What are the symptoms of trichomoniasis?

Trichomoniasis Symptoms in Women

Signs and Symptoms of Trichomoniasis in Women7
Sign/Symptom Percent of Patients
Asymptomatic ≤ 50%
Vaginal/vulvar erythema (redness) 75%
Frothy, yellow/green discharge 25%
Vulvar itching 20-50%
Strawberry cervix < 2%
Vaginal odor 60%
pH > 5 60-90%
Dyspareunia (pain during sexual intercourse) < 25%
Dysuria (pain during urination) < 25%

Women who have trichomoniasis may notice a frothy, yellow-green vaginal discharge with a strong fishy odor. There may be soreness, itching and irritation of the genital area, urination or sexual intercourse may be uncomfortable or painful. Symptoms are not consistent among women.

Symptoms usually appear in women within 5 to 28 days of exposure, but up to 50% of women may not show any symptoms.1 If not treated within 6 months, however, 30% of infected asymptomatic women will develop symptoms.2

Common clinical signs of infection include:

  • Vulvar erythema (redness)
  • Inflammation
  • Excess of white blood cells seen on a wet mount preparation of vaginal discharge
  • Motile trichomonads in the wet mount preparation
  • Vaginal pH above 5

Most of these symptoms overlap with those of bacterial vaginosis, complicating diagnosis. This differential diagnosis chart compares the symptoms of the three most common vaginal infections.

Trichomoniasis Symptoms in Men

Signs and Symptoms of Trichomoniasis in Men
Sign/Symptom % of Patients
Asymptomatic8 > 50%
Urethral discharge8,9 65-100%
Pruritus (itching)9 98.5%
Semen pH = 7.1–8.011 100%
Dysuria (pain during urination)12 5.5%

Most men with trichomoniasis do not show symptoms of infection, and those who seek treatment typically do so because of an infected partner.

Symptoms in men typically include urethral discharge, pain during urination, mild local itching, and burning after sexual intercourse. T. vaginalis is also a known cause of prostatitis.3,4 Men who are unresponsive to antimicrobial therapy for nonspecific urethritis should be tested for T. vaginalis since 15-20% will be infected with the organism.5,6

  1. Weston TE, Nicol CS. Natural history of trichomonal infection in males. Br J Vener Dis. 1963 Dec;39:251-7.
  2. Rein MF, Muller M. Trichomonas vaginalis and trichomoniasis. In Holmes KK, editor. Sexually Transmitted Diseases. New York: McGraw Hill; 1990, pp. 481-492.
  3. Guenthner PC, Secor WE, Dezzutti CS. Trichomonas vaginalis-induced epithelial monolayer disruption and human immunodeficiency virus type 1 (HIV-1) replication: implications for the sexual transmission of HIV-1. Infect Immun. 2005 Jul;73(7):4155-60.
  4. Gardner WA Jr, Culberson DE, Bennett BD. Trichomonas vaginalis in the prostate gland. Arch Pathol Lab Med. 1986 May;110(5):430-2.
  5. Thomason JL, Gelbart SM. Trichomonas vaginalis. Obstet Gynecol. 1989 Sep;74(3 Pt 2):536-41.
  6. Schwebke JR, Hook EW 3rd. High rates of Trichomonas vaginalis among men attending a sexually transmitted diseases clinic: implications for screening and urethritis management. J Infect Dis. 2003 Aug 1;188(3):465-8. Epub 2003 Jul 10.
  7. Wølner-Hanssen P, Krieger JN, Stevens CE, Kiviat NB, Koutsky L, Critchlow C, DeRouen T, Hillier S, Holmes KK. Clinical manifestations of vaginal trichomoniasis. JAMA. 1989 Jan 27;261(4):571-6.
  8. Krieger JN. Trichomoniasis in men: old issues and new data. Sex Transm Dis. 1995 Mar-Apr;22(2):83-96.
  9. Latif AS, Mason PR, Marowa E. Urethral trichomoniasis in men. Sex Transm Dis. 1987 Jan-Mar;14(1):9-11.
  10. Gopalkrishnan K, Hinduja IN, Kumar TC. Semen characteristics of asymptomatic males affected by Trichomonas vaginalis. J In Vitro Fert Embryo Transf. 1990 Jun;7(3):165-7.
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