Trichomoniasis testing and treatment (Trichomonas vaginalis (TV) testing and treatment)
Testing for the sexually transmitted infection trichomoniasis and, if found, treating it (and partners) with antibiotics.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Trichomoniasis is a treatable STI caused by a parasite; many people have no symptoms, so testing matters if you may have been exposed.
- Testing is usually a swab or urine sample; the most accurate tests detect the parasite's genetic material.
- Treatment is usually the antibiotic metronidazole — avoid alcohol during it and for at least 24 hours after.
- Partners need treating too, and you should avoid sex until you and your partner(s) have completed treatment, to prevent reinfection.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Finds an infection that often causes no symptoms
Self-treating without testing — symptoms overlap with other infections, so a diagnosis matters.
You can carry on as normal. Results are usually available within a few days, depending on the test used.
Clear advice on completing treatment, avoiding alcohol, and when sex is safe again.
You can carry on as normal. Results are usually available within a few days, depending on the test used.
Begin the antibiotic as prescribed. Avoid alcohol during treatment and for at least 24 hours after finishing.
Symptoms usually improve. Avoid sex until you and your partner(s) have completed treatment to prevent reinfection.
If given a single dose, avoid sex for 7 days afterwards, as advised.
What is trichomoniasis testing and treatment?
Trichomoniasis is a sexually transmitted infection (STI) caused by a tiny parasite called Trichomonas vaginalis. It is passed on through sex without a condom and by sharing sex toys. Testing finds out whether you have it; treatment is a course of antibiotics that usually clears it.
Many people have no symptoms at all, which is why testing matters if you think you may have been exposed. When there are symptoms, women may notice abnormal vaginal discharge, soreness, itching or discomfort passing urine; men may notice discharge from the penis or discomfort passing urine.
Testing is usually a swab (from the vagina or, in some cases, from the urethra) or a urine sample. The most accurate tests look for the parasite's genetic material.
Treatment is almost always an antibiotic called metronidazole, taken as a short course or sometimes a single larger dose. Your current and recent sexual partners need treating too, even if they have no symptoms, to stop the infection bouncing back between you. Sexual health care is confidential, and clinics can help tell partners without naming you.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Self-taken or clinician-taken swab
A swab from the vagina (often self-taken) or, in some men, from the urethra, sent to the lab to look for the parasite.
Urine sample
A urine sample can be used, more often in men, to test for the infection.
NAAT (genetic) testing
Tests that detect the parasite's genetic material (nucleic acid amplification tests) are the most sensitive and increasingly used.
Microscopy in clinic
Some clinics can look at a sample under a microscope for a quicker result, though this misses more infections than genetic testing.
Preparing for your treatment
- If you can, avoid passing urine for an hour or so before a urine test, as the clinic may advise.
- Mention any current symptoms, recent partners and when you last had sex.
- Tell the clinician if you are or might be pregnant, as this affects treatment choice.
- List any medicines and allergies, especially previous reactions to metronidazole.
- Plan not to drink alcohol during metronidazole treatment and for at least 24 hours after.
- Be ready to discuss telling partners; the clinic can help do this confidentially.
- Ask about a full sexual-health check, as other STIs can be present at the same time.
What happens
At a sexual health clinic or GP, you will be asked about symptoms and recent sexual contact. A sample is taken — a swab (often one you can do yourself) or a urine sample — and sent to the laboratory. Some clinics can also examine a sample under a microscope for a faster, though less complete, result.
If trichomoniasis is found, you are prescribed antibiotics, usually metronidazole, as a short course or a single dose. You will be advised on avoiding alcohol, avoiding sex until treatment is complete, and getting partners treated.
Because symptoms often overlap with other infections, you will usually be offered testing for other STIs at the same time. The clinic can help you tell partners without revealing your identity.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Self-treating without testing — symptoms overlap with other infections, so a diagnosis matters.
- Using an old or unconfirmed result instead of testing again when symptoms return.
- Relying on a single in-clinic microscopy result to rule out infection when symptoms strongly suggest it, as more sensitive testing may be needed.
- Treating only yourself and not your partner(s), which leads to reinfection.
Delay or rearrange if…
- You are or might be pregnant — testing still applies, but treatment choice and timing are discussed with the maternity team.
- You have had a recent severe reaction to metronidazole.
- You cannot keep tablets down due to vomiting, so the regimen can be reconsidered.
- You drink alcohol regularly and need clear advice before starting metronidazole.
Alternatives to discuss
- No immediate treatment with re-testing if the diagnosis is uncertain.
- A different 5-nitroimidazole antibiotic or an extended course if standard treatment fails.
- A full STI screen to identify another cause of the symptoms.
- Referral to a specialist sexual health clinic for persistent or resistant infection.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Finds an infection that often causes no symptoms
- Treatment usually clears the infection quickly and reliably
- Reduces the risk of complications, including in pregnancy
- Reduces the risk of passing the infection to partners
- Usually done alongside testing for other STIs, giving a fuller picture
- Free and confidential on the NHS
Risks & complications
- Metronidazole can cause nausea, an upset stomach or a metallic taste
- Feeling unwell if you drink alcohol during or just after treatment
- The mild discomfort or inconvenience of testing
- Needing partners treated to avoid reinfection
- A test that misses the infection, so a repeat is sometimes needed
- Reinfection if a partner is not treated
- Treatment not fully working, needing a different or longer course
- An allergic reaction to the antibiotic
- More significant side effects from metronidazole
- Persistent infection that is harder to treat
The main practical points are avoiding alcohol with metronidazole, making sure partners are treated, and not having sex until treatment is finished — otherwise the infection can bounce back. Tell the clinician if you are pregnant, as this guides which treatment is used. No test is perfect, so mention if symptoms persist after treatment.
Published figures to discuss
Trichomoniasis is usually cured with standard antibiotics, but exact cure and failure figures vary with the regimen, whether partners are treated, and the chance of reinfection. Resistance to first-line antibiotics is uncommon but does occur. We describe outcomes in cautious words rather than precise percentages, because individual results depend strongly on completing treatment and treating partners.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Cure with standard metronidazole treatment | Usually high when taken correctly | Treatment failure is more likely if doses are missed, vomiting occurs, resistance is present or partners are untreated. | NHS — Trichomoniasisnhs.ukSource-linked context |
| Reinfection from an untreated partner | Common preventable cause | All current partners usually need treatment, and sex should be avoided until treatment is complete. | NHS — Trichomoniasisnhs.ukSource-linked context |
| Test misses infection | Depends on test type | Modern NAAT tests are more sensitive than wet microscopy; the right sample and timing matter. | NHS — Trichomoniasisnhs.ukSource-linked context |
| Metronidazole side effects or alcohol reaction | Common counselling point | Nausea and metallic taste are common; patients are usually advised to avoid alcohol during treatment and shortly afterwards. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery from the test. After treatment, symptoms usually improve within about a week. The key is completing the course, avoiding sex until you and partners are treated, and avoiding alcohol with the medicine.
- Symptoms easing over the week after starting antibiotics
- A metallic taste or mild stomach upset from metronidazole
- No lasting effects once treatment is complete
- Needing to wait before having sex again until treatment finishes
Aftercare
- Take the full course of antibiotics exactly as prescribed.
- Do not drink alcohol during treatment and for at least 24 hours after finishing.
- Avoid sex until you and your partner(s) have completed treatment.
- If given a single dose, avoid sex for 7 days afterwards.
- Make sure current and recent partners are tested and treated.
- Take metronidazole with or after food if it upsets your stomach.
- Return to the clinic if symptoms do not settle or come back.
- Consider testing for other STIs if not already done.
- Your full antibiotic course collected and a plan to finish it
- A reminder to avoid alcohol during and 24 hours after treatment
- A plan to tell and arrange treatment for partners
- An agreement to avoid sex until treatment is complete
- The clinic's contact details if symptoms persist
- Other STI testing arranged if needed
⚠ Get urgent help if…
- Symptoms that do not improve, or come back, after finishing treatment
- Severe pelvic or lower tummy pain, or fever (possible spread of infection)
- Signs of an allergic reaction to the antibiotic, such as a rash or swelling
- In pregnancy: any vaginal bleeding, severe pain, or signs of early labour
- Severe or persistent vomiting that stops you keeping the medicine down
- Pain or difficulty passing urine that is getting worse
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A clear result means the infection has been found and can be treated, or ruled out. After treatment, a good outcome is symptoms settling and the infection clearing, usually without the need for a routine repeat test if you take the antibiotics correctly.
No test is perfect, so a negative result does not completely rule out infection if symptoms continue, and reinfection is possible if a partner is not treated. If symptoms persist after treatment, the clinic will re-check rather than assume it has cleared.
Once treated and with partners treated, the infection usually clears for good — but trichomoniasis can be caught again from a new or untreated partner. There is no lasting immunity. Using condoms and making sure partners are treated reduces the chance of reinfection.
Related tests, treatments or support
Testing for trichomoniasis is usually combined with a full sexual-health screen, because other STIs (such as chlamydia, gonorrhoea or bacterial vaginosis) can be present at the same time and cause similar symptoms. Treating partners is an essential part of the process. In pregnancy, care is coordinated with your maternity team.
Follow-up & long-term care
If you take the antibiotics correctly and symptoms settle, a routine test-of-cure is not usually needed. You should go back if symptoms persist or return, if a partner could not be treated, or if you are pregnant and need closer monitoring. The clinic will follow up any other STI results.
Repeat, follow-on and what comes next
- If symptoms persist after treatment, a repeat test and a different or longer antibiotic course may be needed.
- Reinfection from an untreated partner is a common reason symptoms return — it is not always treatment failure.
- A routine test-of-cure is not usually needed if you take the antibiotics correctly and symptoms settle.
- Persistent infection occasionally needs specialist input and alternative regimens.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear advice on completing treatment, avoiding alcohol, and when sex is safe again.
- Support to test and treat partners confidentially.
- An offer of full STI screening at the same visit.
- A clear route back to the clinic if symptoms persist or return.
- Coordinated care with the maternity team in pregnancy.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The type of test used (in-clinic microscopy vs more sensitive laboratory genetic testing).
- Whether it is part of a wider STI screen or a single test, if done privately.
- The consultation fee, if using a private service.
- The cost of the antibiotic, if obtained privately.
- Any follow-up appointment if symptoms persist or treatment needs changing.
- Which test is used and how results are given (if private)
- Whether testing for other common STIs is included
- The cost of treatment and whether partner treatment is supported
- A consultation/follow-up if symptoms persist
- What happens if the first treatment does not work
- Confirmation of confidentiality and how partner notification is handled
On the NHS? Testing and treatment for trichomoniasis are free and confidential on the NHS at sexual health clinics and many GP practices; private testing is available but the NHS route is free.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being told to avoid alcohol with metronidazole.
- Not understanding that partners must be treated to prevent reinfection.
- No advice on when it is safe to have sex again.
- Not being offered testing for other STIs that cause similar symptoms.
- Not being told that no test is perfect and what to do if symptoms persist.
Marketing red flags
- Treating symptoms without testing or without offering a broader STI check.
- Selling 'one-off' tests without explaining limitations or partner treatment.
- Over-promising a guaranteed cure without mentioning reinfection.
- Not addressing pregnancy or alcohol advice clearly.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Which test are you using, and how long until I get the result?
- Will a single dose or a longer course be better for me?
- How will my partner(s) be tested and treated?
- When is it safe to have sex again?
- Should I be tested for other STIs at the same time?
- What should I do if my symptoms don't settle after treatment?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Can I have trichomoniasis without symptoms?
How is it treated?
Do my partners need treating?
When can I have sex again?
Is it dangerous in pregnancy?
Why avoid alcohol with metronidazole?
Is testing confidential?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Trichomoniasis NHS — Trichomoniasis treatment BASHH — UK national guideline on Trichomonas vaginalis (2021) NHS Specialist Pharmacy Service — Metronidazole in sexual health services NHS Scotland Right Decisions — Trichomonas vaginalis
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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