About 70% of people with trichomoniasis have no symptoms at all, which makes it one of the harder sexually transmitted infections to detect on your own. If you do develop symptoms, they typically show up within 5 to 28 days of exposure, though some people don’t notice anything for much longer. The only way to know for certain is through a lab test, but there are specific signs worth watching for.
Symptoms in Women
Trichomoniasis tends to be more noticeable in women than in men, though plenty of women carry the infection without realizing it. The most distinctive sign is a change in vaginal discharge. Instead of your normal discharge, you may notice fluid that is thin or frothy and has a strong fishy smell. The color can range from clear to white, yellow, or greenish.
Beyond discharge, other common symptoms include itching, burning, or redness around the genitals, discomfort when urinating, and pain during sex. Some women also notice general soreness or a change in skin color around the vulva. These symptoms can come and go, which sometimes leads people to assume the problem resolved on its own.
Symptoms in Men
Men are even less likely to have noticeable symptoms. When symptoms do appear, they usually involve irritation or itching inside the penis, a mild burning sensation after urinating or ejaculating, and occasionally a thin discharge from the urethra. Because these signs are subtle and easy to dismiss, many men unknowingly pass the infection to sexual partners.
How It Differs From Yeast Infections and BV
Trichomoniasis, bacterial vaginosis (BV), and yeast infections can all cause abnormal discharge and discomfort, so they’re easy to confuse. Here’s how to tell them apart based on what the discharge looks and smells like:
- Trichomoniasis: Profuse, yellow-green, frothy discharge with a strong fishy odor. Redness and irritation are common, and a healthcare provider may notice tiny red spots on the cervix during an exam.
- Bacterial vaginosis: Thin, off-white or grayish discharge with a fishy odor, especially after sex. It usually causes less itching and irritation than trichomoniasis.
- Yeast infection: Thick, white, cottage cheese-like discharge. It typically causes intense itching but little to no odor.
These are general patterns, not rules. Plenty of cases don’t fit neatly into one category, which is why self-diagnosis based on discharge alone is unreliable. If something feels off, testing is the only way to be sure.
How Testing Works
Your provider will collect a sample of fluid, either a vaginal swab or a urine sample, depending on the situation. The quickest and cheapest first step is called wet prep microscopy: the sample goes under a microscope, and a clinician looks for the parasite directly. Results are available within minutes.
The catch is that microscopy misses a significant number of infections. If the initial look comes back negative but your symptoms are suspicious, your provider can run more sensitive tests on the same sample. Nucleic acid amplification tests (NAATs) search for the parasite’s genetic material and are considerably more accurate. Rapid antigen tests, available for vaginal fluid samples, return results in under 15 minutes. Culture tests, where the sample is grown in a lab for up to a week, are another option when other methods are inconclusive.
If you’re considering at-home STI test kits, be aware that most commercially available kits don’t reliably test for trichomoniasis. The parasite is difficult to detect with self-collection methods, and false negatives are common. A clinic-based test is far more dependable for this particular infection.
Who Should Get Tested Even Without Symptoms
Because most infections are silent, testing based on symptoms alone would miss the majority of cases. Annual screening is worth considering if you have multiple sexual partners, a history of other STIs, or if you receive care at an STI clinic or correctional health facility. Routine annual screening is specifically recommended for women living with HIV, since trichomoniasis can worsen HIV-related health outcomes.
If you’ve been treated for trichomoniasis before, retesting about three months after treatment is recommended for women regardless of whether your partner was also treated. Reinfection rates are high, and a negative test at the three-month mark confirms the infection is actually gone.
What Happens If It Goes Untreated
Trichomoniasis is curable with a short course of oral antibiotics, and most people feel better quickly. Left untreated, though, the infection doesn’t just linger harmlessly. It increases the risk of acquiring HIV by roughly 1.5 times, because the inflammation it causes makes genital tissue more vulnerable to other infections.
During pregnancy, untreated trichomoniasis is linked to preterm delivery, low birth weight, and premature rupture of membranes. In rare cases the infection can pass to the newborn during delivery, causing vaginal or respiratory infections. If you’re pregnant or planning to become pregnant and have any reason to suspect exposure, testing is especially important.
What Treatment Looks Like
Treatment is straightforward: a prescription oral antibiotic, taken either as a single dose or over the course of a week depending on the situation. Your sexual partner or partners need to be treated at the same time, even if they have no symptoms. Otherwise, you’ll likely pass the infection back and forth. You should avoid sex until both you and your partner have finished treatment and any symptoms have cleared. Most people recover completely within a week or two.