For 95-97% of cases, infection is resolved after one dose of metronidazole. Studies suggest that 4-5% of trichomonas cases are resistant to metronidazole, which may account for some “repeat” cases. Without treatment, trichomoniasis can persist for months to years in women, and is thought to improve without treatment in men. Women living with HIV infection have better cure rates if treated for 7 days rather than with one dose.
Your sex partner(s) should be treated at the same time you are being treated. This increases the cure rate and reduces the possibility of further transmission or reinfection. Sexual intercourse should be avoided during treatment until symptoms are gone and until partners have been treated. It is best to avoid sex for 1 week after treatment with a single dose of metronidazole. Male partners may not have symptoms but still need treatment.
Evidence from a randomized controlled trials for screening pregnant women who do not have symptoms for infection with trichomoniasis and treating women who test positive for the infection have not consistently shown a reduced risk of preterm birth. Further studies are needed to verify this result and determine the best method of screening. In the US, screening of pregnant women without any symptoms is only recommended in those with HIV as trichomonas infection is associated with increased risk of transmitting HIV to the fetus.
^ Vos T, et al. (GBD Study 2013 Collaborators) (August 2015). "Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 386 (9995): 743–800. doi:10.1016/s0140-6736(15)60692-4. PMC 4561509. PMID 26063472.
A draft sequence of the Trichomonas genome was published on January 12, 2007 in the journal Science confirming that the genome has at least 26,000 genes, a similar number to the human genome. An additional ~35,000 unconfirmed genes, including thousands that are part of potentially transposable elements, brings the gene content to well over 60,000.
Most people infected with Trichomonas vaginalis do not have any symptoms and can be undetected for years. Symptoms experienced include pain, burning or itching in the penis, urethra (urethritis), or vagina (vaginitis). Discomfort for both sexes may increase during intercourse and urination. For women there may also be a yellow-green, itchy, frothy, foul-smelling ("fishy" smell) vaginal discharge. In rare cases, lower abdominal pain can occur. Symptoms usually appear within 5 to 28 days of exposure. Sometimes trichomoniasis can be confused with chlamydia because the symptoms are similar.
^ Jump up to: a b Ginocchio CC, Chapin K, Smith JS, Aslanzadeh J, Snook J, Hill CS, Gaydos CA (August 2012). "Prevalence of Trichomonas vaginalis and coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in the United States as determined by the Aptima Trichomonas vaginalis nucleic acid amplification assay". Journal of Clinical Microbiology. 50 (8): 2601–8. doi:10.1128/JCM.00748-12. PMC 3421522. PMID 22622447.
Trichomoniasis (trich) infection is spread when you have sex with an infected partner. Many women and most men do not have any symptoms of trich. If symptoms appear, they usually start within 1 week after a person is infected. But it may take up to a month for symptoms to appear. In most cases, trich should be treated to prevent transmitting this sexually transmitted infection (STI) to others and to prevent some problems that can happen if you are pregnant. You and your sex partner(s) should be treated for trich at the same time, to avoid reinfecting each other.
The advent of new, highly specific and sensitive trichomoniasis tests present opportunities for new screening protocols for both men and women. Careful planning, discussion, and research are required to determine the cost-efficiency and most beneficial use of these new tests for the diagnosis and treatment of trichomoniasis in the U.S., which can lead to better prevention efforts.