Trichomoniasis symptoms, test, and diagnosis: What to know

Trichomoniasis may have a hard-to-pronounce name, but the infection itself is very common – and, thankfully,
very treatable. This sexually transmitted infection (STI), often called “trich” (sounds like “trick”), is
caused by a tiny parasite that spreads through sex. The twist? Most people never notice symptoms, so the
infection can quietly hang around and keep spreading.

In this guide, we’ll break down trichomoniasis symptoms, how testing works, what diagnosis really means,
and what to expect during the whole process. We’ll also share practical, real-world experiences that can
help you feel less stressed and more prepared if you ever have to deal with trich yourself.

What is trichomoniasis?

Trichomoniasis is a sexually transmitted infection caused by a single-celled protozoan parasite called
Trichomonas vaginalis. The parasite lives in the genital tract – typically the vagina and urethra
in people with a vagina, and the urethra in people with a penis. It spreads primarily through vaginal or
penile–vaginal sex and genital contact without a condom or other barrier.

In the United States, trichomoniasis is one of the most common curable STIs. Health authorities estimate
that millions of people are infected every year, and many don’t know it. A large portion of people with
trich – often quoted around 70–85% – either have no symptoms at all or have very mild symptoms that are
easy to ignore or blame on something else, like a yeast infection or irritation from a new soap.

While anyone who is sexually active can get trichomoniasis, it is diagnosed more frequently in women than
in men and is particularly common in sexually active women over age 25. Untreated trichomoniasis can
increase the risk of getting or passing on other STIs, including HIV, and in pregnancy it is linked to
complications like preterm birth and low birth weight.

Common trichomoniasis symptoms

Symptoms of trichomoniasis can range from “absolutely nothing” to “something is definitely not right.”
They can also come and go over time. That’s why relying on symptoms alone is risky – you can’t look in a
mirror and tell whether you have trich.

Symptoms in women (and others with a vagina)

In people with a vagina, trichomoniasis is more likely to cause noticeable symptoms, including:

• Vaginal discharge that may be yellow-green or gray, sometimes thin or frothy, and can
  have a strong or “fishy” odor.
• Itching, burning, or irritation of the vulva or vagina.
• Discomfort or burning when urinating (peeing).
• Pain with sex (dyspareunia), or feeling sore afterward.
• Lower abdominal discomfort in some cases.

A classic but less common finding is a “strawberry cervix,” where the cervix looks red and dotted with
tiny spots when a clinician examines it. This isn’t something you can see yourself, but it can raise a
strong suspicion for trichomoniasis during a pelvic exam.

Symptoms in men (and others with a penis)

In people with a penis, trichomoniasis often flies under the radar. Many have no symptoms at all. When
symptoms do appear, they may include:

• Burning or irritation in the urethra (the tube you pee through).
• Discomfort or burning when urinating.
• Discharge from the penis, which may be clear or milky.
• Less commonly, discomfort in the testicles or groin, sometimes related to inflammation
  of the epididymis or prostate.

When do trichomoniasis symptoms show up?

After exposure, symptoms usually appear within about 5 to 28 days, but they can show up later, or not at
all. Symptoms can also come and go. For example, you might notice itching or discharge for a few days,
then feel “normal” again – even though the infection is still present.

Can you have trichomoniasis with no symptoms?

Yes. This is one of the most important – and sneaky – aspects of trichomoniasis. Most people either have
no symptoms or don’t recognize them. You can still pass the infection to your partner even if you feel
perfectly fine. That’s why testing is so important, especially if you have new or multiple partners, or if
a partner tells you they tested positive for trich.

Why trichomoniasis can be easy to miss

Trichomoniasis symptoms can overlap with a lot of other common conditions. Vaginal discharge and itching,
for example, can be caused by yeast infections, bacterial vaginosis, allergic reactions, or other STIs.
Burning with urination can look a lot like a urinary tract infection (UTI). Without testing, even
experienced clinicians can’t reliably tell these apart just by looking or listening.

Because symptoms are so nonspecific – and often absent – many people find out they have trichomoniasis
only when:

• They get screened for STIs during a routine exam.
• Their partner tests positive and tells them.
• They’re evaluated for “something else” and trich shows up on a lab test.

When should you get tested for trichomoniasis?

You should consider getting tested for trichomoniasis if:

• You have symptoms such as unusual discharge, genital itching, burning, or pain with sex
  or urination.
• A current or recent partner has tested positive for trichomoniasis.
• You have new or multiple sex partners, or you don’t always use condoms or barriers.
• You are pregnant and have STI risk factors, since trich can affect pregnancy outcomes.
• You are being tested for other STIs like chlamydia, gonorrhea, or HIV and want a more complete picture
  of your sexual health.

If you think you might have been exposed, don’t wait for symptoms to magically “prove it.” Testing is the
only way to know for sure.

Types of trichomoniasis tests

There are several ways to test for trichomoniasis. Some are older, quick tests; others are newer and much
more accurate. Your clinician will choose based on your symptoms, anatomy, and what tests are available in
the clinic or lab they use.

1. Nucleic acid amplification tests (NAATs/PCR)

Nucleic acid amplification tests (NAATs), including PCR-based tests, look for the genetic material of
T. vaginalis. These are currently among the most sensitive tests for trichomoniasis, meaning they
are very good at picking up infection when it’s present.

For these tests, your sample may include:

• A vaginal swab collected by a clinician or sometimes by you in the clinic.
• An endocervical swab during a pelvic exam.
• A urine sample, especially in men or people with a penis.

Results may come back the same day or in a few days, depending on the lab. NAATs are now widely used
because of their accuracy.

2. Wet-mount microscopy

Wet-mount microscopy is one of the classic methods used in clinics. A clinician collects a sample of
vaginal fluid, places it on a glass slide with a drop of saline, and looks at it under a microscope for
moving trichomonads (the parasite).

The good news: this can sometimes give you an answer during your visit. The not-so-good news: it’s
less sensitive than NAATs. If the number of parasites is low or the sample isn’t examined quickly, the
test can miss infections. Because of this, many clinics are shifting toward NAATs when possible.

3. Rapid antigen tests

Rapid antigen tests look for specific proteins (antigens) from the parasite. They can often provide
results in less than an hour and are more sensitive than wet-mount microscopy, though generally not as
sensitive as NAATs. These tests are commonly used in some clinics and urgent care centers.

4. Culture

Culture involves placing a sample (vaginal fluid or urethral swab) into a special medium that encourages
the parasite to grow. It was historically considered a very accurate method, but it takes longer, and in
many settings, culture has been largely replaced by NAATs and rapid tests.

5. At-home and community testing options

Some programs and clinics offer self-collection kits, where you collect a vaginal swab or
urine sample yourself and send it to a lab. Not all at-home STI kits include trichomoniasis, so read the
panel description carefully. For people who are nervous about in-person visits, this can be a more
comfortable way to get tested, but it still needs to be an FDA-cleared, lab-based test for reliable
results.

What to expect during a trichomoniasis test

The idea of STI testing can feel more stressful than the test itself. Here’s what typically happens during
a clinic visit:

1. History and questions. Your clinician will ask about your symptoms, recent sexual
   partners, condom use, and past STIs. This isn’t judgment; it’s data to help pick the right tests.
2. Physical exam. People with a vagina may have a pelvic exam so the clinician can look
   for signs of infection and collect a sample from the vagina or cervix. People with a penis may have a
   brief exam of the genitals and urethral opening.
3. Sample collection. You might:
   • Provide a urine sample.
   • Have a swab collected by the clinician.
   • Do a self-swab in a private room, following instructions.
4. Testing method. The clinic may run a rapid test on site or send your sample out to a
   lab for a NAAT or culture.
5. Results and follow-up. You’ll be told how and when you’ll get results – sometimes
   within the same visit, sometimes by phone, secure portal, text, or mail.

If your clinician strongly suspects trichomoniasis based on your symptoms and exam, they may start
treatment before all lab results are back. This is called presumptive treatment and is common with
suspected STIs.

Understanding trichomoniasis test results

Once your test is done, you’ll get one of a few basic outcomes:

• Positive: The parasite or its genetic material was detected. This means you have
  trichomoniasis and should be treated, even if you don’t have symptoms.
• Negative: The parasite was not detected. If your symptoms are mild or tests were done
  very early after exposure, your clinician might still consider repeat testing or additional evaluation
  for other causes.
• Indeterminate or invalid: The lab couldn’t get a clear answer. This is less common, but
  if it happens, you may need another sample.

A negative test doesn’t protect you forever – it’s just a snapshot of that moment. You can get
trichomoniasis again if you’re exposed later, even if you’ve been treated in the past.

Diagnosis, treatment, and partner follow-up

A diagnosis of trichomoniasis can feel stressful, but the good news is that it’s curable
with prescription antibiotics. The most commonly used medications are metronidazole or tinidazole, taken
as directed by a healthcare professional. It’s important to:

• Take all of your medication, exactly as prescribed, even if symptoms improve before you
  finish.
• Tell your current sexual partner(s) so they can be tested and treated as well. If they
  aren’t treated, you can pass the infection back and forth.
• Avoid sex until you and your partner(s) have completed treatment and symptoms have gone
  away. This usually means waiting several days after finishing your antibiotics, depending on your
  clinician’s advice.
• Ask about retesting. Many guidelines recommend that women be retested about 3 months
  after treatment, because reinfection is common.

Untreated trichomoniasis can increase the risk of pelvic inflammatory disease in some people and is
associated with a higher chance of acquiring or transmitting HIV. In pregnancy, it can contribute to
preterm delivery and low birth weight. Getting diagnosed and treated is not only good for you; it’s good
for your partners and future sexual health.

Can trichomoniasis be prevented?

There’s no vaccine for trichomoniasis, but there are ways to lower your risk:

• Use condoms or other barriers (like internal condoms) correctly every time you have
  sex, especially with new or multiple partners.
• Limit the number of sexual partners and consider mutual monogamy with a partner who has
  been tested and treated for STIs.
• Get regular STI testing based on your sexual activity and risk factors.
• Avoid sharing sex toys or use condoms on toys and clean them properly between uses.

Prevention isn’t about being “perfect” – it’s about stacking the odds in your favor and catching problems
early if they do happen.

Real-world experiences: what living through trichomoniasis is like

Reading about symptoms and lab tests is one thing. Actually going through trichomoniasis – or worrying you
might have it – is a very different experience. While everyone’s story is unique, many people describe a
few common themes that might help you feel less alone.

“Something felt off, but I wasn’t sure what”

A lot of people with trichomoniasis describe a nagging sense that something wasn’t quite right. Maybe it
was a slightly different smell, a bit more discharge than usual, or a mild itching that came and went.
None of it felt dramatic enough to scream “STI,” especially for those used to occasional yeast infections
or changes around their period.

One of the biggest takeaways from these experiences: you don’t need dramatic symptoms to justify
getting checked. Subtle changes are still worth a conversation with a clinician, especially if
they stick around or make you uneasy.

Navigating the appointment and the awkward questions

STI testing appointments can feel intimidating, but many people are surprised by how straightforward –
even routine – the process is. Clinicians who do sexual health work regularly aren’t shocked by your
answers. They’ve heard it all before, from “I forgot the condom” to “The condom broke” to “We didn’t talk
about testing first.”

Patients often say that once they got past the first minute of embarrassment, the rest felt surprisingly
clinical and matter-of-fact: answer some questions, give a sample, get results, follow the plan. The fear
beforehand is usually worse than the visit itself.

Talking with a partner: harder in your head than in real life

Many people dread telling a partner they’ve been diagnosed with trichomoniasis. Common worries include:

• “They’ll think I cheated.”
• “They’ll be angry or disgusted.”
• “They’ll never want to sleep with me again.”

In reality, conversations often go more smoothly than expected when approached with honesty and calm. A
simple script can help, such as:

“I went in for an STI check and found out I have trichomoniasis. It’s a common, curable infection. My
doctor said you should get treated too so we don’t pass it back and forth.”

Framing it as a health issue – not a moral judgment – can lower the emotional temperature. It’s also a
great opportunity to talk more openly about condoms, testing, and mutual responsibility for sexual health.

Dealing with stigma and self-blame

STIs carry a lot of unnecessary stigma, and trichomoniasis is no exception. People often describe feeling
ashamed, dirty, or “careless,” even if they were using protection most of the time. It’s important to
remember:

• Trichomoniasis is extremely common. You are far from the only one dealing with it.
• It takes only one exposure – not a lifetime pattern – to get an STI.
• Getting tested and treated is a sign of responsibility, not failure.

Many people report that once they got through the initial embarrassment and finished treatment, their main
feeling was relief – relief at having answers, relief at knowing their body again, and sometimes relief at
having a deeper, more honest conversation with their partner.

Lessons people often take away

After going through trichomoniasis, individuals often share a few key lessons:

• Trust your instincts. If something feels off, don’t talk yourself out of getting
  checked.
• Normalize testing. STI checks can be part of regular health care, just like dental
  cleanings and eye exams.
• Conversations get easier. The first time you talk about STIs with a partner is usually
  the hardest. It gets better – and more natural – with practice.
• Knowledge reduces fear. Understanding what trichomoniasis is, how it’s treated, and how
  to prevent it can take a lot of the “mystery panic” out of the situation.

Bottom line

Trichomoniasis is common, curable, and often silent – which is exactly why understanding its symptoms,
testing, and diagnosis matters so much. You can’t rely on symptoms alone, but you can rely on good
information, regular testing, and clear communication with partners and healthcare professionals.

If you notice changes in your genital health, have a new partner, or learn that a partner has trich, don’t
wait and worry in silence. Reach out to a clinician, get tested, and follow through with treatment if
needed. Taking action is not only good self-care – it’s an act of care for everyone you’re intimate with.

SEO META JSON