How is trichomoniasis treated?

Trichonomiasis is treated with prescription drugs. The drugs are given in a single dose. The symptoms in infected men may disappear in a few weeks, however; for men who do not have symptoms they will continue to infect or re-infect others. Both partners will need to be treated to prevent re-infection. Persons being treated for trichomoniasis should refrain from sex until completely free of symptoms.

Trichomoniasis (sometimes called "trich") is an infection caused by the parasite Trichomonas vaginalis. This one-celled organism infects the vagina and glands of the lower genital tract. It is passed from one person to another during sexual contact.

Many people with this sexually transmitted disease have no symptoms, but they may still transmit the infection to a sexual partner.

Vaginal infection causes a thin, irritating discharge with an unpleasant odor. The vaginal tissues may feel raw and itchy. There may be a burning sensation when urinating or having sex.

The antibiotic metronidazole is used to treat trich. This drug can be given as a single high dose or as a lower dose taken over seven days. Side effects include nausea, headache, and a metallic taste. People taking this drug must not drink alcohol for 72 hours after treatment to avoid moderate to severe nausea and vomiting. The usual dose of metronidazole cures about 90% of people with trich.

The two most common reasons treatment fails:

• The person taking the drug did not complete all the antibiotics they were prescribed
• The person becomes reinfected by a sexual partner who still has trich

For the best chance of a successful treatment, avoid sexual intercourse for one week after both partners are treated.

If the standard dose does not work, a longer course of treatment with a higher dose is prescribed. Side effects tend to be more severe with higher doses. Or, the doctor may prescribe another drug called tinidazole.

In rare instances, when infection does not go away after these treatments, special testing can determine what other medication options are needed. This often requires a consultation with an infectious disease specialist.

Trichomoniasis (trich) is treated with an oral antiprotozoal medicine, such as metronidazole or tinidazole. The medicine is taken either as a single dose or as multiple doses.

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.

People who are infected with HIV receive the same treatment for trich as those who are HIV-negative.

Trichomoniasis in pregnant women

Trichomoniasis during pregnancy raises the risk of premature rupture of membranes (PROM) and premature delivery. Treating the infection doesn't appear to reduce this risk. If you are pregnant and have trichomoniasis, talk to your doctor about the pros and cons of treatment.

Vaginal suppositories and creams aren't effective in curing trich, but they may reduce discomfort and swelling in the genital area.

Follow-up

• No follow-up is needed if symptoms go away. It is possible to get trich again, so it is important to take measures to reduce your risk for trich and other sexually transmitted infections (STIs).
• If symptoms do not go away, you may need to take the medicine again.
• If treatment fails after this and you have not been reinfected, further testing may be done to find out the cause of your symptoms. It is possible to have a strain of trich that is resistant to antiprotozoal medicines. High-dose tinidazole may be used for metronidazole-resistant trich organisms and is as effective as metronidazole in curing trich.

If trich goes untreated or isn't properly treated, complications can develop, such as pelvic inflammatory disease (PID) in women or conditions that contribute to infertility in men.