Why do I keep getting trichomoniasis?

Dear Scared,  

It appears that trichomoniasis is trying to trick you into more visits to the health care provider. It's hard to tell if you have trichomoniasis, a yeast infection, or something else entirely because the first two have similar symptoms. Trichomoniasis can return after treatment due to reinfection through sex or a lack of response to treatment. When untreated, trichomoniasis symptoms may come and go, similar to recurring yeast infections. That said, seeking the guidance of a health care provider can be important for getting the right diagnosis and proper treatment. 

What is trichomoniasis? 

Trichomoniasis, or “trich,” is a sexually transmitted infection (STI) caused by the parasite Trichomonas vaginalis. Both people with vaginas and people with penises can get trich. Only 30 percent of people who have trich ever develop symptoms, and during an infection, the symptoms often come and go. Common symptoms include: 

• Itching and irritation in the genitals. 
• Discomfort when peeing. 
• Pain or discomfort after ejaculation for those with a penis. 
• Abnormal discharge from the vagina or penis, specifically a clear, white, yellowish, or greenish discharge with a fishy smell from the vagina. 

List adapted from the U.S. Centers for Disease Control and Prevention 

What is a yeast infection? 

This, as the name suggests, is an infection that’s most often caused by a fungus called Candida. Anyone can get a yeast infection, regardless of genitalia. This fungus is a normal part of the body, but it becomes a problem when it grows too much. A yeast infection isn’t considered an STI because people can become infected through sex as well as by other means like taking antibiotics, being in a humid environment, or staying in wet clothing. The symptoms of a yeast infection can be similar to trich, but can also include: 

• A burning feeling during sex or when urinating.  
• Redness and swelling of the genitals. 
• Pain and soreness in the genitals. 
• Thick, white discharge from the vagina or penis. 

List adapted from Mayo Clinic and Healthline 

Yeast infection can develop into a recurring and chronic condition. Additionally, similar to trich, certain kinds of bacteria that lead to yeast infections can also be resistant to treatment or not thoroughly treated during the first infection. If this happens, more long-term treatment may be required. 

Can you get trichomoniasis again after being treated? 

While trich is curable, reinfection or persistent infection is possible. In general, there are two cases in which trich may not go away or it comes back after treatment. One possibility is reinfection through sex. After completing treatment, if you have sex without a condom with someone who has trich, whether they have symptoms or not, there’s a chance for you to be infected again. Within three months of receiving treatment, the reinfection rate is roughly one in five people. 

Another possibility is that your trich infection didn’t respond to treatment in the first place. This requires further consultation with a health care provider and the potential for another examination. Solutions in this case might include longer treatment or higher doses of medication. 

How can you prevent the transmission of trichomoniasis? 

Not having sex is the most effective way to prevent the transmission of trich. However, if you’re sexually active, consider using a condom to help prevent trich from spreading. Double-checking that the condom is being used properly every time to create a barrier between you and an uninfected person. You may also consider communicating with your partner(s) about your condition and encouraging them to get tested. This way, they can receive any potential treatment as early as possible. By taking these preventive measures, you can protect both yourself and others from unknowingly spreading an infection. 

Hopefully the only thing you have coming back in the future is a solid bill of health!