Even if you think you know a lot about STIs, there’s a high chance you still have some questions. For example, what is trichomoniasis? Given that an estimated 3.7 million people in the United States have the illness, you wouldn’t be alone in thinking that most people haven’t even heard of it. According to the Centers for Disease Control and Prevention, this makes it the most prevalent STI that can be treated (CDC). Since awareness is crucial when it comes to STIs in general, we spoke to some specialists about all you need to know about trichomoniasis.

What is trichomoniasis?

Trichomonas vaginalis is a type of single-celled parasite that causes trichomoniasis (or protozoon). According to Ghananewsaid.net, it is alive and can be seen swimming around when examined under a microscope, according to ob-gyn Michael Cackovic of Ohio State Wexner Medical Center.

Yet, there is still much about trichomoniasis that is unknown, and little is being done to stop its spread. Despite the fact that trichomoniasis is quite widespread, the CDC, state and local health authorities do not require new cases to be reported when they are discovered. This implies that, in comparison to other STIs, public health initiatives aren’t making as much of an effort to monitor or stop its transmission. As a result, “we don’t have a lot of data on it [and] we don’t know a lot about it,” says Dr. Cackovic.

How do you get trichomoniasis?

These parasites are easily transferred from one person to another via genital contact and sexual activity—from the vagina to the penis, the penis to the vagina, and the vagina to the vagina. These parasites thrive in wet areas, particularly the urethra, vagina, and vulva, even though fluid isn’t necessary for transmission. (The fact that fluid exchange is not always necessary means that physical barriers like condoms do not completely safeguard against trichomoniasis.)

According to the CDC, trichomoniasis is more prevalent in those who have a vagina than in those who have a penis. Very simply, female anatomy makes you more vulnerable to trichomoniasis, just as it does with UTIs (and so many other health issues). The precise reason why those who have a vagina are more vulnerable is not well understood. Nevertheless, unlike the male anatomy, the female anatomy provides the entire lower genital tract (vulva, vagina, cervix, and urethra) for trichomoniasis parasites to inhabit (people with a penis usually get this infection just in the urethra, the CDC notes).

According to Dr. Cackovic, trichomoniasis and bacterial vaginosis frequently co-occur. If you already have B.V., your risk of developing trichomoniasis may further increase. According to Dr. Cackovic, one theory is that alterations in the vagina caused by one infection raise the likelihood of developing the other, but more research is required to be sure. Either way, the very frustrating fact of the matter is that it’s not rare to wind up with both of these illnesses at the same time.

What are the symptoms of trichomoniasis?

Despite how widespread trichomoniasis is, only 30% of those who have it experience symptoms. According to the Mayo Clinic, persons who have a penis are more likely to be asymptomatic than those who have a vagina. Even if you do experience symptoms, there is still uncertainty regarding the incubation period for trichomoniasis (i.e., how long after exposure symptoms begin to show). The CDC estimates that it can take anywhere between 5 and 28 days, though some people don’t have symptoms for a very long time.

Even if you don’t have any symptoms when you initially contract trichomoniasis, it’s likely that if it worsens enough and is left untreated, you will ultimately start to feel sick. Some trichomoniasis symptoms to watch out for if you have a vagina include:

obnoxious vaginal discharge
discharge that is white, gray, yellow, or green.
genital crimson
Itching and burning
discomfort during urination or sexual activity

Above all, the infection is most recognisable by its peculiar fishy odor. According to Dr. Cackovic, “[Trichomoniasis] has a very distinct, horrible smell. It is so obvious that occasionally an ob-gyn can detect it before inserting the speculum.

All told, it’s always a good idea to pay attention to what’s occurring with your genitals and get in touch with your ob-gyn if you notice any change in your discharge color and smell, or have vaginal pain or burning, adds Dr. Cackovic.

Are there negative effects from untreated trichomoniasis?

Unlike chlamydia and gonorrhea, which can lead to pelvic inflammatory disease and subsequent infertility if left untreated, trichomoniasis can’t travel up your reproductive tract and infect those organs. The parasites will stay localized, and may continue to multiply but not spread. However, according to the CDC, the infection can cause some complications for pregnant people such as early delivery and low birth weights.

In the early 1980s, a significant study involving almost 13,000 pregnant women discovered that trichomoniasis was linked to a 30% rise in preterm births and a 30% rise in low-birth-weight newborns. Although the specific cause is still unknown, one idea suggests that trichomoniasis may damage the amniotic membrane, increasing the likelihood that it would rupture early in the pregnancy. Dr. Cackovic claims, “On two separate times in my career, I’ve seen it colonized in amniotic fluid,” while the available scientific data is still quite limited.

Due to the vaginal inflammation it produces, trichomoniasis may also raise your risk of contracting another STI (and spreading it to others), including HIV.

How do you get tested for trichomoniasis?

According to the Mayo Clinic, doctors use a sample of urine or vaginal fluid to determine whether a patient has trichomoniasis. According to Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology at Yale Medical School, trichomoniasis testing used to involve cultivating a culture, but more recent, quicker tests are more frequently employed now.

You must request the trichomoniasis test separately because it isn’t often included in everyone’s STD screening panel, according to Dr. Minkin. Otherwise, if you have symptoms, your ob-gyn will advise you to get it (like the unique odor). Ask your ob-gyn if it could be a good idea for you to request the test even if you aren’t exhibiting any symptoms. If you’re engaging in unprotected sex outside of a mutually monogamous relationship, Dr. Minkin advises being checked out. The same is true if you intend to become pregnant because, as we already indicated, trichomoniasis can result in difficulties.

How is trichomoniasis treated?

The CDC reports that the good news is that trichomoniasis may be treated with medications, usually in a single dose. Trichomoniasis is treated with the same oral medicines used to treat B.V., metronidazole or tinidazole.

One extra-important point here: Regardless of symptoms, if you or a sexual partner of yours has trichomoniasis, you both need to be treated to prevent unintentionally spreading it to one other or to someone else. According to the CDC, about one in five trichomoniasis patients relapse within three months of treatment. It is crucial that everyone having intercourse with a trichomoniasis patient likewise take those medications.

Also, Dr. Cackovic advises returning to the doctor two weeks after treatment to confirm that the condition has improved. He continues by saying that trichomoniasis can occasionally go away without treatment, especially in those with a penis. Yet, if left untreated, trichomoniasis can frequently persist for months or even years in those who have a vagina.