Signs and Symptoms of Trichomoniasis

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Trichomoniasis does not always produce symptoms yet women who are infected are more likely to develop symptoms than men who are infected. The most common symptoms include itching, discharge, and an unpleasant odor. Complications can be serious, including an increased risk of becoming infected with HIV—or spreading it—and an increased risk of low birth weight and premature babies. 

trichomoniasis symptoms
© Verywell, 2018

Frequent Symptoms

Trichomoniasis can cause obvious and uncomfortable symptoms, but, if you have trichomoniasis, you might not experience any symptoms at all. If symptoms do occur, they usually appear within four weeks of exposure. 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 irritation of the vagina and thighs
  • Inflammation, redness, or swelling in and around the vagina
  • Foul-smell that may be described as "fishy"
  • Frothy, whitish-grey or yellow-green vaginal discharge
  • Pain with sexual intercourse

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 include:

  • Irritating sensation inside the penis
  • Burning sensation after urination
  • Burning sensation 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.

Rare Symptoms

Although it is not common, the symptoms of trichomoniasis may linger and can become more aggressive than usual. It is particularly unusual for symptoms such as pain to occur for men. Some of the less common symptoms of trichomoniasis include:

  • Discharge from the penis in men
  • Pain with intercourse is rare for men, but it can occur. 
  • Urinary frequency or urgency is not common for women and is rare for men.
  • Pain with urination is not common for women and is rare for men.
  • Sores or ulcers on the vagina or penis. It is particularly unusual for sores not to heal quickly.  
  • Blood in the urine for both men and women is uncommon.
  • Abdominal pain can rarely occur. It is more often with women than with men.

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, throat, or anus. 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 occurs 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 (openings where they shouldn't be). 

When to See a Doctor

There are a number of signs and symptoms of trichomoniasis for which you should see the doctor as they can be indications of trichomoniasis or another illness that needs to be treated. You should see your doctor 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

Pregnancy and STDs

If you are pregnant or planning to become pregnant, you should be sure to tell your doctor about any STD that you have had, including trichomoniasis. Many STDs 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 STD, you should both get tested. If you are not able to convince your partner to get tested, you should see your doctor 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. 

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