vaginal issues

Trichomoniasis, or “trich” for short, is a common sexually transmitted infection (STI). One of the unpleasant symptoms can be a very strong fishy odor. A colleague of mine had a patient who was so repelled by the smell she sat in a bleach solution! Don’t do that, it will give you a terrible rash, break down the skin and cause more problems. She had tried numerous other remedies from floral-scented feminine washes to washing herself with vinegar and became so frustrated, all she could think of was using bleach. I wish she had gone in to see a women’s health provider, but I get the –– I’ll do anything to make this go away–– feeling.

The infection Trichomonas vaginalis is caused by a tiny parasite. This one-celled protozoan hitches a ride in semen or vaginal fluids during sexual contact, traveling between partners. This can happen during all kinds of unprotected sex–anal, oral, or vaginal. And, ejaculation is not necessary to pass this infection to a partner. It may take anywhere from 4 to 28 days after a person is exposed for the infection to take hold and start causing symptoms. 

And this is super important to know:  It is common to have NO symptoms and still pass this on to a sexual partner. And, that’s what we think happens most of the time. Most partners don’t purposefully pass on infections, they just don’t have symptoms and don’t know what else they are sharing.

Symptoms of Trichomoniasis in Women

The vagina, vulva, cervix, or urethra can be infected and cause: 

  • Abnormal vaginal discharge that may be thick, frothy, and yellow-green in color
  • More discharge than normal
  • Discharge with an unpleasant fishy smell, this can become worse after a period
  • Soreness, swelling and itching around the vagina – sometimes the inner thighs also become itchy
  • Pain or discomfort when passing urine or having sex
  • Some spotting from irritation on the vulvar and vaginal area

Having trichomoniasis also appears to make it easier for women to become infected with HIV, the virus that causes AIDS.

Pregnant women who have trichomoniasis might: 

  • Deliver prematurely
  • Have a baby with a low birth weight
  • Transmit the infection to the baby as he or she passes through the birth canal

Symptoms in Men

In men, the parasite usually infects the urethra inside the penis and can cause:

  • Pain when urinating or during ejaculation
  • Needing to urinate more frequently than usual
  • A thin, white discharge from the penis
  • Soreness, swelling, and redness around the head of the penis or foreskin

Note, men are even more likely than women to have no symptoms.

Get Yourself Checked

If you have any of these symptoms, or if you’ve had a new partner in the last year, it’s time to see your healthcare provider. Trichomoniasis can be diagnosed with a swab taken from the vagina or penis. If the test is positive, it is essential that the person tested and any of their partners get treated or it will just come back and/or be passed to new partners. Also, it can now be diagnosed when women have their routine Pap smear test for cervical cancer. Ask your provider to check for trich, as you could be asymptomatic and still infected.

Many companies have made home tests available, such as: 

LetsGetChecked: This company offers three sexual health tests, including trichomoniasis. Individuals take their samples at home, send them off with a pre-paid mailing label that comes with the testing kit, and can check their results 2–5 days later at a secure online location. 

EverlyWell: One of the dozens of different tests this company conducts is a urine test for trichomoniasis. You mail your sample in a pre-paid bio-hazard bag that comes with their test kits. A board-certified doctor contacts people to discuss positive results.

Luckily– it’s Curable

The most common treatment for trichomoniasis involves taking one megadose of metronidazole (Flagyl) or tinidazole (Tindamax). If a course of antibiotics is prescribed you must take all the medication, even if your symptoms have improved.

The Food and Drug Administration has expanded the approval of Solosec® (secnidazole) to include the treatment of trichomoniasis.  Previously, this nitroimidazole antimicrobial agent had only been approved for bacterial vaginosis. It is also a one-dose medication.


Use a condom, every time. 

And, please no bleach baths! And while we’re on the topic, please save your hard-earned money and skip those feminine washes. They’re loaded with perfumes that can irritate the skin. 

Ok, that’s it! Have fun and be safe.

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