What are the symptoms of trichomoniasis in adults, including pregnant women?

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Symptoms of Trichomoniasis in Adults

Most men infected with Trichomonas vaginalis are asymptomatic, while many women present with a diffuse, malodorous, yellow-green vaginal discharge accompanied by vulvar irritation, though some women also have minimal or no symptoms. 1

Symptoms in Women

Symptomatic women typically present with:

  • Diffuse, malodorous, yellow-green vaginal discharge (characteristic presentation) 1
  • Vulvar irritation and inflammation 1
  • Vaginal discharge may be frothy in appearance 2
  • Vaginitis and cervicitis 3, 4
  • Vaginal soreness 4
  • Dyspareunia (painful intercourse) 2
  • External dysuria (painful urination) 2

However, a significant proportion of infected women remain asymptomatic or have minimal symptoms, making screening important in high-risk populations 1, 3

Symptoms in Men

The majority of men with T. vaginalis infection are asymptomatic, which contributes to ongoing transmission 1

When symptomatic, men may develop:

  • Nongonococcal urethritis (NGU) 1, 5
  • Urethral discharge 3

Special Considerations in Pregnant Women

Pregnant women with trichomoniasis present with the same symptoms as non-pregnant women (malodorous yellow-green discharge with vulvar irritation when symptomatic) 1

Critical pregnancy-related complications include:

  • Premature rupture of membranes 1
  • Preterm labor and preterm delivery 1
  • Low birth weight infants 1

These adverse pregnancy outcomes make identification and treatment particularly important in pregnant women, even though many remain asymptomatic 1

Clinical Pitfalls

The high rate of asymptomatic infection in both sexes (particularly men) means that:

  • Screening based solely on symptoms will miss many cases 3
  • Sexual partners of infected individuals should be treated regardless of symptoms 1, 6
  • Failure to treat asymptomatic partners leads to reinfection 6

Additional health implications beyond symptoms:

  • Increased risk of HIV acquisition and transmission in both men and women 6, 3, 5
  • Potential association with cervical neoplasia in women 6, 5
  • Contribution to male factor infertility 5
  • Atypical pelvic inflammatory disease 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Treating vaginitis.

The Nurse practitioner, 1999

Research

Trichomoniasis: clinical manifestations, diagnosis and management.

Sexually transmitted infections, 2004

Research

Trichomoniasis: under control or undercontrolled?

American journal of obstetrics and gynecology, 2004

Guideline

Treatment of Trichomonas Vaginalis Infection

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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