Trichomoniasis: Signs, Symptoms and Complications - Verywell Health

Most people who have trichomoniasis do not have any symptoms, yet women who are infected are more likely to develop symptoms than men who are infected. The most common symptoms are itching, discharge, and an unpleasant odor.

Complications can be serious, including an increased risk of becoming infected with human immunodeficiency virus (HIV)—or spreading it—and an increased risk of low birth weight and premature babies. 

© Verywell, 2018

Frequent Symptoms

Trichomoniasis is a common sexually transmitted infection (STI) caused by a parasite that can produce obvious and uncomfortable symptoms. However, if you have trichomoniasis, you might not experience any symptoms at all. If symptoms do occur, they usually appear within five to 28 days of exposure, or even later. Symptoms can come and go. The symptoms are different for women than they are for men. 

Symptoms in Women

In women, the infection involves the vagina and surrounding areas and can affect the cervix as well. Symptoms may persist unless treated. The most common symptoms in women are:

• Itching and swelling in and around the vagina
• Frothy, foul-smelling discharge
• Spotting
• Urge to urinate more frequently
• Pain or burning when urinating

Some women may have discomfort during sex. Lower abdominal pain is a rare symptom.

Symptoms in Men

Most men will have few or no symptoms after being infected. Typically, when men experience symptoms they are mild and last for a short time. 

The most common area of infection for men is the urethra, the tube inside the penis that carries urine and semen from inside to outside the body. The most common symptoms in men are:

• Discharge from the penis
• Urge to urinate more frequently
• Pain or burning when urinating

Some men may experience burning after ejaculation.

Whether you are a man or a woman, if your sexual partner has symptoms of trichomoniasis, there is a strong chance that you also have the infection, even if you do not have any symptoms yourself. A person who does not have symptoms can spread the infection, so the presence or absence of symptoms does not provide any insight about who may have had the infection first. 

While the infection in men lasts only a short time, infected men can easily transmit the parasite that causes trichomoniasis to a female partner.

Oral or Rectal Trichomoniasis

In general, the parasite that causes trichomoniasis, Trichomonas vaginalis or T. vaginalis, is known to survive in and around the vagina and urethra in women and in the urethra in men. It is not typically associated with infections of the mouth or anus.

However, there have been rare case reports of trichomoniasis causing infections of the mouth and throat. The symptoms can include irritation, burning, and pain in these affected areas.

Complications

There are several serious complications of trichomoniasis. This is why treatment is so important.

HIV Infection 

Women with trichomoniasis have an increased risk of HIV infection. And, if an HIV-positive woman has a trichomoniasis infection, this increases her risk of passing HIV to sexual partners, too.

This association is believed to occur because the inflammatory process that results when a woman has a trichomoniasis infection makes the skin and blood vessels more fragile, allowing microorganisms, such as the HIV virus, to become transmitted through the skin of the vagina more easily.

This inflammation makes a woman who has trichomoniasis more susceptible to becoming infected from an HIV-infected partner. It also makes her partner more susceptible to becoming infected with HIV if she has both HIV and trichomoniasis. 

Pregnancy and Newborns

Women who have trichomoniasis can transmit the infection to babies through the vaginal canal during delivery. This has been described as causing oral or vaginal infections in the baby, although these incidents are rare. 

The more serious and recognized complications of trichomoniasis in pregnant women are delivering prematurely and giving birth to low-birth-weight babies. It is not clear how or why this occurs, but it is an observation with trichomoniasis. 

Prostate Involvement

Rarely, the prostate can become infected as a complication of trichomoniasis. Another complication that has recently been described is a possible increased risk of prostate cancer in men who have had trichomoniasis, possibly due to inflammatory changes induced by the infection.  

Urinary and Reproductive Tract

While it is rare, the infection can involve/spread to the internal organs of the reproductive system or the urinary system. This can cause major problems, such as pus-filled lesions or fistulas (abnormal connections between body parts or organs). 

When to See a Healthcare Provider

There are many signs and symptoms of trichomoniasis for which you should see your primary care provider or other healthcare professional as these signs can be indications of trichomoniasis or another illness that needs to be treated. You should see your healthcare provider if you have: 

• Itching, irritation, or pain in or around the vagina 
• Itching, irritation, or pain in or around the penis
• Urinary frequency
• Urinary urgency
• Pain with urination
• Vaginal discharge
• Discharge from the penis
• Sores, ulcerations, crusting or bleeding areas from the vagina
• Sores, ulcerations, crusting or bleeding from the penis
• Pain with sexual intercourse
• Abdominal pain

Trichomoniasis Doctor Discussion Guide

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Pregnancy and STIs

If you are pregnant or planning to become pregnant, you should be sure to tell your healthcare provider about any STI that you have had, including trichomoniasis. Many STIs can cause serious problems for your baby if you have not been adequately treated for the infection 

Unprotected Sex

If you have had unprotected sex with a partner who may have an STI, you should both get tested. If you are not able to convince your partner to get tested, you should see your healthcare provider and mention your concerns. This is something that you can take care of even if it has been years since your exposure as diagnosis and treatment can eliminate the infection. 

Frequently Asked Questions

• Yes, genital irritation and itching are common symptoms of trichomoniasis in women. Oral or rectal infections, though rare, can also cause irritation and burning.

• In women, trichomoniasis can cause red, irritated genitals and a change in vaginal discharge. In men, it can cause an unusual penile discharge. Trichomoniasis discharge can be clear, white, yellowish, or greenish. Trichomoniasis does not cause ulcers or sores. 

• Fish. Discharge from trichomoniasis has a strong fishy odor. If you experience a foul-smelling discharge from your penis or vagina, see a healthcare provider.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Planned Parenthood. What are the symptoms of trichomoniasis?

2. U.S. Department of Health and Human Services. womenshealth.gov. Trichomoniasis

3. Planned Parenthood. How do I get treated for trichomoniasis?

Additional Reading

• Carter-Wicker K, Utuama O, OmoleF. Can trichomoniasis cause pharyngitis? A case report. SAGE Open Med Case Rep. 2016 Dec 9;4:2050313X16682132. doi: 10.1177/2050313X16682132. eCollection 2016.
• Francis SC, Kent CK, Klausner JD, et al. Prevalence of rectal Trichomonas vaginalis and Mycoplasma genitalium in male patients at the San Francisco STD clinic, 2005-2006. Sex Transm Dis. 2008 Sep;35(9):797-800. doi: 10.1097/OLQ.0b013e318177ec39.
• Gosnell BI, Costiniuk CT, Mathaba E, Moosa MY. Trichomonas vaginalis Associated with Chronic Penile Ulcers and Multiple Urethral Fistulas. Am J Trop Med Hyg. 2015 May;92(5):943-4. doi: 10.4269/ajtmh.14-0597. Epub 2015 Mar 16.
• Kim JH, Han IH, et al. Proliferation of prostate epithelia induced by IL-6 from stroma reacted with Trichomonas vaginalis. Parasite Immunol. 2018 Apr 6:e12531. doi: 10.1111/pim.12531. [Epub ahead of print]

By Mark Cichocki, RN
Mark Cichocki, RN, is an HIV/AIDS nurse educator at the University of Michigan Health System for more than 20 years.  

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