Trichomoniasis in Men: Symptoms, Tests and 7-Day Treatment in Chennai

Written and medically reviewed by Dr Shah Dupesh, MBBS, DCE, FASM, Consultant Andrologist & Sexologist, Chennai · Last reviewed: 7 October 2026

Been told you have trichomonas? Call 97907 83856 or message me on WhatsApp. Send a message any time; we reply when we open, and you are seen in private, by me, in T Nagar.

Hello! Vanakkam and Namaste. This is Dr Shah Dupesh, consultant sexologist in Chennai.

Trichomoniasis is the STD men have never heard of. Yet it is the most common curable one in the world that is not a virus (CDC, 2021). In fact, most men who carry it feel perfectly well.

So it usually reaches my clinic in one of three ways. First, a test report comes back positive.

A wife’s gynaecologist finds it. Or a man has a sore, cracked foreskin that will not settle.

Whichever way it reached you, however, trichomoniasis is treatable. It needs the right test, the right tablets, and one thing most men forget: treating your partner at the same time.

Below, I go through each of these in detail, in the order I explain them in my clinic. So use the list to jump to what worries you most.

What is trichomoniasis? The basics in plain words

Trichomoniasis (say “trick-oh-moh-NYE-uh-sis”), or “trich”, is a sexually transmitted infection. A single-celled parasite called Trichomonas vaginalis causes it. Under a microscope it is a pear-shaped cell that moves with a jerky motion, driven by whip-like threads at its front end.

In men it lives mainly in the urethra. In 2016, the WHO estimated 156 million new cases worldwide, more than chlamydia or gonorrhoea (Rowley, 2019).

Even so, men rarely hear about it. For years, doctors thought it was harmless in men (Van Gerwen, 2021a). In fact, it can cause urethritis and inflame the prostate, and it may raise the risk of HIV (Van Gerwen, 2021a).

Is trichomoniasis a UTI or an STD?

It is an STD, not a urinary infection. The burning can certainly feel like a UTI.

But ordinary UTI antibiotics usually do not touch it. Only the nitroimidazole family (metronidazole and its relatives) is proven to cure it (CDC, 2021).

So if you keep getting “UTI” tablets and the burning keeps returning, ask for an STD test.

Trichomoniasis symptoms in men: what you may (or may not) notice

Most men with trichomoniasis notice nothing. Between 70% and 85% of infected people have minimal or no symptoms (CDC, 2021).

When there are symptoms, they are usually mild. These are the ones men describe to me:

• a thin, clear or white discharge from the penis;
• burning or stinging when you pass urine;
• itching or irritation inside the tip of the penis;
• burning after ejaculation;
• a sore, red head of the penis and foreskin, sometimes with small cracks.

In one US clinic, 47% of infected men reported discharge and 22% reported burning on passing urine (Wendel, 2003). Rarely, it spreads to the epididymis behind the testicle or to the prostate (CDC, 2021).

The sore foreskin: what most of my trichomonas patients actually have

Textbooks talk about discharge. In my clinic, however, the commonest picture is different. Instead, it is balanoposthitis, an inflamed glans and foreskin.

Older studies saw the same. In a series of 46 men with trichomoniasis, 16 had lesions of the glans and foreskin, and the main complication was a tight foreskin (Michalowski, 1981). The authors also thought a long foreskin made infection more likely.

If this sounds like you, read my page on balanitis. After all, a sore foreskin has many causes, and an STD swab sorts them out.

What does trichomonas discharge look like in men?

In men it is usually scanty: thin, clear or whitish. Men especially notice it first thing in the morning. Thick yellow-green pus points more towards gonorrhoea.

Still, you cannot reliably tell the germ from the colour. Only a test can.

Can you smell trich on a man?

Usually not. The bad smell people search for is a sign in women (CDC, 2021). Men, on the other hand, rarely notice any smell, which is one more reason it goes unnoticed.

How do men get trichomoniasis, and does it mean someone cheated?

Trichomonas spreads mainly through vaginal sex (CDC, 2021). In other words, it passes from penis to vagina and back. It does not spread through kissing, sharing food or holding hands.

Infection of the throat or back passage, however, is uncommon. In a large Dutch study, positivity was 0.1% at the throat and 0.2% at the rectum, against 0.5% in the genitals (Kampman, 2026). So routine throat and rectal tests for trich are not recommended (CDC, 2021).

Oral sex is therefore a much smaller risk for trich than for gonorrhoea or herpes. What matters is genital contact, so a massage parlour visit with intercourse carries the real risk.

Can a man get trich without cheating?

This is the question I am asked most, often by a frightened husband or wife. The truth is that a positive test cannot tell you when the infection was caught, or from whom.

Untreated trichomoniasis might last for months to years, especially in women, and most carriers feel nothing (CDC, 2021). So it may have been caught recently, or long ago, by either partner, without knowing.

In any case, sex is by far the usual route. Non-sexual spread is considered very rare, though a few men tell me the only exposure they can recall was a dirty toilet while travelling. Memory is not proof either way, and it does not change the plan: both partners are treated, together.

If you need words for your wife, keep them simple: “My test found a common infection that can hide for a long time. The doctor is treating both of us together.”

But please do not use a lab report as evidence in a quarrel. If the fear itself is taking over, my page on STD and HIV fear may help.

Testing for trichomoniasis in men (and why your urine report said “normal”)

Trichomoniasis in men is diagnosed with a PCR (NAAT) test on first-catch urine or a urethral swab. However, a routine urine report, read under a microscope, often misses it. Even in women, microscopy finds only 44–68% of the infections that culture finds, and this falls to about 20% within an hour of collection (CDC, 2021).

Male urine microscopy has not been well studied. Many men reach me holding a “normal” urine report; yet the PCR panel is positive. For this reason, I do not rely on microscopy.

A DNA test (NAAT or PCR), on the other hand, is far better. In one US clinic, PCR found trichomonas in 17% of men; culture found it in only 5% (Schwebke, 2002). For example, one assay found 97.2% of infections in male urine (Schwebke, 2018).

“Trichomonas vaginalis seen” in your urine report: what it means

Some men arrive with the opposite: the urine report says Trichomonas vaginalis seen. If the lab saw live, moving parasites, that is usually reliable. But some reports come from automated machines or still samples, where other cells can be mistaken for trichomonas.

So I confirm it with a PCR panel, which also checks for chlamydia and Mycoplasma genitalium, before treating you both. The results take 2 days.

Swab or urine: which is better?

In fact, both work with a good PCR test. In one recent study of 148 men, first-void urine and a urethral swab found exactly the same number of infections, 27 and 27 (Shishniashvili, 2026).

For the urine test, give the first 20–30 mL of the stream (Shishniashvili, 2026). The lab will usually ask you not to pass urine for at least an hour beforehand.

What my STD panel checks, and how fast

When a man has burning, discharge or a sore foreskin, I take a swab. It goes for a NAAT panel covering chlamydia, gonorrhoea, Mycoplasma genitalium, Trichomonas and Gardnerella. Then the results come back in 2 days.

A note on Gardnerella. It is the germ behind bacterial vaginosis in women. In a man it is not an STD in the usual sense, and a positive result can simply mean it is present on the skin.

In my experience it passes between partners and can keep a sore foreskin inflamed. The metronidazole tablets act on it too, though whether men need treatment for Gardnerella alone is still debated. I explain to your partner what it means for her.

Anyone with trichomonas should also be tested for HIV, syphilis, gonorrhoea and chlamydia (CDC, 2021). I add hepatitis B as part of my routine screen. For the full list, see my STD clinic in Chennai.

Who should get tested?

• You have burning, discharge or itching inside the penis.
• A sore, cracked foreskin keeps coming back.
• Your partner has trichomonas, even if you feel fine.
• Urethritis returns after a first course of antibiotics (CDC, 2021).
• Men with fertility concerns and signs of genital infection.

Not sure what your symptoms mean? My guide to STD symptoms in men sorts them out by sign.

How I treat trichomoniasis in men

Trichomoniasis in men is treated with metronidazole tablets: my course is 400–500 mg twice a day for 7 days, taken by you and your partner at the same time. Creams and gels, however, do not work. Only the nitroimidazole family of medicines has been shown to cure it (CDC, 2021).

The course does not treat chlamydia or gonorrhoea. So I start it once the 2-day panel is back, and add the right antibiotic if the panel finds more than trich.

Why 7 days, when the CDC allows a single dose for men?

In fact, the CDC recommends a single 2 g dose for men and 7 days for women. But no trial has compared the two doses in men (CDC, 2021), and the best way to treat men is still not known (Van Gerwen, 2021a).

In women, the 7-day course cut the number still positive after treatment by about 40–50% (Kissinger, 2018; Kissinger, 2010). The chart shows both trials.

A later pooling of trials found the advantage smaller than first thought, but still there (OuYang, 2020). The 7-day course is also what guidelines give a man who stays positive after a single dose without being re-exposed (CDC, 2021). For men with persistent urethritis, a 2015 review also adds metronidazole at this dose to the usual antibiotics (Moi, 2015).

Trichomoniasis treatment options compared

So I prefer the longer course. As a result, you and your wife take the same tablets, on the same days, and finish together.

Side effects of metronidazole

Most people tolerate it. In a large trial in women, the commonest side effects were nausea (about 1 in 4), headache (7%) and vomiting (4%) (Kissinger, 2018). Some people also notice a metallic taste.

I advise taking the tablets after food, which can ease nausea. Do not stop when the burning settles; not finishing the course is one reason it can come back.

Tell me before you start if you take any of these

• warfarin or acenocoumarol (Acitrom), because metronidazole strengthens their effect; aspirin and clopidogrel are fine, but tell me about them;
• lithium, because metronidazole can raise its level;
• disulfiram, now or in the last 2 weeks;
• medicine for fits (such as phenytoin), or if you have liver disease.

Your urine may turn darker during the course; this is harmless. If you vomit soon after a tablet, call us before taking another.

Allergic to metronidazole?

It is rare. A true allergy to this family of drugs is managed by desensitisation, which I arrange with an allergy specialist, not by switching to a cream (CDC, 2021; Van Gerwen, 2021c). Tell me about any past reaction before we start.

When to call me at once

• A testicle becomes swollen and painful, or you get a fever: call 97907 83856 the same day.
• A testicle suddenly hurts badly, especially with vomiting: it may be twisted, which needs a surgeon within about six hours. Call me at once, and if you cannot reach me, go to the nearest emergency department immediately. Do not wait for morning.
• Swelling of the lips or face, or difficulty breathing, after a tablet: stop the tablets and get emergency help immediately.
• A rash, or numbness or tingling in the hands or feet: stop the tablets and call me.

Your wife or partner must be treated at the same time

Your partner must take treatment at the same time as you, even if she feels well or her test is negative, or the infection passes back and forth (CDC, 2021). Doctors call it the ping-pong effect.

However, telling a partner to “go and get checked” rarely works. In one study, of 20 enrolled women with trichomonas, only 1 male partner ever contacted the study (Pearlman, 2024).

So I do not leave it to chance. I prescribe for your partner too, so you both start the same day. Current partners should be treated even before their own test is back (CDC, 2021).

Before I write her prescription, I need four facts. Is she pregnant or breastfeeding? Is she allergic to any medicine?

Does she take warfarin, acenocoumarol, lithium or other regular tablets? Does she have liver disease or fits?

I need to speak to her myself before I prescribe: she comes with you to my STD clinic, or talks to me by phone or video. Above all, I do not prescribe for a partner who does not know what the tablets are for. She has a right to know, and she deserves her own full test, because trich often travels with chlamydia, which these tablets do not treat.

If you have had any other partner in the past few months, she needs testing and treatment too. I can also help you work out how to tell her.

What your wife may notice

Women carry trich silently too. When it causes symptoms, they include a discharge that may be smelly or yellow-green, with itching or soreness (CDC, 2021).

In pregnancy, trichomonas is linked with early delivery, early rupture of the waters and low birth weight (Van Gerwen, 2021b); the low-birth-weight risk was about twice as high. However, whether treatment prevents these is not yet proven. But treatment relieves her symptoms and reduces passing the infection back and forth (CDC, 2021).

If your wife is pregnant, tell me. Studies have not found harm to babies from metronidazole, while tinidazole is avoided in pregnancy (CDC, 2021).

I coordinate with her obstetrician. If she is breastfeeding, tell me that too, so I can advise on timing.

When can I have sex after trichomoniasis treatment?

Avoid sex until both of you have finished the tablets and any symptoms have settled (CDC, 2021). With my 7-day course, that means at least a week, often a little longer.

Alcohol, sex and other rules during treatment

These rules go with the tablets. Men break them most often.

Can I drink alcohol on metronidazole?

My advice: no alcohol during the course and for 24 hours after the last tablet (72 hours if you are given tinidazole). This is my own precaution, stricter than the CDC.

However, the old warning about a violent reaction is now questioned. In a small controlled study (6 men on metronidazole, 6 on placebo), a modest dose of alcohol caused no reaction (Visapää, 2002). The CDC now calls avoiding alcohol unnecessary (CDC, 2021).

A review found that a reaction is possible but of uncertain frequency (Mergenhagen, 2020), and a 2026 review found the evidence for it weak (Orire, 2026). Still, my rule is simply caution: you are already on a tablet that can cause nausea, and alcohol adds to it.

Other practical rules

• Finish all 14 doses, even if you feel fine on day 2.
• No sex, including oral sex, until both of you are done and symptom-free.
• Keep the foreskin clean and dry if it is sore (see my balanitis care page); no antiseptic liquids on the penis.
• Also, do not borrow tablets from a friend or a chemist’s shelf. Dose and duration matter.

Does trichomoniasis go away on its own in men?

Sometimes, but you cannot count on it. In an older study, 36% of untreated men cleared it (Krieger, 1993). In a recent one, 7 in 10 men were still positive about a week later (Van Gerwen, 2024).

Meanwhile, untreated infection might last for months to years (CDC, 2021). All that time, you can pass it to your partner without knowing. So do not wait.

How long does trich last in males?

Untreated, there is in fact no fixed limit. One case report describes a man in his early 90s with years of urinary and prostate discomfort, in whom trichomonas was found and treated (Fakhar, 2025).

Treated properly, however, most infections are cured by the course of tablets. For some men, depending on symptoms and history, I repeat the test sooner, at least 3 weeks after the last tablet. For everyone, the check that matters is at about 3 months, or sooner if symptoms return.

How common is trichomoniasis in men?

In the general population, it is uncommon in men: about 0.5% of US men aged 18 to 59 (Daugherty, 2019), and 0.6% of men aged 15 to 49 worldwide (Rowley, 2019). But the figure rises sharply in men with symptoms or an infected partner.

The chart shows how much it varies: from 8.5% of Karnataka men with urethral discharge (Becker, 2010) and 9.8% of men at a US STD clinic (Muzny, 2014), to 71.7% of male partners of infected women (Seña, 2007).

However, Indian data on men are thin. A 2024 Indian paper summarised earlier studies as finding it in 0 to 5.6% of men (Surya, 2024). In Bengaluru, it was found in 2 of 100 men with urethritis (Nayak, 2017).

If your partner has trichomonas, assume you have it too, whether you feel anything or not, and book a private STD test.

What happens if trichomoniasis is left untreated in men?

Left untreated, trichomoniasis in men can keep causing urethritis, may inflame the prostate, and keeps passing to your partner. Many men feel nothing while this happens.

The table grades each possible effect by how strong the evidence is, so you are not frightened by links that are not proven.

Fertility and HIV: what this means for you

On fertility, however, the evidence is uncertain. If you are trying for a baby and have signs of infection, I test for it, alongside a semen culture where needed.

On HIV: good data in men are lacking, but in women trich is linked with about 1.5 times the risk of catching HIV (CDC, 2021; Barker, 2022). So I always offer an HIV test, timed to your exposure. Read more about HIV and AIDS and the HIV window period.

Still positive after treatment? Why trichomoniasis comes back

Most repeat infections are reinfections (CDC, 2021). The usual story is an untreated partner, or sex before both of you finished.

True resistance is less common than reinfection. Guidelines quote 4–10% of vaginal infections (CDC, 2021), and a 2025 pooled estimate was about 15% in laboratory studies, varying widely between studies (Faizi, 2025).

When should I retest?

• Not too early. This is because a PCR test can stay positive from dead parasite DNA. Wait at least 3 weeks after your last tablet (CDC, 2021; Craig-Kuhn, 2019).
• At about 3 months. Reinfection is common. The CDC’s trichomoniasis guidance says the data on retesting men are insufficient, but its urethritis guidance asks men to come back at 3 months (CDC, 2021). So I ask my patients to retest at about 3 months.
• Sooner, if symptoms return. Instead, come back; do not repeat the old tablets on your own.

Still positive? Then I first ask about new exposure.

With any new exposure, we repeat the same 7-day course, both of you together. Without one, guidelines advise a stronger course (metronidazole or tinidazole 2 g once daily for 7 days), ideally guided by a culture to check for drug resistance (CDC, 2021).

Test negative, but still burning?

If the repeat PCR panel is negative and the burning continues, the infection has usually gone, and something else is keeping the area irritated: a prostate problem, a skin condition of the foreskin, or irritation that takes time to settle. If your first test checked trich alone, I also test for Mycoplasma genitalium.

Come back so we can look again; my guide to other causes of burning explains them. New pain or swelling in a testicle, or fever, needs the urgent check described in “When to call me at once” above.

Trichomoniasis rarely comes alone: the other STDs I test for

In a large French study, about 1 in 4 people with trichomonas, mostly women, had another STD at the same time (Hamet, 2025). Chlamydia and Mycoplasma genitalium were the usual partners.

This matches my clinic. In fact, mixed infections are common, which is why one swab is tested for five germs at once. Blood tests then cover HIV and syphilis (CDC, 2021), and I add hepatitis B.

Note that metronidazole kills trichomonas, but it does not treat chlamydia, gonorrhoea or Mycoplasma genitalium. If the panel finds one of these too, I add the right antibiotic for it, and your partner’s prescription changes to match.

Trichomoniasis vs other STDs: how they compare

Here is how trich compares with the infections men most often confuse it with.

The table summarises the 2021 CDC guidelines in plain words (CDC, 2021). Had a recent risky contact?

Read what to do if a condom broke, and whether PEP for HIV applies to you. PEP should start as soon as possible, and is only given within 72 hours of the exposure.

Indeed, most fear and quarrels come from these myths. If one has already caused trouble at home, bring your partner along. A calm explanation from a doctor often settles what an argument cannot, and psychosexual counselling helps when guilt or fear lingers.

How to prevent trichomoniasis

• Condoms, every time. Correct, consistent condom use is the best protection (CDC, 2021).
• Treat both partners together, every time either of you tests positive.
• Retest at about 3 months after treatment. This is my routine, although for men the guideline evidence is limited.
• Test before a new relationship, or after any new partner, with a full panel.

Does circumcision help? The evidence is mixed. In one trial, wives of circumcised men had about half the risk (Gray, 2009).

In another, the benefit in men was borderline, though significant in men who were actually circumcised (Sobngwi-Tambekou, 2009). So I never recommend circumcision just to prevent trich.

However, a tight foreskin that keeps cracking and getting infected is a different matter. For that, see my page on phimosis surgery in Chennai.

Trichomoniasis treatment in Chennai: what a visit involves

Here is what happens when you come to my clinic in T Nagar:

1. A private talk. Your symptoms, your partner, any reports you already have.
2. A gentle examination, especially of the foreskin and the tip of the penis.
3. One swab or urine sample for the PCR panel. Results in 2 days.
4. Blood tests for HIV, syphilis, hepatitis B and, where needed, blood sugar.
5. Treatment for both of you, with clear written instructions.
6. A retest plan, so you know when you are truly clear.

How much does trichomoniasis treatment cost in Chennai?

Your fee covers only the tests your history needs, so I do not quote one price. Besides, metronidazole itself is a low-cost generic medicine. Call or WhatsApp 97907 83856, and we will tell you exactly what your visit includes.

Men visit from across Chennai, including T Nagar, Anna Nagar, Velachery and Adyar. Above all, your visit is private, and nothing you tell me is shared.

Trichomoniasis in men: FAQs

What are the first signs and symptoms of trichomoniasis in males?

Usually none. When signs appear, they are mild burning on passing urine, itching inside the tip, a thin clear or white discharge, burning after ejaculation, or a sore, cracked foreskin.

What does trich feel like in a man?

Often like nothing at all. When felt, it is a mild sting on passing urine, an itch or tickle inside the tip, or a sore, raw foreskin. It rarely feels severe.

Can trich cause abdominal pain in men?

Rarely. It can inflame the prostate or the epididymis behind the testicle, causing pelvic or testicular aching. Such pain often has another cause, so get tested.

Does trichomoniasis cause a rash in men?

Not usually. The nearest thing is a red, sore head and foreskin (balanoposthitis), sometimes with small cracks. A true rash points to other causes, such as syphilis.

Can trichomoniasis cause bleeding in men?

Rarely. A cracked, inflamed foreskin can bleed a little. Blood in your urine or semen is not a typical sign of trich and has commoner causes, so get it examined.

Is trichomoniasis a type of chlamydia?

No. Trichomonas is a parasite; chlamydia is a bacterium.

They feel similar and often occur together, so one PCR panel tests for both. They need different medicines.

How soon does trich show up in men?

If symptoms come, they usually start within about 1 to 3 weeks, but many men never get any. Do not wait for signs. If your partner tests positive, get a PCR test and treatment now.

Can you have trich for 2 years without knowing?

It is possible. Untreated infections might last months to years, and most carriers have no symptoms.

Some men clear it sooner (Krieger, 1993). A positive test cannot say when it was caught.

How did my husband get trichomoniasis?

Almost always through sex. It may be recent or older: trich is usually silent and can last a long time, especially in women.

Either partner may also have carried it unknowingly. Both of you need treatment together.

What causes trichomoniasis?

A single-celled parasite, Trichomonas vaginalis, passed mainly during vaginal sex. It is a parasite, not a bacterium or virus.

Can a woman get trichomoniasis on her own?

Not from hygiene, stress or tight clothes. Trich is passed during sex, and because it can sit silently for a long time, she may have caught it long ago, or from you.

What is the best antibiotic for trichomoniasis?

Metronidazole is the standard first choice; tinidazole works as well or better in single-dose trials. I prescribe metronidazole twice daily for 7 days for both partners. However, creams do not work for men.

How do I stop itching from trichomoniasis?

Treat the cause: the itch settles as the tablets kill the parasite. Meanwhile, wash with plain water, keep the foreskin dry, and avoid antiseptics and scratching. Still, itch after treatment needs a retest.

Is 7 days of metronidazole enough for trich?

For most people, yes. In women it nearly halved the number still positive versus a single dose (Kissinger, 2018); no trial has compared the doses in men. Finish every tablet.

How long does it take for trichomoniasis to go away after treatment?

In my experience most men feel better during the 7-day course. If symptoms persist, a repeat PCR waits at least 3 weeks after finishing, because dead parasite DNA can still show.

Is trichomoniasis 100% curable?

Almost. Metronidazole cures about 84–98% in trials. Most failures are reinfections from an untreated partner, so treat both of you together.

Should my wife be treated if her test is negative?

Yes. Current partners should be treated presumptively. Tests can miss it, and treating only one partner lets the infection bounce back.

How did I test positive for trichomoniasis and my partner didn’t?

Tests can miss it, especially older ones, and some infected men clear it on their own (Krieger, 1993). A negative partner may still carry it. So both of you are treated together.

How does a woman catch trichomoniasis?

Mainly through vaginal sex with an infected partner, often a man with no symptoms. It can also pass between women through shared genital fluids or sex toys. For this reason, treating the man matters.

What are the first signs of trichomoniasis in females?

Often none. When present: a discharge that may be smelly or yellow-green, with itching or soreness. Her gynaecologist or I can treat her.

Is metronidazole safe during pregnancy?

Studies have not found harm to babies, and guidelines use metronidazole for pregnant women. Tinidazole is avoided. If your wife is pregnant, I coordinate with her obstetrician.

Can males get tested for trichomoniasis?

Yes. A first-catch urine sample or a urethral swab, tested by a validated PCR, is accurate in men. My panel also checks chlamydia, gonorrhoea and Mycoplasma genitalium, with results in 2 days.

Can a blood test detect trichomoniasis?

Not in routine practice. Trich is diagnosed by a PCR test on urine or a urethral swab. Blood tests check for HIV, syphilis and hepatitis B, which I test alongside.

Why did my urine test not show trichomonas?

Routine urine reports are not designed to find trichomonas, and older tests miss many cases. In one study of men, PCR found more than three times as many infections as culture (Schwebke, 2002).

Can trichomoniasis cause infertility in men?

Possibly, but the evidence is weak. One review links it with infertility; another calls the effect minor (Zhang, 2022; Ochsendorf, 2008). Still, it is worth treating if found.

Can you permanently get rid of trichomoniasis?

Yes, the infection can be cured, but there is no immunity. Reinfection is common if a partner is untreated, so I advise a retest about 3 months after treatment.

Can you get trich from oral sex?

It is uncommon. Throat infection was found in 0.1% in a large Dutch study (Kampman, 2026). Read more about STDs from oral sex.

Can a man give another man trichomonas?

It is uncommon. Trichomoniasis is rare among men who have sex with men, and rectal infection is rare (Kampman, 2026). It spreads mainly through vaginal sex.

Can you get trich from a toilet seat?

Very unlikely. Trich spreads through sex, and toilet seats are not a recognised route. A few men recall only a dirty toilet, but both partners still need treatment.

Do condoms prevent trichomoniasis?

Yes, when used correctly every time. Consistent condom use is the best way to prevent it (CDC, 2021).

Should men be treated for trichomoniasis even without symptoms?

Yes. A man without symptoms can still pass it to his partner. If you test positive, or your partner does, you need treatment.

The bottom line on trichomoniasis in men

Trichomoniasis is common, usually silent, and curable. Get a PCR test, not just a urine report.

Take 7 days of metronidazole together with your partner. Skip alcohol, skip sex until you are both done, and retest.

Many men also carry guilt about their marriage, and talking it through helps alongside the tablets. I hope this helped. This is Dr Shah, consultant andrologist in Chennai.

Call or WhatsApp 97907 83856. Nothing you say leaves the room.

References

Guidelines, epidemiology and symptoms

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Testing and co-infections

14. Schwebke JR, et al. Improved detection by DNA amplification of Trichomonas vaginalis in males. 2002. PMID 12354865.
15. Schwebke JR, et al. Clinical Evaluation of the Cepheid Xpert TV Assay for Detection of Trichomonas vaginalis with Prospectively Collected Specimens from Men and Women. 2018. PMID 29167292.
16. Van Der Pol B, et al. Trichomonas vaginalis Detection in Urogenital Specimens from Symptomatic and Asymptomatic Men and Women by Use of the cobas TV/MG Test. 2021. PMID 34319805.
17. Shishniashvili D, et al. FIRST-VOID URINE VERSUS URETHRAL SWAB FOR MOLECULAR DETECTION OF SEXUALLY TRANSMITTED INFECTIONS IN MEN WITH MULTIPLE SEXUAL PARTNERS. 2026. PMID 42830059.
18. Hamet L, et al. Prevalence and bio-clinical characterisation of Trichomonas vaginalis infection in a large cohort of French patients screened using a molecular syndromic panel for sexually transmitted infections. 2025. PMID 40912588.

Treatment, retesting and alcohol

19. Kissinger P, et al. Single-dose versus 7-day-dose metronidazole for the treatment of trichomoniasis in women: an open-label, randomised controlled trial. 2018. PMID 30297322.
20. Kissinger P, et al. A randomized treatment trial: single versus 7-day dose of metronidazole for the treatment of Trichomonas vaginalis among HIV-infected women. 2010. PMID 21423852.
21. OuYang Z, et al. Single-dose versus multidose metronidazole for the treatment of vaginal trichomoniasis: A meta-analysis. 2020. PMID 33080486.
22. Moi H, et al. Management of non-gonococcal urethritis. 2015. PMID 26220178.
23. Muzny CA, et al. Efficacy and Safety of Single Oral Dosing of Secnidazole for Trichomoniasis in Women: Results of a Phase 3, Randomized, Double-Blind, Placebo-Controlled, Delayed-Treatment Study. 2021. PMID 33768237.
24. Muzny CA, et al. Secnidazole for Trichomoniasis in Women and Men. 2022. PMID 35153156.
25. Van Gerwen OT, et al. Management of Trichomoniasis in the Setting of 5-Nitroimidazole Hypersensitivity. 2021c. PMID 33137011.
26. Faizi F, et al. Global Prevalence of 5-nitroimidazole Resistance in Trichomonas vaginalis: A Systematic Review and Meta-analysis. 2025. PMID 41185508.
27. Craig-Kuhn MC, et al. Optimal Timing for Trichomonas vaginalis Test of Cure Using Nucleic Acid Amplification Testing. 2019. PMID 30601374.
28. Visapää JP, et al. Lack of disulfiram-like reaction with metronidazole and ethanol. 2002. PMID 12022894.
29. Mergenhagen KA, et al. Fact versus Fiction: a Review of the Evidence behind Alcohol and Antibiotic Interactions. 2020. PMID 31871085.
30. Orire I, et al. Revisiting the Disulfiram-Like Reaction Between Alcohol and Oral Metronidazole. 2026. PMID 41366815.

Partners and natural history

31. Pearlman RL, et al. Challenges in Male Partner Referral Among Trichomonas vaginalis -Infected Women. 2024. PMID 38180841.
32. Van Gerwen OT, et al. Trichomoniasis and adverse birth outcomes: a systematic review and meta-analysis. 2021b. PMID 34036690.
33. Krieger JN, et al. Natural history of urogenital trichomoniasis in men. 1993. PMID 8501787.
34. Van Gerwen OT, et al. Spontaneous resolution of. 2024. PMID 38937096.
35. Fakhar M, et al. Persistent trichomoniasis in a man in his early 90s with a history of prostatic hyperplasia: A case report. 2025. PMID 40439056.

Complications

36. Barker EK, et al. Risk of Human Immunodeficiency Virus Acquisition Among High-Risk Heterosexuals With Nonviral Sexually Transmitted Infections: A Systematic Review and Meta-Analysis. 2022. PMID 35034049.
37. Sivaraj V, et al. Epididymitis and its aetiologies in a central London sexual health clinic. 2021. PMID 33292092.
38. Zhang Z, et al. A systematic review of the correlation between Trichomonas vaginalis infection and infertility. 2022. PMID 36116548.
39. Ochsendorf FR. Sexually transmitted infections: impact on male fertility. 2008. PMID 18336453.
40. Najafi A, et al. Is there association between Trichomonas vaginalis infection and prostate cancer risk?: A systematic review and meta-analysis. 2019. PMID 31539586.
41. Langston ME, et al. Trichomonas vaginalis infection and prostate-specific antigen concentration: Insights into prostate involvement and prostate disease risk. 2019. PMID 31376187.
42. Yang HY, et al. Association between trichomoniasis and prostate and bladder diseases: a population-based case-control study. 2022. PMID 36100630.

Prevention

43. Gray RH, et al. The effects of male circumcision on female partners’ genital tract symptoms and vaginal infections in a randomized trial in Rakai, Uganda. 2009. PMID 18976733.
44. Sobngwi-Tambekou J, et al. Male circumcision and Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis: observations after a randomised controlled trial for HIV prevention. 2009. PMID 19074928.