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What trichomoniasis is

Trichomoniasis is caused by Trichomonas vaginalis, and the first thing worth saying is that it is not a bacterium and not a virus. It is a parasite: a single-celled protozoan that lives in the urethra and the vagina.

That matters practically, because it is treated differently from the bacterial STIs and because it is missed by tests that are only looking for bacteria. It is widely described as the most common curable STI in the world, and it is also one of the least talked about.

How it spreads

Through vaginal sex, and through genital contact and shared sex toys. Unlike chlamydia and gonorrhoea, it does not typically establish itself in the throat or the rectum, so oral and anal transmission are not the usual routes.

Symptoms, if there are any

Around 70% of people with trichomoniasis have no symptoms at all. Where symptoms appear, they tend to show up 5 to 28 days after exposure, and they are easy to mistake for thrush or bacterial vaginosis.

• Frothy discharge, often yellow-green, sometimes with a strong odour
• Genital itching, burning or soreness
• Discomfort when urinating or during sex
• In men, usually nothing, occasionally irritation inside the penis or a thin discharge

Men frequently carry it without symptoms and pass it on without knowing, which is a large part of why it persists in couples who have both been treated for something else.

What happens if it is left

• Higher HIV risk. The inflammation it causes makes both acquiring and transmitting HIV more likely. This is the best-documented consequence.
• Pregnancy complications, including preterm delivery and low birth weight.
• Persistent symptoms that get treated repeatedly as thrush and keep coming back, because the actual cause was never identified.
• Prostatitis and urethritis in men, uncommonly.

How trichomoniasis is tested at Epicentre

By PCR on a self-collected swab or a urine sample. PCR is substantially more sensitive than the older wet-mount microscopy, which misses a large share of infections, particularly in men.

Trichomonas vaginalis is included in every one of our PCR sexual health panels.

If your symptoms are discharge, itching and odour, the 17-target vaginal panel is worth the difference over the Medium. Trichomoniasis, bacterial vaginosis and thrush produce overlapping symptoms and are treated differently, and the wider panel tells you which of the three you are dealing with rather than narrowing it to one.

When to test after exposure

From around 1 to 2 weeks. Symptoms, where they occur, can take anywhere from 5 to 28 days to appear, so a negative test very early after exposure does not close the question if symptoms develop later.

Your result, and what happens next

You get one report, emailed to you and to nobody else. It is the YourGenes patient report: colour coded, in plain language, with a line for every organism on your panel saying whether it was detected. There is no second document, and no separate practitioner version. This report is what your doctor reads too.

If trichomoniasis is detected, Epicentre does not treat it. We are a diagnostic laboratory. We collect samples, run tests and report results. We do not diagnose, prescribe medication or provide treatment, anywhere, including on WhatsApp. You have two equally good routes from here:

• Your own doctor, clinic or pharmacy clinic. Take the report. It names the organism, which is exactly what they need.
• An independent doctor we work with, who consults online or in person on sexual health results. She prescribes on her own responsibility, not as an Epicentre service.

Where to test

Walk in during those hours, no appointment and no doctor's referral. All three branches are closed on South African public holidays. If you would rather not come in, a home kit is couriered to you in discreet packaging and a free courier collects the sample.

Common questions