Trichomoniasis: The STI No One Warned You About
If you’ve never heard of trichomoniasis, you’re not alone. It’s one of the most common sexually transmitted infections — and somehow one of the least talked about. That combination can make a diagnosis feel confusing, embarrassing, or like you missed a memo everyone else got.
You didn’t. Trich is common, treatable, and very manageable once you know what you’re dealing with.
What Is Trichomoniasis?
Trichomoniasis (usually just called “trich” for short) is a sexually transmitted infection caused by a microscopic parasite called Trichomonas vaginalis. It’s not a bacteria or a virus — it’s its own thing - which matters when it comes to testing and treatment.
Trich spreads through sexual contact, most commonly vaginal sex. Many people who have it don’t know they’re infected, which is part of why it spreads so easily.
What Does Trich Feel Like?
This is where trich gets tricky: a lot of people have no symptoms at all.
When symptoms do happen, they may include:
· Vaginal discharge that’s yellow-green, gray, or frothy
· A strong or unusual vaginal odor
· Vulvar irritation or itching
· Discomfort with sex
· Burning with urination (less common)
Symptoms can come and go, which makes it easy to miss — or to assume it’s something like BV or a yeast infection.
How Is Trich Diagnosed?
Trich is diagnosed with a vaginal swab. It can sometimes show up on a Pap smear, but that’s not guaranteed and should not be relied on — trich needs to be tested for separately. It can also be detected with a urine test.
While some providers include trich testing as part of routine STI screening, not all do — especially providers who don’t specialize in women’s health care. If you’re being tested for STIs and trich isn’t mentioned specifically, it’s reasonable — and important — to ask for it to be included.
How Is Trich Treated?
Trich is very treatable.
Treatment is typically:
· A short course of oral antibiotics (usually metronidazole, twice a day for seven days)
It’s important to:
· Take the full course, even if symptoms improve quickly
· Avoid sex until treatment is complete
· Make sure sexual partners are treated as well
When Will Symptoms Get Better?
Symptoms often start to improve within a few days of beginning treatment, but that doesn’t mean the infection is gone.
It’s important to finish the entire course of antibiotics, even if you feel better sooner. Most providers recommend avoiding sex until treatment is complete and until all partners have been treated, to reduce the risk of reinfection.
If symptoms don’t improve, or if they return shortly after treatment, follow up with your provider — you may need repeat testing or further evaluation.
What About Partners?
Partners should be treated even if they don’t have symptoms. Reinfection is common if only one person is treated.
This isn’t about blame — it’s about breaking the cycle.
It’s also important to know that men are not routinely tested for trich, which is frustrating and unfair, given how easily it spreads. So if a male partner says they were “tested recently,” that doesn’t always mean trich was included.
That’s why it’s important to:
· Get your own STI testing if you have symptoms or concerns
· Make sure all partners are treated if trich is diagnosed
Can Trich Cause Complications?
Untreated trich can increase the risk of:
· Pelvic inflammatory disease (PID)
· Other STI transmission, including HIV
· Pregnancy complications in pregnant patients
That’s why treatment matters, even when symptoms are mild or absent.
How Can You Prevent Trichomoniasis?
Using hormonal birth control (like the pill, patch, ring, or IUD) does not protect against STIs, including trich.
The most reliable ways to reduce risk are:
· Not having sex
· Using condoms consistently and correctly
When used properly, condoms significantly reduce the risk of trichomoniasis, though no method is perfect. Using them more often is still far better than not using them at all.
Is Trich Serious?
Trich is not dangerous in the long term when treated. It doesn’t cause cancer, it doesn’t stay in your body forever, and it doesn’t mean anything about your hygiene or your choices.
It’s just an infection - and a very common one.
The Bottom Line
Trichomoniasis is common, often silent, and completely treatable. If you’re diagnosed, it doesn’t mean you did anything wrong — it just means you caught something that spreads easily and responds well to treatment.
Once you know what it is, it’s usually a straightforward fix.
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