root cause of vaginal yeast infections, our approach provides lasting relief and addresses the underlying imbalances that contribute to recurrent issues. This comprehensive 4-step program is also an excellent option for those dealing with recurring trichomoniasis or bacterial vaginosis, offering a holistic solution for long-term vaginal health.

Step 1. – Identify The Cause
Identify the cause, stop repeated drug prescriptions.
Step 2. – Deep Cleansing
Deal with and clean-up bacterial and yeast infections.
Step 3. – Balancing Microbiome
Rebuild health gut and vaginal bacteria, restore Ph levels. Using probiotics, prebiotics, specialised supplements, diet and lifestyle changes to rebuild microbial balance.
Step 4. – Lasting Health
Prevent future fungal /bacterial overgrowth by building a resilient microbiome through diet, and ongoing care.

Trichomoniasis Prevention

Preventing Trichomoniasis

Trichomoniasis is a preventable sexually transmitted infection, and taking proactive steps can significantly reduce the risk of contracting or spreading this common STI.

The most effective way to prevent the spread of trich is to practice safe sexual habits and maintaining open communication with partners, the two essential components of prevention.

While no method guarantees 100% protection, these strategies are highly effective:

Key Prevention Methods

Consistent and Correct Condom Use:
Using condoms every time during vaginal, anal, or oral sex reduces the risk of transmission.
Ensure proper condom use to avoid breakage or slippage.
Partner Notification and Treatment:
Inform current and recent sexual partners if you are diagnosed so they can be tested and treated.
Seek assistance from your doctor if you feel uncomfortable notifying partners directly.
Routine STI Testing:
Get tested regularly, especially if you or your partner has new or multiple sexual partners.
Testing is particularly important if symptoms like unusual discharge, itching, or pain occur.
Abstinence During Treatment:
If diagnosed, abstain from sex until both you and your partner(s) have completed treatment and are symptom-free.
Limit Sexual Partners:
Reducing the number of sexual partners lowers exposure risk to STIs, including trichomoniasis.
Open Communication with Partners:
Discuss STI testing and sexual health openly before engaging in sexual activity.

Take-Aways

Always use condoms correctly to reduce the risk of trichomoniasis and other STIs.
Notify and encourage sexual partners to get tested and treated if needed.
Prioritise routine STI screenings, especially with new or multiple partners.
Refrain from sexual activity during and after treatment to prevent reinfection.
Maintain honest communication with sexual partners about health and STI prevention.
Limit the number of sexual partners to decrease exposure to infections.

By combining these preventive measures, individuals can protect themselves and their partners while promoting better overall sexual health.

Thanks for reading this post, please leave any comments below.

Eric Bakker N.D.

Greetings! I am a naturopathic physician from New Zealand. Although I’ve retired from clinical practice since 2019, I remain passionate about helping people improve their lives. You’ll find I’m active online with a focus on natural health and wellbeing education through my Facebook page and YouTube channel, including this website.