Trichomoniasis (commonly referred to as “trich”) is a common sexually transmitted disease (STD) caused by a parasite called Trichomonas vaginalis. Most instances of trichomoniasis can be successfully treated with a simple course of antibiotics — however, some people may experience repeated bouts of this STD that can be more difficult to eliminate. Why does this happen?
Let’s talk about some of the possible reasons trichomoniasis won’t go away after treatment.
7 reasons trichomoniasis won’t go away
Some of the reasons why trichomoniasis won’t go away include:
- Reinfection by your partner
- Metronidazole-resistant Trichomonas
- Incomplete or inadequate treatment
- New infection from a new partner
- A different, undiagnosed STD
- An asymptomatic infection
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Now, let’s talk in depth about each of these possible reasons.
Reason #1: You got reinfected by your partner
It’s possible for you to get reinfected with trichomoniasis by your sexual partner even after receiving treatment. In some cases, the infection can be passed back and forth between partners.
According to the CDC, approximately 1 in 5 people get reinfected with trichomoniasis after receiving treatment. The best way to avoid getting reinfected by your partner is to abstain from having sex while both you and your partner(s) receive antibiotic treatment. You should also get tested for trichomoniasis again around 3 months after your initial course of treatment in order to make sure you haven’t gotten reinfected.
Reason #2: You have metronidazole-resistant trichomoniasis
Most cases of trichomoniasis can be treated with a single dose of an antibiotic and antiprotozoal medication called metronidazole. This is the first line of treatment against this STD — according to a study published by the journal Clinical Microbiology Reviews, oral or intravenous metronidazole is effective in curing 85 to 95 percent of trichomoniasis cases.
Although relatively rare, there are cases in which Trichomonas vaginales can become resistant to metronidazole. This can be one of the reasons why trichomoniasis won’t go away, even after treatment. In these cases, your doctor may recommend a longer course of treatment, an increased dosage, or trying a different medication such as tinidazole.
Reason #3: You didn’t complete your course of antibiotics
It’s not uncommon for people to stop taking their antibiotics once they start to feel better, but before completing the treatment as it was prescribed by their doctor. Most antibiotics start acting within 2 to 3 days of the start of the treatment, but that doesn’t mean that they have fully eliminated the disease by then.
According to a study published by the journal Infectious Diseases in Clinical Practice, approximately 40 percent of patients who require antibiotics don’t adhere to their treatment. This can lead to recurrent infections and antibiotic-resistant microbes. If your doctor prescribes antibiotics to treat trichomoniasis — or any other disease — it’s important to take them until you finish your treatment.
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Reason #4: You have a different STD
According to the Cleveland Clinic, the symptoms of trichomoniasis can include:
- Vagina discharge that can be thin or foamy; white, yellow, or greenish; and have a bad smell
- Pain or irritation on your genitals
- White penile discharge
- Burning or painful sensation when you urinate
- Painful intercourse
- Pain or burning after ejaculation
Other STDs, such as chlamydia and gonorrhea, can cause very similar symptoms. If you’re still experiencing symptoms of trichomoniasis after receiving treatment, it’s possible that they’re actually symptoms of a different, undiagnosed STD. It’s important to get screened for different STDs regularly — you can learn more about STD multi-testing at STDWatch.com.
Reason #5: Your new partner also has trichomoniasis
As we mentioned above, it’s possible to get reinfected with trichomoniasis and pass the infection back and forth with the same partner. But if you have a new partner after treatment, it’s also possible for them to have trichomoniasis and pass it to you.
According to the Pan American Health Organization (PAHO), there are nearly 150 million new cases of trichomoniasis worldwide each year. So it’s actually pretty easy to see how you could get trichomoniasis from two or more separate partners, even after receiving treatment. That’s another good reason why you should always get tested for STDs if you have a new partner.
Reason #6: Your received an inadequate treatment
Both oral and intravenous metronidazole are very effective against trichomoniasis; however, vaginal metronidazole can be less effective against this STD, according to a study published by the journal Sexually Transmitted Diseases.
Vaginal administration of metronidazole could be unable to reach the necessary concentration to kill the parasite. Additionally, certain body structures, such as Skene’s glands (which are located near the urethral opening and produce natural lubrication in women) can act as an infection reservoir.
Reason #7: You had an asymptomatic infection
If you received treatment for trichomoniasis and didn’t receive a follow-up test, you could have had a new asymptomatic infection that went undetected. If this asymptomatic infection becomes symptomatic, you may think that it’s a relapse of your previous infection, when in reality you’re experiencing the symptoms of a new case of trichomoniasis.
The best way to detect trichomoniasis to make sure you receive the appropriate treatment is through regular STD testing. Nowadays, it’s very easy to test for STDs (including trichomoniasis) at home, which allows you to protect your privacy and comfort. STD testing is the best way to protect yourself and your partner(s) from any possible complications.
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- Trichomoniasis — CDC Fact Sheet - cdc.gov
- Treatment of Infections Caused by Metronidazole-Resistant Trichomonas vaginalis - ncbi.nlm.nih.gov
- Noncompliance in Current Antibiotic Practice - journals.lww.com
- Trichomoniasis - my.clevelandclinic.org
- Trichomoniasis: Frequently Asked Questions - www3.paho.org
- A pilot study of metronidazole vaginal gel versus oral metronidazole for the treatment of Trichomonas vaginalis vaginitis - pubmed.ncbi.nlm.nih.gov