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# Trichomoniasis

Trichomoniasis is a sexually transmitted infection by the parasite Trichomonas vaginalis; it affects the [vagina](https://durgical.com/en/anatomy/vagina/) and urethra and often causes no symptoms.

Updated 2026-10-30

## Structures involved

Tap one to see what it is and open it in 3D.

- [Vagina](https://durgical.com/en/anatomy/vagina/)
- [Cervix](https://durgical.com/en/anatomy/cervix-of-uterus/)
- [Urethra (female)](https://durgical.com/en/anatomy/female-urethra/)
- [Vaginal fornix](https://durgical.com/en/anatomy/vaginal-fornix/)
- [Urinary bladder](https://durgical.com/en/anatomy/urinary-bladder/)

## Microorganisms that cause it

- [Trichomonas vaginalis](https://durgical.com/en/microbiology/trichomonas-vaginalis/)

## What it is

A sexually transmitted infection caused by the flagellated protozoan Trichomonas vaginalis. It infects the vagina, urethra and [cervix](https://durgical.com/en/anatomy/cervix-of-uterus/) in women and the urethra in men, and is often asymptomatic.

## Who gets it

The most common curable non-viral sexually transmitted infection worldwide. In a cohort of 264 women from three Colombian cities (Bogotá, Girardot, Chaparral), 26.1% had it at baseline and 40.9% had at least one episode during follow-up. Many infected people, especially men, have no symptoms and transmit it unknowingly.

## Causes

- Trichomonas vaginalis, a flagellated protozoan
- Spread almost always by sexual contact

## Risk factors

- Multiple or new sexual partners
- Previous sexually transmitted infections
- Condomless sex
- Older age among women (unlike chlamydia and gonorrhoea)

## Pathophysiology

The parasite adheres to squamous epithelium, damages it and triggers a strong neutrophilic inflammation. Vaginal pH rises above 4.5. Small haemorrhages in the cervix can produce the strawberry cervix. The inflamed mucosa makes acquiring and transmitting HIV easier.

## Symptoms and signs

- Frothy, yellow-green, foul-smelling vaginal discharge
- Vulvar itching and irritation
- Pain on urination and during intercourse
- Strawberry cervix (punctate haemorrhages), seen in a minority
- Many women and most men have no symptoms; men may have urethritis

## Red flags

- Infection in pregnancy
- Pelvic pain or fever suggesting upper genital tract infection
- Symptoms persisting after treatment of both partners

## Diagnosis

**Clinical**
Symptoms and examination suggest it but are not reliable alone; vaginal pH is usually above 4.5.

**Tests**
Nucleic acid amplification tests (most sensitive, preferred); wet mount microscopy showing motile trichomonads (quick but less sensitive); rapid antigen tests or culture. Testing for HIV, syphilis, chlamydia and gonorrhoea.

**Imaging**
Not needed.

## Differential diagnosis

- Bacterial vaginosis
- Vulvovaginal candidiasis
- Cervicitis from chlamydia or gonorrhoea
- Urinary tract infection

## Goal of treatment

Cure the infection in the patient and all sexual partners and prevent reinfection and complications.

## Treatment

**Medical**
Nitroimidazole antibiotics by mouth for the patient and, at the same time, for sexual partners.

**Conservative**
Avoiding sex until both partners have completed treatment and symptoms have resolved.

**Follow-up**
Retesting after treatment is recommended because reinfection is common.

## Drugs for this condition

- [Metronidazole](https://durgical.com/en/pharmacology/metronidazole/)
- [Tinidazole](https://durgical.com/en/pharmacology/tinidazole/)
- [Secnidazole](https://durgical.com/en/pharmacology/secnidazole/)

## Complications

- Preterm birth, premature rupture of membranes and low birth weight
- Higher risk of acquiring and transmitting HIV
- Pelvic inflammatory disease (association reported)
- Prostatitis and urethritis in men
- Reinfection

## Prognosis

Treatment cures most infections. Reinfection is common when partners are not treated.

## Prevention

- Consistent condom use
- Simultaneous treatment of sexual partners
- Screening of women at higher risk, according to guidelines

## Test yourself

Think of the answer, then tap the question to see it.

## What type of organism causes trichomoniasis?

A flagellated protozoan, Trichomonas vaginalis.

## What is the classic discharge of trichomoniasis?

Frothy, yellow-green and foul-smelling, with a vaginal pH above 4.5.

## What is the strawberry cervix?

Punctate haemorrhages on the cervix caused by trichomoniasis, seen in a minority of cases.

## Which is the most sensitive diagnostic test for trichomoniasis?

Nucleic acid amplification testing (NAAT).

## Why are sexual partners treated at the same time?

Partners are often asymptomatic carriers, and untreated partners cause reinfection.

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## Related conditions

- [Bacterial vaginosis](https://durgical.com/en/conditions/bacterial-vaginosis/)
- [Vulvovaginal candidiasis](https://durgical.com/en/conditions/vulvovaginal-candidiasis/)
- [Gonorrhoea](https://durgical.com/en/conditions/gonorrhoea/)
- [Chlamydia infection](https://durgical.com/en/conditions/chlamydia-infection/)
- [HIV infection and AIDS](https://durgical.com/en/conditions/hiv-infection-and-aids/)
- [Pelvic inflammatory disease](https://durgical.com/en/conditions/pelvic-inflammatory-disease/)
- [Urinary tract infection (acute cystitis)](https://durgical.com/en/conditions/urinary-tract-infection/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Trichomoniasis](https://www.ncbi.nlm.nih.gov/books/NBK534826/) (StatPearls (NCBI Bookshelf), 2026); [Trichomonas vaginalis follow-up and persistence in Colombian women](https://europepmc.org/article/PMC/PMC8604905) (Scientific reports, 2021) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/conditions/trichomoniasis/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/trichomoniasis/