You just got a trichomoniasis diagnosis, and you have questions. Is it serious? Will it go away? Do you have to tell your partner? Take a breath. Trichomoniasis is the most common curable, nonviral STI, and a short course of antibiotics clears it for the vast majority of people.
How is trichomoniasis treated?
Trichomoniasis is treated with prescription antibiotics that target the parasite (Trichomonas vaginalis) behind the infection. The cure is oral medication, not a cream or a topical gel. There is no effective over-the-counter or home remedy, so treatment always means a prescription from a clinician.
The CDC recommends different regimens depending on who is being treated. Doses are decided by your clinician, so the list below is general education, not dosing instructions for you to follow on your own.
- For women: metronidazole 500 mg orally twice daily for 7 days (CDC, 2021).
- For men: a single 2 g oral dose of metronidazole.
- Alternative: tinidazole 2 g orally in a single dose.
- Secnidazole (Solosec), FDA-approved for trichomoniasis in July 2021, is a single 2 g oral granule dose.
Why a 7-day course for women instead of one dose?
For years, a single 2 g dose was the standard for everyone. That changed after a large randomized trial in women compared the two approaches head to head.
In that trial of 623 women, the 7-day metronidazole regimen clearly outperformed the single dose: only 11% (34 of 312) still tested positive at test-of-cure, versus 19% (58 of 311) in the single-dose group (Lancet Infectious Diseases, 2018). That evidence is why the CDC now recommends the 7-day course as the preferred therapy for women, while a single dose remains standard for men.
What about topical gels and home remedies?
It is tempting to reach for a cream, but topical metronidazole gel is explicitly not recommended for trichomoniasis. It does not reach therapeutic levels in the urethra and perivaginal glands, so it is less effective than oral medication and can leave the infection behind (CDC).
There is no proven natural or over-the-counter cure. Because trichomoniasis lives in tissues that a surface treatment can't reach, oral antibiotics are the only reliable way to clear it.
How long does treatment take to work?
Most people feel better within a few days of finishing their medication, and the antibiotics begin acting quickly. Even so, it's important to take the full course exactly as prescribed and to wait until treatment is complete and symptoms have resolved before having sex again.
One practical note: avoid alcohol while taking these medications. Alcohol can trigger an unpleasant disulfiram-like reaction (nausea, flushing, vomiting). The general guidance is to avoid alcohol for 72 hours after metronidazole or tinidazole, and 48 hours after secnidazole (Mayo Clinic). Your clinician will give you the specifics for your medication.
Why your partner needs treatment too
Treating only yourself is one of the most common reasons trichomoniasis comes back. The infection passes back and forth between partners, so all sexual partners should be treated at the same time, even if they have no symptoms. In fact, most infected people never develop symptoms at all, so a partner can carry and pass on the parasite while feeling completely fine.
Because reinfection is so common, the CDC advises retesting all sexually active women about 3 months after treatment, regardless of whether their partners were treated. It's also a good time to test for other STIs, since trichomoniasis often travels with infections like gonorrhea, chlamydia, HIV, and syphilis.
When to see a doctor
See a clinician if you have symptoms of trichomoniasis or a partner has been diagnosed. Common symptoms, when they appear, include unusual vaginal or penile discharge, itching, burning, redness, discomfort with urination, or pain during sex. Symptoms typically begin 5 to 28 days after exposure, but untreated infection can quietly persist for months to years (Mayo Clinic).
You should also follow up if your symptoms don't improve after finishing treatment, or if they return, since that can signal reinfection or a need for a different regimen. Trichomoniasis is highly treatable, and getting evaluated is the fastest path to a cure for you and your partner. A licensed clinician, including through a telehealth service like Nolla, can confirm the diagnosis and prescribe the right treatment when appropriate.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any new skincare treatment, especially if you have underlying health conditions, are pregnant, or are taking medications.
