Use of male condoms or female condoms may help prevent the spread of trichomoniasis,[22] although careful studies have never been done that focus on how to prevent this infection. Infection with Trichomoniasis through water is unlikely because Trichomonas vaginalis dies in water after 45–60 minutes, in thermal water after 30 minutes to 3 hours and in diluted urine after 5–6 hours.[23]
There were about 58 million cases of trichomoniasis in 2013.[38] It is more common in women (2.7%) than males (1.4%).[39] It is the most common non-viral STI in the U.S., with an estimated 3.7 million prevalent cases and 1.1 million new cases per year.[40][41] It is estimated that 3% of the general U.S. population is infected,[21][42] and 7.5-32% of moderate-to-high risk (including incarcerated) populations.[43][44][45][46][47][48][49][50]

Trichomoniasis is a sexually transmitted infection (STI) which is most often spread through vaginal, oral, or anal sex.[1] It can also spread through genital touching.[1] People who are infected may spread the disease even when symptoms are not present.[2] Diagnosis is by finding the parasite in the vaginal fluid using a microscope, culturing the vagina or urine, or testing for the parasite's DNA.[1] If present other STIs should be tested for.[1]
Blood in semen is also known as hematospermia. Blood in semen can be caused by many conditions affecting the tubes that distribute semen from the testicles (seminal vesicles) or the prostate gland. Symptoms that may accompany blood in semen include blood in the urine, fever, painful urination, pain with ejaculation, tenderness, and swelling in the testes or groin area. Urinalysis, ultrasound, and MRI may be used to diagnose blood in the semen. Treatment depends upon the underlying cause of blood in the semen.
Most people infected with Trichomonas vaginalis do not have any symptoms and can be undetected for years.[6] 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.[7] Sometimes trichomoniasis can be confused with chlamydia because the symptoms are similar.[8]
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.[29][30] 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.[31]
The advent of new, highly specific and sensitive trichomoniasis tests present opportunities for new screening protocols for both men and women.[24][27] 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.[24][27]
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