Trichomoniasis

Key points

• Most men have no symptoms at all, which is a major reason the infection spreads without being noticed.
• Women more often notice an unusual, strong-smelling discharge along with itching or discomfort during urination.
• Tinidazole is typically given as one large dose, making it straightforward to complete the full course.
• Alcohol should be avoided during treatment and for several days afterwards, since combining the two can cause severe nausea.

Recognising the infection

Symptoms vary considerably between individuals. Women often notice a frothy, yellow-green vaginal discharge with an unpleasant odour, along with itching, soreness, or discomfort during urination or sex. Men are usually asymptomatic, which is a key reason trichomoniasis spreads silently. Where symptoms do appear in men, they may include irritation inside the penis or a mild discharge. Both partners need treatment to prevent re-infection.

How trichomoniasis is treated

Treatment centres on oral antiparasitic medicines from the antiparasitics group. Tinidazole is commonly used as a single high dose, making adherence straightforward. Ornidazole is an alternative that can be given over a short course. Both belong to the nitroimidazole class and work by disrupting the parasite’s DNA. Alcohol should be avoided while taking either medicine and for at least 72 hours afterwards, as the combination can cause severe nausea.

Sexual partners should be treated at the same time, even if they have no symptoms, and penetrative sex should be avoided until both partners have completed treatment and any symptoms have cleared.

Further reading

• About Trichomoniasis - CDC
• Trichomoniasis - NHS
• Trichomoniasis - Healthdirect
• Trichomoniasis - World Health Organization (WHO)