It is possible to have both chlamydia and trichomoniasis simultaneously. Chlamydia is a common bacterial sexually transmitted infection (STI), while trichomoniasis is a widespread parasitic STI. Co-infection with these, or other, STIs is not uncommon.
Why Co-infection Occurs
Both chlamydia and trichomoniasis are common STIs, sharing similar transmission routes through sexual contact, including vaginal, anal, and oral sex. Chlamydia trachomatis bacteria and Trichomonas vaginalis parasites are carried in sexual fluids, facilitating their spread. Having one STI can sometimes increase susceptibility to another, as inflammation may create an environment conducive to other pathogens. Unprotected sexual activity and multiple sexual partners are risk factors for contracting either or both infections.
Identifying Symptoms
Many individuals with chlamydia or trichomoniasis do not experience symptoms. When symptoms do manifest, they often overlap.
For chlamydia, individuals with vaginas might notice unusual vaginal discharge, painful urination, or bleeding between periods. Those with penises may experience clear or cloudy penile discharge and painful urination. Chlamydia can also infect the anus, throat, or eyes, causing pain, discharge, or irritation.
Trichomoniasis is asymptomatic in about 70% of infected individuals. When symptoms occur in those with vaginas, they include frothy, yellow-green, or white vaginal discharge with a strong, often fishy odor, along with genital itching, soreness, or pain during urination or sexual activity. For individuals with penises, symptoms are less common but can involve discharge, itching inside the penis, or pain during urination or ejaculation.
Accurate Diagnosis and Testing
Due to the high rate of asymptomatic cases for both chlamydia and trichomoniasis, accurate diagnosis relies on specific laboratory tests rather than symptom observation alone. For chlamydia, nucleic acid amplification tests (NAATs) are the most common diagnostic method, utilizing urine samples or swabs from the cervix, vagina, urethra, rectum, or throat. While urine tests offer convenience, swab tests tend to be more accurate.
Diagnosing trichomoniasis often involves wet-mount microscopy, where a healthcare provider examines a sample to identify the parasite. However, NAATs are considered the gold standard for trichomoniasis diagnosis due to their higher sensitivity and ability to detect the parasite’s genetic material in various sample types, including urine and swabs. Healthcare providers frequently perform comprehensive STI screenings, testing for multiple infections simultaneously.
Comprehensive Treatment
Both chlamydia and trichomoniasis are treatable and curable with appropriate medication. Chlamydia is typically treated with antibiotics such as doxycycline (usually seven days) or a single dose of azithromycin. For trichomoniasis, treatment involves antiparasitic medications, most commonly metronidazole, prescribed as a single dose for men or a seven-day course for women. Tinidazole is another effective single-dose option.
It is important to complete the entire course of prescribed medication, even if symptoms improve or disappear. Treating sexual partners simultaneously is crucial to prevent re-infection. Individuals undergoing treatment should abstain from sexual activity for at least seven days after completing medication and until all their sexual partners have also been tested and treated. Retesting for trichomoniasis is often recommended for women approximately three months after initial treatment due to a notable risk of re-infection.
Reducing Risk of Infection
Implementing preventive measures reduces the risk of contracting chlamydia, trichomoniasis, and other STIs. Consistent and correct use of condoms during vaginal, anal, and oral sex lowers transmission. Regular STI testing, particularly when starting a new sexual relationship or having multiple partners, is a key preventive step. Open and honest communication with sexual partners about STI status and testing history promotes safer sexual practices. Limiting the number of sexual partners or engaging in a long-term, mutually monogamous relationship with a tested, uninfected partner reduces infection risk.