Trichomonas Vaginitis

Trichomoniasis Vaginitis Comes from a Bug with a Tail and it’s not Bacterial Vaginosis

Trichomonas Vaginitis Comes from a Bug with a Tail and its not Bacterial Vaginosis

Trichomonas vaginalis (TV) is caused by a parasite or protozoan with a tail—called a flagellum. Trichomonas vaginalis a very common STD and is more prevalent than Chlamydia trachomatisNeisseria gonorrhoeae, and syphilis combined. The global prevalence has been estimated to be about 8% in women, which is probably an underestimation. Infections may occur at any age. Risk factors include unprotected sexual activity, new or multiple sex partners, concurrent sexually transmitted infections  (STIs), or a history of other STIs, and bacterial vaginosis (BV). There is an association of TV with other STIs, such as herpes infectionschlamydiagonorrhea, and syphilis, as well as pelvic inflammatory disease and a poor pregnancy outcome, such as preterm labor and premature rupture of membranes.TV has also been suggested in studies to increase the risk of HIV acquisition.

The parasite produces trichomonas vaginalis, in women that is usually characterized by vaginitis with a thin, white to yellow discharge accompanied by vulvar and cervical lesions, abdominal pain, or dysuria. The incubation period is 5–28 days. In men, the infection can be asymptomatic or have characteristics of urethritis, epididymitis, and prostatitis. BV, on the other hand, is characterized by a clear watery discharge that has a distinct odor similar to ammonia. It is not considered an STI but it is only seen in sexually active women and is associated with the presence of sperm. Semen that carries the sperm has an alkaline pH, which could partially explain why BV occurs. The vagina’s healthy pH is acidic. When it is alkalinized, and the pH rises, there is a predisposition for other types of bacteria to prolifierate, leading to BV

Trichomoniasis will go away on its own in about 40% of men and less than 20% of women. Transmission is primarily by sexual contact. TV has been demonstrated to be viable on inanimate objects (e.g,. for 45 minutes on toilet seats and up to 25 hours on damp towels). 

BV may also wax and wane but usually needs to be treated with an antibiotic, metronidazole or Tinidazole. Although generally more expensive, tinidazole is associated with fewer adverse effects than metronidazole and is equal or superior in resolving T vaginalis infection.Topical metronidazole and other antimicrobials are not effective and should not be used to treat trichomoniasis.

The good news is that Trichomonas and BV are treated with the same medication. Boric acid capsules administered vaginally may help keep the vagina acidic and help eradicate BV but is not effective against TV. You need to see your doctor for any persistent symptoms and make sure your partner is aware of the diagnosis.


Kimberly Langdon M.D.

Kimberly Langdon is a Doctor of Medicine and graduated from The Ohio State University in 1991. She completed her residency in Obstetrics and Gynecology at The Ohio State University Hospitals, Department of OB/GYN. Board-Certified in 1997, she is now retired from clinical practice after a long and successful career. Currently, she is the Founder and Chief Medical Officer of a Medical Device Company that is introducing a patented product to treat vaginal microbial infections without the need for drugs. She is an expert in Vaginal Infections, Menstrual disorders, Menopause, and Contraception.