Trichomoniasis

Treatment Overview

Trichomoniasis (trich) is treated with an oral antiprotozoal medicine, such as metronidazole or tinidazole. The medicine is taken either as a single dose (2 grams) or as multiple doses (250 to 500 mg) to equal a total of around 7 grams. The cure rate in treating trich using metronidazole is 90% to 95%. The cure rate using tinidazole is 86% to 100%.⁷

Sex partner(s) should be treated at the same time you are being treated to increase the cure rate and reduce the possibility of further transmission or reinfection. Sexual intercourse should be avoided during treatment until symptoms have gone away and until partners have been treated. Ideally, 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 does not appear to reduce this risk.² If you are pregnant and have trichomoniasis, talk to your doctor about the pros and cons of treatment.

Vaginal suppositories and creams are not 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 STDs.
• 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 determine 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.⁹

If trich goes untreated or is not properly treated, complications can develop, such as pelvic inflammatory disease (PID) in women or conditions that contribute to infertility in men.¹⁰

What To Think About

Metronidazole vaginal suppositories or creams are not recommended because oral metronidazole is much more effective. Vaginal medicines are not effective in treating trich, especially in areas other than the vagina and cervix. Vaginal medicines cure trich in less than 50% of cases.⁷

Metronidazole vaginal gel, which is used to treat bacterial vaginosis, is not recommended by the CDC for treatment of trich.⁷

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Author:	Amy Fackler, MA Debby Golonka, MPH	Last Updated: August 10, 2006
Medical Review:	Renée M. Crichlow, MD - Family Medicine Kathleen Romito, MD - Family Medicine Jeanne Marrazzo, MD, MPH - Infectious Disease
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