Trichomoniasis treatment: Antibiotics and other options

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Trichomoniasis is a widespread sexually transmitted infection that is more common in females than males. Symptoms usually show up within 28 days, although many people do not have any symptoms. Treatment with the antibiotic metronidazole is usually effective.

This article discusses trichomoniasis symptoms and testing, the main treatment options, when to see a doctor, and more.

Please note that the writer of this article has not tried these products. All information presented is purely research-based.

Trichomoniasis is one of the sexually transmitted infections (STI) in the United States and worldwide. It is more prevalent than chlamydia, gonorrhea, and syphilis combined. Females are more likely to have trichomoniasis than males, and older females are more likely to have had it than younger females.

Causes

The parasite Trichomonas vaginalis, which is invisible to the naked eye, causes trichomoniasis, or trich. The disease is transmissible through sex, most often through penile-vaginal contact but also through vagina to vagina contact, shared sex toys, and occasionally hand, mouth, and anal transmission.

Symptoms

According to the Centers for Disease Control and Prevention (CDC), roughly 70% of people who get trichomoniasis do not show symptoms, so they can transmit it without knowing they have it. When a person has symptoms, they usually show up 5 to 28 days after contracting the infection.

Symptoms typically include:

irritation, itching, and inflammation of and around the genitals
discomfort after urination or ejaculation
discharge from the vagina or penis

Learn about other STDs that cause itching.

Testing

Doctors often find it challenging to diagnose trichomoniasis even where symptoms exist because they often resemble those of other STIs. People may be hesitant about getting tested for trichomoniasis, but it is the best way to determine if someone has the infection.

A person who believes they have trichomoniasis should speak with a doctor. They can recommend various tests to ensure an accurate diagnosis.

Home tests are available, making it possible for people to connect with certified labs from the privacy of their homes. Options include:

LetsGetChecked: This company offers three sexual health tests, including trichomoniasis. Individuals take their samples at home, send them off with a pre-paid mailing label that comes with the testing kit, and can check their results 2–5 days later at a secure online location. Doctors review the test results, and the nursing team provides a consultation. Learn more about LetsGetChecked here.

EverlyWell: One of the 30 different tests this company conducts is a urine test for trichomoniasis. Users take their samples and mail them in a pre-paid bio-hazard bag that comes with their test kits. A board-certified doctor contacts people to discuss the next steps if their test results are positive.

People should always speak with a doctor if they receive positive or uncertain results.

Learn more about trichomoniasis testing here.

Learn more about Everlywell here.

Typically, doctors prescribe antibiotics to treat trichomoniasis, usually metronidazole, which is generally highly effective and requires a prescription. Doctors may also prescribe other antibiotics, such as tinidazole and secnidazole, instead.

Metronidazole

Doctors usually prescribe metronidazole, also known under the brand name Flagyl, in pill form as either a single dose of 2 grams or a 7-day series of 500 milligrams (mg), taken twice a day. It is safe to take during pregnancy.

One study found that females who received the 7-day dose were less likely to test positive for trichomoniasis after treatment than those who got the single dose. Studies also found people who took the single tablet were more likely to have side effects, such as nausea and vomiting. However, the single-dose approach eliminates problems with adherence.

People should not use alcohol when they are taking medication for trichomoniasis treatment. They should also abstain from alcohol for 24 hours after their last dose of metronidazole and 72 hours after completing tinidazole treatment.

Learn more about metronidazole here.

Boric acid

Some people are allergic to metronidazole. In 2015, health professionals treated a female who contracted trichomoniasis many times and was also allergic to metronidazole. They treated them with a 600-mg boric acid vaginal suppository twice a day for 60 days, which cleared the infection.

Doctors do not typically prescribe this treatment for trichomoniasis, and people should not use it as an alternative to antibiotics unless a doctor advises it.

Learn more about boric acid here.

Even though an individual might not experience trichomoniasis symptoms, it is essential to seek treatment because the infection may increase the risk of:

contracting or transmitting HIV
problems with pregnancy, including premature delivery and low birth weight
contracting or transmitting herpes

Although most people with trichomoniasis will not have symptoms, people who do notice symptoms, such as itching or irritation around the genitals or discharge from the vagina or penis, should see a doctor for testing. They may not have trichomoniasis, but they may have something else that needs treatment.

People should also see a doctor if:

they test positive for another STI
a sexual partner tests positive for trichomoniasis or another STI
they have sex without using barrier contraception with someone whose sexual history they do not know

People can get trichomoniasis again. According to the CDC, 1 in 5 people who complete trichomoniasis treatment get the infection again. To stop this cycle, people who get treatment should make sure their sexual partners get tested and treated, too.

The majority of people with trichomoniasis do not show symptoms. However, it can lead to significant health problems, including a greater risk of getting or transmitting HIV and pregnancy issues.

Treatment with metronidazole is the standard approach to trichomoniasis treatment and is generally effective.

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