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.
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.
Bacterial vaginosis is an abnormal vaginal condition with signs and symptoms of vaginal discharge, vaginal odor, and vaginal pain. Bacterial vaginosis results from an overgrowth of normal bacteria in the vagina. Although it may cause some disturbing symptoms (discharge and odor), it is not dangerous and cannot be passed by sex. Diagnosis becomes important to exclude serious infections like gonorrhea and Chlamydia. Many treatment options are available such as oral antibiotics and vaginal gels.
^ McGregor, James A.; French, Janice I.; Parker, Ruth; Draper, Deborah; Patterson, Elisa; Jones, Ward; Thorsgard, Kyja; McFee, John (1995). "Prevention of premature birth by screening and treatment for common genital tract infections: Results of a prospective controlled evaluation". American Journal of Obstetrics and Gynecology. 173 (1): 157–167. doi:10.1016/0002-9378(95)90184-1. PMID 7631673.
Currently there are no routine standard screening requirements for the general U.S. population receiving family planning or STI testing. The Centers for Disease Control and Prevention (CDC) recommends Trichomoniasis testing for females with vaginal discharge and can be considered for females at higher risk for infection or of HIV-positive serostatus.
^ Epstein, Aaron; Roy, Subir (2010). "Chapter 50: Vulvovaginitis". In Goodwin, T. Murphy (ed.). Management of Common Problems in Obstetrics and Gynecology (5th ed.). Wiley-Blackwell. p. 228. ISBN 978-1405169165. Archived from the original on 2017-02-15. In 80% of cases, the diagnosis of trichomoniasis is confirmed by microscopic examination of saline wet mount, with the observation of motile trichominondas; their shape is "football-like" with moving flagella.