Even if you don’t experience symptoms when you first get it, chances are, if trichomoniasis goes untreated and gets bad enough, you may start to have symptoms eventually. If you have a vagina, some trichomoniasis symptoms to look out for include:
- Foul-smelling vaginal discharge
- White, gray, yellow, or green discharge
- Genital redness
- Burning and itching
- Pain with urination or sexual intercourse
Above all, it’s the unusual fishy smell that makes the infection the most identifiable. “[Trichomoniasis] has a very distinct, putrid odor,” Dr. Cackovic explains. “It’s so distinct [that an ob/gyn] can sometimes notice it before they even put the speculum in.”
All told, it’s always a good idea to pay attention to what’s happening with your genitals and get in touch with your ob/gyn if you notice any change in your discharge color and smell, or experience vaginal pain or burning, says Dr. Cackovic.
Are there complications if trichomoniasis goes untreated?
Unlike chlamydia and gonorrhea, which can lead to pelvic inflammatory disease and subsequent infertility if left untreated, trichomoniasis can’t travel up your reproductive tract and infect those organs. The parasites will stay localized, and may continue to multiply but not spread. However, according to the CDC, the infection can cause some complications for pregnant people such as early delivery and low birth weights. One landmark study of over 13,000 pregnant women in the early 1980s found that trichomoniasis was associated with a 30 percent increase in low-birth-weight infants and a 30 percent increase in preterm birth. We still don’t know exactly why, but one theory is that trichomoniasis may weaken the amniotic membrane, making it more likely to rupture earlier in the pregnancy. “In two separate occasions in my career, I’ve seen it colonized in amniotic fluid,” Dr. Cackovic says, though the science here is still pretty scant.
Trichomoniasis may also increase your chances of getting another STD (and passing it on to others), including HIV, because of the genital inflammation it causes.
How do you get tested for trichomoniasis?
Doctors diagnose trichomoniasis based on a sample of vaginal fluid or urine, according to the Mayo Clinic. Trichomoniasis testing used to involve growing a culture, but newer, faster tests are more common now, Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology at Yale Medical School, tells SELF.
“In general [trichomoniasis tests] aren’t necessarily in everyone’s panel for STDs, so you need to request it separately,” says Dr. Minkin. Either that, or your ob/gyn will recommend it if you’re having symptoms (like the unique odor). If you’re not showing symptoms and wondering whether to request the test, you can talk to your ob/gyn about if it might make sense for you. Dr. Minkin says it’s not a bad idea to get checked if you’re having unprotected sex outside of a mutually monogamous relationship. The same goes for if you’re planning a pregnancy, since trichomoniasis can cause complications like we mentioned above.
How is trichomoniasis treated?
The good news is that trichomoniasis is treatable with antibiotics, typically in a single dose, the CDC notes. The same oral antibiotics given for BV—metronidazole or tinidazole—are used to treat trichomoniasis.
One extra-important part here: If you or a sexual partner of yours has trichomoniasis, both of you need to be treated, regardless of symptoms, to avoid unknowingly passing it to each other or along to someone else. Around one in five people with trichomoniasis get it again within three months of treatment, the CDC says, so it’s really important that everyone having sex with someone who has trichomoniasis also get those antibiotics.
“It’s also recommended to check back in with your doctor two weeks after treatment to makes sure it’s cleared up,” Dr. Cackovic says. For people with penises especially, trichomoniasis sometimes clears up on its own without medication, he adds. But most of the time, and typically for people with vaginas, trichomoniasis can last for months or years if left untreated.