Trichomoniasis in the UK: Symptoms, Testing, Treatment & Why It's Often Missed

Trichomoniasis in the UK: Symptoms, Testing, Treatment & Why It's Often Missed

Trichomoniasis symptoms are frequently mistaken for other common conditions such as thrush or bacterial vaginosis (BV), which means this sexually transmitted infection is one of the most underdiagnosed in the UK. Many people have never heard of trichomoniasis, yet it is one of the most common curable STIs worldwide. It can affect both men and women, though symptoms differ significantly between the sexes — and in many cases, symptoms may be absent altogether.

The challenge with trichomoniasis is that its signs overlap considerably with non-sexually transmitted conditions. A change in vaginal discharge, mild irritation, or discomfort during urination can all be attributed to more familiar causes. Without testing, the true cause may go unidentified, and the infection can be passed on unknowingly.

The good news is that trichomoniasis is treatable, and testing can clarify the cause of your symptoms. Our clinic provides private STI testing services. We do not provide GP services, but if treatment is required, you will be signposted to your GP or sexual health service. In this guide, we explain what trichomoniasis is, how it presents in men and women, how it compares to thrush and BV, and what testing involves.

What Is Trichomoniasis?

Trichomoniasis is a sexually transmitted infection caused by a tiny parasite called *Trichomonas vaginalis*. It is not caused by bacteria (as with chlamydia or gonorrhoea) or by yeast (as with thrush). It is a distinct type of infection with its own characteristics and treatment approach.

Key facts about trichomoniasis:

• It is one of the most common curable STIs in the world — the World Health Organization estimates millions of new infections annually
• It is transmitted through sexual contact — specifically through vaginal, penile, or vulval contact. It is not typically spread through oral or anal sex
• It is often underdiagnosed — because symptoms overlap with other conditions and it is not always included in routine STI screening panels
• It affects both men and women — though it is diagnosed more frequently in women, partly because symptoms are more noticeable in women

Understanding that trichomoniasis is caused by a parasite rather than bacteria or yeast is important, because it means the treatment approach differs from what you might expect for thrush or BV. It also means that over-the-counter thrush treatments will not clear a trichomoniasis infection.

Trichomoniasis Symptoms in Women

Trichomoniasis symptoms in women can range from barely noticeable to quite uncomfortable. When symptoms are present, they typically involve changes in vaginal discharge and genital irritation.

Common symptoms include:

• Changes in vaginal discharge — discharge may become more noticeable in volume, colour, or consistency
• Green or yellow discharge — a greenish or yellowish tinge is a recognised feature, though not always present
• Frothy texture — frothy discharge is sometimes associated with trichomoniasis, though not all women experience this
• Strong or unpleasant odour — the discharge may have a fishy or unusual smell
• Vaginal irritation or soreness — itching, redness, or general discomfort around the vulva and vaginal area
• Pain during sex — discomfort during vaginal intercourse
• Pain when urinating — a burning or stinging sensation

However, it is important to note that some women have no symptoms at all. The infection can be present without producing any noticeable signs, which is one reason why it is so easily missed.

Trichomoniasis symptoms can overlap significantly with other conditions that affect vaginal discharge. Our guide on how STDs change vaginal discharge explains how different infections can affect discharge colour, consistency, and odour.

Trichomoniasis Symptoms in Men

Trichomoniasis in men is often even harder to detect than in women, because many men experience no symptoms at all. When symptoms do occur, they tend to be mild and may be dismissed as minor irritation.

Symptoms in men may include:

• Mild urethral irritation — a slight burning or tingling sensation inside the penis
• Discharge from the penis — usually thin and whitish, though it may not be immediately noticeable
• Burning when urinating — mild discomfort during urination
• Discomfort after ejaculation — some men report mild soreness or irritation following ejaculation

Because trichomoniasis in men is so often asymptomatic, men may carry and transmit the infection without ever being aware of it. This makes partner testing particularly important when one partner has been diagnosed.

If you have noticed any unusual penile discharge, our guide on penile discharge explained covers the various possible causes and when to consider testing.

Trichomoniasis vs Thrush vs BV

One of the most common sources of confusion is the overlap between trichomoniasis, thrush (vaginal candidiasis), and bacterial vaginosis (BV). All three can cause changes in vaginal discharge and genital discomfort, but they have different causes and require different approaches.

This trichomoniasis vs thrush vs bv comparison highlights why self-diagnosis is unreliable. The symptoms can look and feel similar, but the underlying causes — and therefore the treatments — are quite different. Using thrush treatment for a trichomoniasis infection will not clear it, and the infection will persist.

If you are experiencing symptoms and are unsure of the cause, testing can help clarify what is going on and ensure that the right approach is taken.

How Is Trichomoniasis Diagnosed in the UK?

Testing for trichomoniasis in the UK involves a clinical sample that is analysed to detect the presence of the *Trichomonas vaginalis* parasite.

Testing methods include:

• Vaginal swab — a swab taken from the vaginal area, either by a clinician or as a self-collected sample
• Urine testing — in men, a urine sample may be used to detect the parasite
• NAAT testing — nucleic acid amplification testing offers high sensitivity and is increasingly used for trichomoniasis detection
• Microscopy — in some clinical settings, a wet mount microscopy technique may be used to visualise the parasite directly

One important point to be aware of is that trichomoniasis is not always included in standard STI screening panels. If you have symptoms that suggest trichomoniasis, or if you have specific risk factors, it is worth mentioning this when booking your test so that the appropriate testing can be arranged.

Our clinic provides private STI testing. We do not prescribe medication. If prescription treatment is required, you will be signposted to your GP or sexual health service.

Trichomoniasis Treatment

Treatment for trichomoniasis is usually straightforward. The infection is typically treated with a course of oral antibiotics — most commonly metronidazole or tinidazole. These are prescription medications that are available through your GP or sexual health service.

Key points about treatment:

• Both partners should be treated — even if only one partner has symptoms, both should receive treatment to prevent reinfection
• Avoid alcohol during treatment — metronidazole can interact with alcohol, causing nausea and other side effects
• Avoid sex during treatment — sexual contact should be avoided until both partners have completed treatment and symptoms have resolved
• Follow clinician advice — complete the full course of antibiotics as prescribed

Treatment is usually effective, though it is important to follow the prescribed course fully. If you are unsure about when it is safe to resume sexual activity, our guide on can you have sex after STI treatment provides practical information on waiting periods for different infections.

If further medical evaluation or prescription treatment is required, you may be advised to consult your GP or appropriate healthcare service.

Why Trichomoniasis Is Often Missed

Trichomoniasis is one of the most commonly missed STIs, and there are several reasons for this:

• Symptoms mimic other conditions — the overlap with thrush and BV means that many people self-treat with over-the-counter products without ever being tested for trichomoniasis
• Not always included in routine screening — many standard STI panels focus on chlamydia, gonorrhoea, HIV, and syphilis, with trichomoniasis not automatically included
• Mild or absent symptoms — particularly in men, symptoms may be so mild that they go unnoticed entirely
• Low awareness — compared to better-known STIs, trichomoniasis receives less public attention, meaning many people simply do not think to ask about it
• Stigma around STI testing — some individuals may avoid testing altogether, which allows infections to go undiagnosed

The combination of these factors means that trichomoniasis can circulate quietly, being passed between partners without either party being aware. This is not a reason for alarm — it is simply a reason why targeted testing matters when symptoms are present or when there is a reason to check.

Can You Get Trichomoniasis Again?

Yes, reinfection with trichomoniasis is entirely possible. Successfully completing treatment clears the current infection, but it does not provide any lasting immunity against the parasite.

Reinfection can occur if:

• Your partner was not treated — if only one partner receives treatment, the untreated partner can reinfect the treated partner
• You have sexual contact with a new infected partner — subsequent exposure carries the same risk as the first
• Treatment was not completed fully — stopping antibiotics early may allow the infection to persist

Partner treatment is one of the most important steps in preventing reinfection. Our guide on can you get the same STI twice covers this topic across various infections.

Retesting after treatment is sometimes recommended, particularly if symptoms persist or if there is uncertainty about whether a partner has been treated. Your clinician can advise on whether follow-up testing is appropriate for your situation.

Testing After Symptoms Clear

It is worth noting that trichomoniasis symptoms may improve or resolve before the infection has been fully cleared. This can happen naturally or during the early stages of treatment. However, the absence of symptoms does not necessarily mean the infection is gone.

Important considerations:

• Complete your treatment course — even if symptoms have resolved, finishing the full course of antibiotics ensures the best chance of clearing the infection
• Follow-up testing may be appropriate — in some cases, a test of cure may be recommended to confirm that the parasite has been cleared
• Symptoms resolving without treatment does not mean the infection has cleared — trichomoniasis rarely resolves entirely on its own, and lingering infection can still be transmitted to partners

Some STIs can be entirely asymptomatic, and trichomoniasis is a good example of an infection where symptom absence should not be assumed to mean infection absence.

Frequently Asked Questions

What are the most common trichomoniasis symptoms?

The most common trichomoniasis symptoms in women include changes in vaginal discharge (particularly greenish-yellow or frothy discharge), genital irritation, pain during sex, and discomfort when urinating. In men, symptoms are often mild or absent, but may include mild urethral irritation, slight discharge, or burning during urination.

Can men have trichomoniasis without symptoms?

Yes. Many men with trichomoniasis have no symptoms at all. The infection can be carried and transmitted without any noticeable signs, which is why partner testing is important when one person in a relationship has been diagnosed.

Is trichomoniasis serious?

Trichomoniasis is not typically considered a serious infection, and it responds well to antibiotic treatment. However, if left untreated, it can cause ongoing genital irritation and may increase vulnerability to other infections. Treatment is straightforward, and early detection helps prevent onward transmission.

Can trichomoniasis go away on its own?

Trichomoniasis rarely clears on its own without treatment. While symptoms may fluctuate or improve temporarily, the parasite usually persists in the body until it is treated with appropriate antibiotics. Testing and treatment are the most reliable approach.

How is trichomoniasis different from BV?

Trichomoniasis is caused by a sexually transmitted parasite, while BV is caused by an imbalance of bacteria that naturally occur in the vagina. BV is not considered sexually transmitted, though sexual activity may contribute to it. The treatments are different, which is why accurate diagnosis through testing matters.

Can I have sex during trichomoniasis treatment?

It is recommended that you avoid sexual contact until both you and your partner have completed treatment and any symptoms have resolved. This helps prevent reinfection and ensures that the treatment has had time to work effectively.

When to Seek Medical Advice

You should consider seeking medical advice if you experience:

• Persistent or unusual discharge — particularly if it is greenish, frothy, or has an unpleasant odour
• Pelvic pain — discomfort in the lower abdomen that does not resolve
• Fever — may indicate a more significant infection or complication
• Worsening symptoms — if symptoms are getting worse rather than improving, or if they return after treatment

If symptoms persist or worsen, consultation with your GP or appropriate healthcare provider may be advised. These situations do not necessarily indicate a serious problem, but clinical assessment helps ensure that the right diagnosis and treatment approach is identified.

Confidential Trichomoniasis & STI Testing in the UK

If you are experiencing symptoms or would like reassurance, confidential STI testing appointments are available at our UK clinic. Testing decisions depend on your symptoms and exposure history.

Whether you are concerned about unusual discharge, genital irritation, or symptoms that have not responded to over-the-counter treatments, testing can help clarify whether trichomoniasis or another infection may be the cause. If results indicate that prescription treatment or GP referral is needed, you will be signposted to your GP or sexual health service.

Book a confidential appointment at a time that suits you.