From the Guidelines
Yes, someone can contract Trichomoniasis without sexual intercourse, although sexual transmission is the most common route. Trichomoniasis is caused by the parasite Trichomonas vaginalis and can occasionally be transmitted through sharing damp towels, wet clothing, or bathing suits with an infected person 1. It can also potentially spread through sharing sex toys that haven't been properly cleaned. Rarely, the infection might be acquired from toilet seats or other surfaces, though the parasite can only survive for a short time outside the body. Babies can also contract the infection during birth if the mother is infected.
Key Points to Consider
- Symptoms of trichomoniasis include itching, burning, redness or soreness of the genitals, discomfort during urination, and unusual discharge with an unpleasant odor.
- Treatment typically involves a single dose of metronidazole (2 grams) or tinidazole (2 grams), or metronidazole 500 mg twice daily for 7 days, as recommended by the CDC 1.
- All sexual partners should be treated simultaneously to prevent reinfection, and individuals should abstain from sex until treatment is complete and symptoms have resolved 1.
Important Considerations for Treatment
- Metronidazole is the only oral medication available in the United States for the treatment of trichomoniasis, with cure rates of approximately 90%-95% 1.
- Metronidazole gel is not recommended for use due to its lower efficacy compared to oral preparations 1.
- Ensuring treatment of sex partners might increase the cure rate, and treatment of patients and sex partners results in relief of symptoms, microbiologic cure, and reduction of transmission 1.
From the FDA Drug Label
Since trichomoniasis is a sexually transmitted disease with potentially serious sequelae, partners of infected patients should be treated simultaneously in order to prevent re-infection [see Clinical Studies ( 14. 1)]. T. vaginalis infection is a venereal disease.
Trichomoniasis Transmission: The FDA drug labels indicate that trichomoniasis is a sexually transmitted disease.
- There is no direct information in the drug labels that supports the idea that someone can contract Trichomoniasis without sexual intercourse.
- The labels emphasize the importance of treating sexual partners to prevent reinfection, further suggesting that the disease is primarily spread through sexual contact 2, 3.
From the Research
Transmission of Trichomoniasis
- Trichomoniasis is primarily transmitted through sexual intercourse, as stated in the study 4.
- However, there have been cases of nonsexual transmission, including a reported case of probable grandmother to granddaughter transmission 5.
Nonsexual Transmission
- Nonsexual transmission of trichomonas is rare, but there have been numerous case reports and studies showing that it does occur 5.
- The study 5 highlights the need to broaden the search for contacts beyond sexual transmission.
Treatment and Prevention
- The treatment with metronidazole or tinidazole is recommended for trichomoniasis, but cure failures remain problematic due to noncompliance, reinfection, and/or lack of treatment of sexual partners 4.
- Strategies for protection, including sexual behavior, condom usage, and therapy, have not contributed to the decrease in disease prevalence, pointing to the need for innovative approaches 4.
- A study 6 found that compliance with single-dose treatment was significantly better than long-duration oral regimen and has a significant relation with side effects of the treatment.
Special Cases
- A case report 5 presented a case of probable nonsexual transmission of trichomonas, where the patient had no prior sexual contact for the last 11 years.
- The patient required high-dose metronidazole for seven days for treatment, highlighting the need for effective treatment options for nonsexual transmission cases.