Trichomonas is a protozoan, or a single-celled parasite, that thrives in the moist environment of the vagina. It is an extremely common STD, affecting approximately nearly one out of every 10 women in the U.S. Trichomonas is an extremely contagious STD and often women have the infection for several months before symptoms develop. There are more than 3 million cases in the U.S. every year.
The most common symptom of trichomonas is copious, frothy vaginal discharge that is often so heavy a panty liner is needed. This is that “my-panty-liner-can’t-hold-it-when-I-stand-up-it-runs-down-my-leg” kind of discharge. Some women even think their water was broken only to get the unfortunate diagnosis of trichomonas.
Sometimes the discharge is white but can also be a yellow-green color. Trichomonas won’t kill you, but it can cause other symptoms besides gross discharge.
- painful urination
- pelvic cramping
- bleeding after sex
So if it’s so common, why aren’t people talking about it? There are a large number of people who have trichomoniasis and do not understand their symptoms.
It has also been associated with infertility and an increased risk of contracting HIV. In pregnancy, it has been associated with preterm delivery and it can also be spread to the baby at the time of delivery (in addition to embarrassing “did my water break?” visits).
The parasite is passed from an infected person to an uninfected person during sex. In women, the most commonly infected part of the body is the lower genital tract (vulva, vagina, or urethra), and in men, the most commonly infected body part is the inside of the penis (urethra). During sex, the parasite is usually transmitted from a penis to a vagina, or from a vagina to a penis, but it can also be passed from a vagina to another vagina. It is not common for the parasite to infect other body parts, like the hands, mouth, or anus. It is unclear why some people with the infection get symptoms while others do not, but it probably depends on factors like the person’s age and overall health. Infected people without symptoms can still pass the infection on to others.
The CDC recommends that all women complaining of vaginal infections be tested for trichomonas if they have new or multiple sexual partners. To test for trichomonas, we start by looking at the vaginal discharge under the microscope, but we now know that we miss the little swimmers about 40% of the time by simple microscopy. Most recent lab tests, using a swab of vaginal secretions, are up to 99% accurate and are indicated if the microscopy is negative.
The other good news is that trichomonas is usually easy to treat with simple antibiotics.
However, because it is so contagious, it is important to have all sexual partners fully treated – and then, wait an additional 7 days before resuming sexual contact.
Trichomonas can also live on sex toys, so it is important to thoroughly clean them (the dishwasher is best… but not with your dishes) to prevent reinfection.
Trichomonas is best prevented by maintaining a mutually monogamous relationship and, secondarily, by consistent condom use.
Men have a lower rate of trichomonas than women and rarely have obvious symptoms of the infection.
When they do, their symptoms may include irritation of the urethra or prostate.
If you have a persistent frothy discharge, see your provider for testing. And make sure you are getting trichomonas testing with your regular STD screening.