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Trichomoniasis is a topic covered in the 5-Minute Clinical Consult.

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  • Sexually transmitted urogenital infection caused by a pear-shaped, parasitic protozoan
  • Causes vaginitis/urethritis in women, nongonococcal urethritis in men
  • In pregnancy, increases risk of preterm labor, preterm premature rupture of membranes, small for gestational age infant, and possibly stillbirth
  • Synonym(s): trich; trichomonal urethritis


  • The most common curable sexually transmitted infection (STI); in 2008, >275 million new cases worldwide, over half of curable STIs (1)
  • Estimated 1.1 million new cases annually in the United States
  • 10–25% of vaginal infections
  • 1–17% of cases of NGU in males; reported prevalence among men without urethritis ranges from 0% to 8%.
  • Predominant age: middle-aged adults
    • Rare until onset of sexual activity
    • Common in postmenopausal women; age is not protective and long-term carriage is common.
  • Women have higher prevalence (1.5 to 4.4 times more than men) (2).

Pediatric Considerations
Rare in prepubertal children; diagnosis should raise concern of sexual abuse.

  • 3.1% of all U.S. women age 25 to 49 years; 1.5% of U.S. women age 15 to 24 years
  • Racial disparity demonstrated
    • 1.3% of white, non-Hispanic women
    • 1.8% of Mexican American women
    • 13.3% of black, non-Hispanic women

Etiology and Pathophysiology

  • Trichomonas vaginalis: a pear-shaped, flagellated, parasitic protozoan
  • Grows best at 35–37°C in anaerobic conditions at pH of 5.5 to 6.0
  • STI, but nonsexual transmission is possible because organism can survive several hours in moist environment.

No known genetic considerations

Risk Factors

  • Multiple sexual partners
  • Unprotected intercourse
  • Lower socioeconomic status
  • Other STIs
  • Untreated partner with previous infection
  • Use of douching or feminine powders

General Prevention

  • Use of male or female condoms
  • Limiting numbers of sexual partners
  • Male circumcision may be protective (3)[B].

Commonly Associated Conditions

  • Other STIs, including HIV
  • Bacterial vaginosis

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Stephens, Mark B., et al., editors. "Trichomoniasis." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116616/all/Trichomoniasis.
Trichomoniasis. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116616/all/Trichomoniasis. Accessed April 26, 2019.
Trichomoniasis. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116616/all/Trichomoniasis
Trichomoniasis [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 26]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116616/all/Trichomoniasis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Trichomoniasis ID - 116616 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116616/all/Trichomoniasis PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -