What is trichomoniasis (trich) in teens?

Trichomoniasis is a common sexually transmitted infection (STI). It’s also known as trich. It can cause vaginal redness and swelling (inflammation) in teens assigned female at birth. In teens of either sex, it can cause pain when peeing (urinating). Because only about 30 out of 100 people infected have any symptoms, teens at risk for STIs should be screened for trich. Without treatment, the infection can go on for years.

This STI is not a life-limiting illness. It is often easy to cure. But it's important to get it treated right away. That’s because trich can make it easier for a teen assigned female at birth to get HIV during sex. During pregnancy, the infection is linked to preterm birth and babies who are smaller than normal. It is easily curable.

What causes trich in a teen?

Trich is caused by a parasite (Trichomonas vaginalis). Trich is passed from person to person through unprotected sexual contact. Both sexes can get this infection. People assigned female at birth are most likely to have an infection in their vagina or vulva. People assigned male at birth are most often infected in their urethra. This is the tube inside the penis that carries semen as well as urine.

Which teens are at risk for trich?

A teen is at risk for trich if they have unprotected sex with someone who has trich. Experts believe that at least 1 in 4 new infections in both adults and children occur in teens assigned female at birth.

What are the symptoms of trich infection in a teen?

Most people who have a trich infection don't have symptoms. If symptoms occur, they may start from a few days to months after infection with the parasite.

Symptoms in teens assigned female at birth can include:

• Itching or irritation in the vagina 

• A bad-smelling discharge from the vagina that is frothy and yellow or green

• Burning feeling in the vagina

• Pain or discomfort when peeing and during sex

Symptoms in teens assigned male at birth can include:

• Irritation and itching in the penis

• A discharge of pus from the penis 

• Pain or discomfort when peeing and during sex

The symptoms of trich can seem like other health conditions. Make sure your teen sees their healthcare provider for a diagnosis.

How is trich diagnosed in a teen?

The healthcare provider will ask about your teen’s symptoms and health history. They may also ask about your teen’s sexual history. They will give your teen a physical exam. The physical exam may include an exam of the genitals. They may have a pelvic exam to look for small red sores in the vagina. These symptoms are not specific. So a trich diagnosis depends on identifying the parasite under a microscope. Or more recently, it is diagnosed by looking for its DNA using NAAT (nucleic acid amplification testing) technology. NAAT of either urine, vaginal, cervical, or urethral samples is the most reliable test for trich.

How is trich treated in a teen?

Without treatment, the infection can go on for years. It can infect other parts of the genital tract. Treatment is done with antibiotics. Your teen's healthcare provider will prescribe an antibiotic medicine called metronidazole or tinidazole to treat the infection. Make sure your teen:

• Takes all the medicine as prescribed, even if they feel better

• Doesn’t drink any alcohol while on metronidazole. This can make them very sick

• Tells their provider about a pregnancy or possibility of one because some medicines should not be taken during the first trimester of pregnancy                                         

About 1 in 5 people get the infection again after being treated, either from a sexual partner or because the antibiotic course didn't cure it. Your teen's partner should be treated at the same time. Neither one should have sex until the treatment is finished and symptoms have gone away. The current advice is to retest your teen 3 months after treatment. This is to make sure that the infection is gone.

Talk with your teen’s healthcare providers about the risks, benefits, and possible side effects of all medicines.

How can I help prevent trich in my teen?

The safe sex habits that your teen needs to prevent trich are the same ones that can prevent any STI. Have a talk with your teen about prevention. Teens can prevent a trich infection by:   

• Not having sex. The most certain way to prevent trich and other STIs is to not have sex.

• Asking about a person’s sexual history.  This should be done before having sex. Advise your teen that if they are planning to have sex with someone, the teen should ask about the partner's sexual history. It's best if they both agree to get tested for STIs before having sex.

• Having protected sex.  Talk with your teen about how to have safe and protected sex. They should always use a new latex condom for sex. Condoms may help reduce the risk of getting or spreading trich. But it’s important to note that condoms may not always protect against trich infection. IUDs, birth control shots, a diaphragm, spermicides, douching, and birth control pills don't prevent infection.

When should I call my teen’s healthcare provider?

Call the healthcare provider if your teen:

• Has symptoms that don’t get better, or get worse

• Has new symptoms

• May be a victim of sexual abuse

Key points about trichomoniasis in teens

• Trichomoniasis (trich) is a common sexually transmitted infection (STI).

• Most people who have a trich infection don't have symptoms. So it is important to screen for it in at-risk teens.

• Symptoms can include irritation, fluid discharge, pain when peeing, and pain during sex.

• Treatment of trich is done with medicine. Your teen's healthcare provider may prescribe an antibiotic to treat the infection.

• About 1 in 5 people get the infection again after being treated. Without treatment, the infection can linger for years.

• Your teen's partner should be treated at the same time. Neither one should have sex until the treatment is finished and symptoms have gone away. 

• The safe sex habits that your teen needs to prevent trich are the same ones that can prevent any STI. Talk with your teen about prevention and safe sex.

Next steps

Tips to help you get the most from a visit to your teen’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your teen.

• Know why a new medicine or treatment is prescribed and how it will help your teen. Also know what the side effects are and when they should be reported.

• Ask if your teen’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your teen does not take the medicine or have the test or procedure.

• If your teen has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your teen’s provider after office hours. This is important if your teen becomes ill and you have questions or need advice.