Trichomoniasis, often referred to as "trich," is a common but lesser-known sexually transmitted infection (STI) that mainly affects women. It doesn’t usually cause symptoms and can lie dormant for months, so it’s not uncommon to feel like it just showed up out of the blue. But like any STI, you can’t contract it on your own. Keep scrolling to learn more about how trichomoniasis is spread, its warning signs, and how to treat it.

What is trichomoniasis?

Trichomoniasis is a sexually transmitted infection caused by a parasite called Trichomonas vaginalis. This tiny organism infects the urogenital tract, which includes the vagina, urethra, and bladder in women. While it’s more common in sexually active women, men can also contract and spread the infection via sexual intercourse.

Trichomoniasis is usually spread through unprotected sexual contact with an infected partner. This can include:

  • vaginal sex
  • oral sex
  • anal sex.

Since T. vaginalis can be spread via semen, pre-cum, and vaginal fluids, you can also get a trich infection by sharing sex toys if you do not wash them or cover them with a condom before use. It's important to note that women in same-sex relationships can also spread a trichomoniasis infection via vulva-to-vulva contact. It can not be contracted through casual contact, such as hugging, kissing, sharing towels, or sitting on dirty toilet seats.

Trichomoniasis symptoms

Trich is usually asymptomatic, meaning most people with it may not experience any noticeable symptoms, contributing to its spread. Around 70% of people with trichomoniasis don't experience any signs or symptoms at all, according to the Centers for Disease Control and Prevention (CDC).

When symptoms do appear, they can include:

  • itching or irritation inside and around your vulva and vagina
  • abnormal vaginal discharge that may be green, grey, frothy, with a foul or fishy smell
  • A burning sensation when you pee 
  • the frequent need to pee
  • spotting or bleeding between periods
  • pain during sex.

These can often be a sign of other infections, including bacterial vaginosis (BV), a yeast infection, a urinary tract infection (UTI), or another sexually transmitted infection. Since other infections can look and feel like trich, getting tested and seeing your healthcare provider for proper treatment is always a good idea.

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Can a woman get trichomoniasis on her own?

While it's technically impossible to "get" trich on your own without any form of contact with an infected individual, the infection can lie dormant and lead to confusion.

Trich is that it can lie dormant for weeks, months, or even longer. It has an incubation period of around 5 to 28 days, according to the CDC — but it might take way longer for signs to show up. This means that an infected person may not show signs right away, or at all, which can lead to unknowingly spreading the infection. A woman may believe she contracted it without sexual contact if symptoms appear long after a previous sexual encounter. It’s also worth noting that women can get reinfected if their partners are not treated simultaneously.

Regular STI screenings are crucial, especially if you have new or multiple sexual partners. You can reduce your risk of getting trichomoniasis by using condoms and dental dams each time you have sex and covering sex toys with a condom during partnered sex.

Testing for trichomoniasis

If you’re sexually active, it’s important to get tested — whether or not you’re experiencing symptoms. 

Getting tested for trich is pretty straightforward. The testing process usually involves a:

  • Pelvic exam: A healthcare provider examines the vaginal area for signs of infection.
  • Vaginal swab: A sample of vaginal fluid is taken and examined under a microscope to detect the presence of Trichomonas vaginalis. In some cases, a urine sample may also be used for testing.

Trichomoniasis tests are not typically part of every STI panel, so you may have to request it specifically. Alternatively, you can also do an at-home STI test, such as Evvy's Expanded PCR Panel and Vaginal Health Test, by taking the sample yourself and sending it to a lab for analysis.

Treatment 

Trich is treatable with prescription antibiotics, most commonly metronidazole (taken as a single dose) and tinidazole (generally taken in a lower dose twice a day for seven days). 

It’s important to complete the entire course of treatment to ensure the infection clears entirely. You should also inform any recent sexual partners, as they will need to be treated as well to prevent reinfection (even if they don’t have any symptoms).

Taking care of trich (or any other STIs you may have) is important, as it can lead to serious health issues if you don't get treatment. Specifically, trich can cause inflammation in the genital area and make it more likely for you to get other STIs. If it's not treated, trichomoniasis can also cause cervicitis, an inflammation in the cervix. Signs of cervicitis include bleeding between periods, pain during or after sex, and unusual discharge.

Like STIs such as chlamydia and gonorrhea, trichomoniasis can also spread from the lower genital area to the uterus and ovaries, leading to pelvic inflammatory disease (PID). 

Trichomoniasis can be especially tough for pregnant women. Although it's rare, having trichomoniasis during pregnancy can lead to preterm delivery or a low birth weight. So, if you're pregnant and have signs of trichomoniasis, it's really important to see your doctor right away.

FAQ

How did I get trichomoniasis if no one cheats?

If you're in a committed relationship and you unexpectedly contract trichomoniasis, it's natural to suspect infidelity, but STIs aren't always a sign of cheating. Most people with trichomoniasis won't have any signs of the infection. Additionally, you can harbor the Trichomonas vaginalis parasite for many months without knowing. This means that you might have contracted it from a previous relationship or sexual encounter and are only now showing symptoms. It also means you could have acquired the infection from a past relationship and unknowingly transmitted it to your current partner.

Can a man give a woman trichomoniasis and not have it?

No, a man can't give a woman trichomoniasis without being infected himself. This infection is caused by a parasite called Trichomonas vaginalis, which is passed through sexual contact. So, for a man to pass it on to a woman, he needs to have the parasite himself. One thing to keep in mind is that many men with trichomoniasis don't have any symptoms and might not even know they're infected. This means they can unintentionally transmit the parasite to their partners. So, even if a man doesn't have symptoms, he could still carry and spread the parasite. Both partners will have to get tested and treated for trichomoniasis. 

How long can a woman have trichomoniasis without knowing?

A woman can have trichomoniasis for months or even years without knowing. The infection is often asymptomatic, which makes it possible for a woman to be unaware she has it. When symptoms do appear, they can develop within five to 28 days after exposure, but it's also common for the infection to remain asymptomatic for a much longer period. Regular screening and STI tests are crucial, especially if you have new or multiple sexual partners, to detect and treat trichomoniasis even in the absence of symptoms.