Trichomoniasis discharge has a characteristic look, consistency, and smell — and yet it’s often mistaken for bacterial vaginosis (BV). Knowing what to look for can help you catch trichomoniasis early and get the treatment needed.

Keep scrolling to learn more about trichomoniasis symptoms, treatment, and prevention. 

What is trichomoniasis?

Trichomoniasis — or trich, for short — is a very common sexually transmitted infection (STI) caused by a parasite called Trichomonas vaginalis. All sexually active people can get trich, but women have an increased risk. Risk factors for trichomoniasis include a history of STIs, new sex partners, and having unprotected sex.

Most of the time, trichomoniasis doesn’t cause any symptoms, but when it does, trichomoniasis symptoms include unusual vaginal discharge, genital itching, and painful urination.

The most common symptom of trich is abnormal vaginal discharge that has the following characteristics:

  • Color: Typically yellow, green, or gray. These colors are distinct and often differ from normal vaginal discharge, which is usually clear or white.
  • Consistency: Thin, frothy, or bubbly. This frothy texture is a hallmark of trichomoniasis, setting it apart from other types of vaginal discharge.
  • Odor: Trichomoniasis causes a foul or fishy vaginal odor.
  • Quantity: The amount of discharge can be more than usual. You might notice a significant increase in the volume of vaginal discharge. For reference, women produce around half to one teaspoon (2 to 5 mL) of normal discharge daily.

Besides the characteristic discharge, trichomoniasis can cause several other symptoms:

  • Genital itching and irritation
  • Redness and swelling
  • Pain or burning when peeing
  • The frequent need to pee
  • Spotting or bleeding between periods
  • Painful intercourse

Keep in mind that other sexually transmitted infections or vaginal infections can cause similar symptoms to the ones above. If you’re experiencing symptoms that you think might be trichomoniasis, it’s important to get tested to receive a proper diagnosis and exclude any other infection.

To diagnose trich, your healthcare provider will take a vaginal swab and perform a nucleic acid amplification test (NAATs) to detect Trichomonas vaginalis.

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Trichomoniasis treatment

If you test positive for trichomoniasis, your healthcare provider will prescribe oral antibiotic treatment such as metronidazole, secnidazole, or tinidazole.

Your sexual partner will also have to get treated for trichomoniasis, even if they don’t have any symptoms. Treating your sexual partner is crucial to prevent reinfection and reduce the risk of recurrent infections and associated complications. Men rarely have any symptoms of trichomoniasis, but that doesn’t mean they don’t have the infection. And if they don’t get treated, they might spread trich back to you or other sexual partners.

It’s really important to treat trichomoniasis (or any other STI) because it can lead to serious health complications if left untreated.

Untreated trichomoniasis can cause inflammation and increase the risk of contracting other sexually transmitted diseases, including human immunodeficiency virus (HIV). It can also cause cervicitis, which is inflammation of the cervix. Symptoms of cervicitis may include bleeding between periods, pain during or after sex, and abnormal discharge.

For pregnant women, trichomoniasis can be especially risky. Although it’s rare, untreated trichomoniasis in pregnancy could lead to preterm delivery and poor birth outcomes (including low birth weight). So, if you’re pregnant and experiencing symptoms of trichomoniasis, it’s really important to talk to your doctor right away.

How to prevent trichomoniasis and its risk factors

The only way to reduce your risk of getting trichomoniasis is by practicing safe sex. Although it won’t guarantee total protection, using a barrier method like a condom or dental dam during sex (including oral sex) drastically reduces the chances of contracting trichomoniasis or another sexually transmitted infection. Trichomoniasis can also be transmitted through anal sex. Since trich can be passed on by sharing sex toys, you should always wash toys before and after each use, and cover them with a condom during partnered sex.

Getting regular STI tests is also important. Although STI tests won’t prevent you from contracting an infection, they make it easier to catch and treat a sexually transmitted infection before you have the chance to pass it on to someone else. Not only do they curb the rate of transmission, but they reduce your risk of developing long-term health problems due to an untreated infection.

Anyone sexually active should get tested at least once a year, according to the Centers for Disease Control and Prevention (CDC) — more often if you have multiple sexual partners or after having sex with someone new.

Other causes for abnormal vaginal discharge

Trichomoniasis isn’t the only culprit behind abnormal vaginal discharge. Other causes include:

Any drastic changes in the way your vaginal discharge looks or smells are a sign to see your healthcare provider — especially if you’re experiencing other symptoms, including vaginal itching, burning, or pelvic pain.

FAQ

Is trichomoniasis treatable?

Yes, trichomoniasis is treated with antibiotics. Depending on the medication, trichomoniasis usually goes away within seven days. Your sexual partners will have to be treated too, even if they don’t have any symptoms. Although trich is easily treatable, reinfection happens in about 1 in 5 people within three months of treatment.

Does trichomoniasis discharge smell?

Unusual and foul-smelling discharge is a dead giveaway that something’s up down there, and it’s one of the most common signs of trich. Discharge caused by trichomoniasis usually has a strong, unpleasant, and sometimes fishy smell. It’s worth noting, however, that other sexually transmitted infections and vaginal infections can cause foul-smelling discharge so that alone isn’t enough to diagnose trich. 

Is trichomoniasis a serious STD?

All sexually transmitted diseases (STDs) are serious. In most cases, sexually transmitted infections can be easily treated with antibiotics and the infection should go away within a couple of days. Even in cases where an STD isn’t curable, there are treatment and management options available. But if left untreated, STIs can cause long-lasting health problems, especially for women and pregnant people.