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Sexual health testing guide · 2026
Trichomonas is the most common curable non-viral STI worldwide and is still frequently diagnosed with a method that misses half of cases.
Trichomonas vaginalis is a parasite and the most common curable non-viral STI globally. It should be diagnosed by nucleic acid amplification testing (NAAT/PCR), which is substantially more sensitive than the wet-mount microscopy still widely used — microscopy misses a large share of infections, particularly in men, where it performs poorly. Most infections in men and a majority in women cause no symptoms. Treatment is with nitroimidazole antibiotics, all sexual partners must be treated, and retesting around three months later is recommended because reinfection is common.
| Preferred method | NAAT/PCR — far more sensitive than wet-mount microscopy |
|---|---|
| Sample (women) | Vaginal swab, which can be self-collected |
| Sample (men) | First-void urine or urethral swab; microscopy performs poorly in men |
| Partners | All partners require treatment, symptomatic or not |
| Retest | Around 3 months after treatment, due to high reinfection rates |
| Price | Listed on the MedEx STD and STI testing page and the lab test catalogue |
Wet-mount microscopy looks for motile organisms under a microscope, and it is quick and cheap. Its problem is sensitivity: it detects only a proportion of infections in women and performs markedly worse in men, where organism numbers are lower. Motility also declines rapidly after collection, so any delay reduces yield further.
NAAT detects the parasite’s genetic material and is substantially more sensitive from urine and from self-collected vaginal swabs. Where trichomonas is a real consideration, NAAT is the test to request.
Culture is more sensitive than microscopy but slower than NAAT and is now rarely the first choice. Check which method a provider uses before booking — the MedEx lab directory lists available methods.
In women, when symptomatic: a frothy discharge that may be yellow-green, an unpleasant odour, itching or soreness, discomfort on passing urine, and pain during sex. A majority of infections, however, produce no symptoms.
In men, infection is usually asymptomatic. When symptoms occur they resemble any urethritis: discharge, irritation or discomfort on passing urine. Men are frequently the untreated reservoir that causes reinfection in a partner.
Untreated infection is associated with increased risk of HIV acquisition and transmission, and in pregnancy with preterm birth and low birth weight. It is also associated with pelvic inflammatory disease, particularly in the context of HIV. These associations are the main reason trichomonas is worth finding even when it is not causing distress.
Ask for NAAT rather than microscopy — it finds what microscopy misses.
Routine screening of asymptomatic people at low risk is not generally recommended. If you are unsure which panel fits your situation, the STI PCR panel guide maps symptoms to tests, or discuss it when booking private testing.
Treatment is with a nitroimidazole antibiotic prescribed by a clinician. Current guidance for women favours a multi-day regimen over a single dose, based on trial evidence showing lower recurrence. Regimens differ in pregnancy and for people with allergy, so this is not a situation for self-medication.
Three things prevent recurrence:
Retesting is recommended around three months after treatment because reinfection rates are high. Arrange treatment and follow-up through a doctor consultation, with prescriptions available via medicine express where appropriate.
No. Wet-mount microscopy misses a large share of infections, particularly in men where organism numbers are lower, and sensitivity falls further with any delay before examination. NAAT or PCR is substantially more sensitive.
Yes, and infection in men is usually asymptomatic. Untreated male partners are the most common reason a woman is reinfected after treatment.
When present: a frothy discharge that may be yellow-green, an unpleasant odour, itching or soreness, discomfort on passing urine and pain during sex. A majority of infections cause no symptoms at all.
Yes, all sexual partners should be treated regardless of symptoms, and sex should be avoided until everyone has completed treatment.
Yes, around three months later. Reinfection rates are high, most often from an untreated partner.
It has been associated with preterm birth and low birth weight. Treatment regimens differ in pregnancy, so it should be managed by a clinician.
Partners need treating too, or the infection comes straight back.
Medical disclaimer: This article is general health information and does not replace medical advice, diagnosis or treatment. Laboratory reference ranges differ between laboratories and results must be interpreted alongside your symptoms, medicines and medical history. Speak with a qualified clinician before starting, stopping or changing any treatment. Service details, inclusions and prices can change — confirm them with MedEx before booking.
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