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Diagnosis of trichomoniasis: modern methods of detecting infection

smear under a microscope, image of trichomonads
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What is trichomoniasis?

Trichomoniasis is sexually transmitted disease, caused by the simplest microorganism Trichomonas vaginalis. It is transmitted mainly sexually and affects the genitourinary system. Trichomoniasis is one of the most common urogenital infections in the world, with more than 200 million cases reported each year, according to the WHO.

The peculiarity of the infection is often asymptomatic, especially in men. That's why timely diagnosis is critical for both treatment and prevention of further spread.

When to get diagnosed

Diagnosis of trichomoniasis is recommended:

  • if available symptoms (burning, itching, discharge)

  • at casual sexual contact without protection

  • at detection of other STIs (often combined with chlamydia, gonorrhea)

  • in case of pregnancy planning

  • at history of miscarriages or pregnancy complications

  • by referral from a gynecologist, urologist or venereologist

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doctor counseling patient about STIs

What symptoms does trichomoniasis cause?

In women:

  • copious, foamy, or yellowish-green vaginal discharge with an unpleasant odor

  • itching and burning in the vagina

  • pain when urinating

  • discomfort during sexual intercourse

  • sometimes - inflammation of the cervix

In men:

  • burning sensation when urinating

  • urethral discharge (often unnoticeable)

  • pain or discomfort in the perineum

  • in most cases — asymptomatic course

Methods for diagnosing trichomoniasis

MethodPrecisionComment
Smear microscopy~60–70%Fast and cheap method, effective at high concentrations of the pathogen
Cultural method (sowing)~80–95%Accurate, but takes time (up to 7 days)
PCR (polymerase chain reaction)over 95%High sensitivity and accuracy, detects pathogen DNA
ELISA (enzyme-linked immunosorbent assay)80–90%Detects antibodies or antigens to Trichomonas
Rapid testsup to 85%Convenient, but less accurate than PCR or culture methods
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How is the examination carried out?

  1. In women take vaginal swab or cervix

  2. In menurethral scraping or the first portion of urine

  3. Recommended to abstain from sexual contact 48 hours before delivery

  4. Do not use vaginal suppositories or antiseptics on the eve of the analysis

  5. The material is being collected in the morning, before urination (for men)

Advantages of the PCR method

PCR is the most accurate method diagnosis of trichomoniasis, because:

  • allows you to detect even single copies of the pathogen's DNA

  • can be held at any stage of the disease

  • does not depend on the presence of symptoms

  • suitable for simultaneous testing for multiple STIs

What to do after confirming the diagnosis

  • Start treatment at the same time as your partner

  • Most often prescribed metronidazole or tinidazole

  • Abstain from sexual activity during treatment

  • Re-examine through 2–3 weeks

  • Follow hygiene rules, avoid self-medication

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Why it is important to treat even asymptomatic trichomoniasis

  • Increases risk HIV transmission

  • May cause pelvic inflammatory disease

  • In men, it causes prostatitis, urethritis, infertility

  • In pregnant women - premature birth, infection of the newborn

  • Often causes repeated STIs or complicates their course

Trichomoniasis is not just an unpleasant infection, but a risk factor for serious complications. Timely testing, proper treatment, and shared responsibility of partners are the key to effective prevention and preservation of reproductive health.

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