Date: 11 Nov 2025
Trichomoniasis, also known as trichomonas vaginitis, is a common sexually transmitted infection caused by the protozoan Trichomonas vaginalis. It often presents with characteristic symptoms in women and may remain asymptomatic in men.
Left untreated, it has been linked to adverse reproductive outcomes, increased HIV transmission risk, and chronic discomfort.
Trichomoniasis is recognized as the most prevalent non‑viral STI, affecting millions globally each year. Transmission occurs primarily through sexual contact.
In women, the parasite adheres to vaginal and cervical epithelial cells, provoking inflammation and the typical symptoms of vaginitis; in men, it may infect the urethra, prostate, or epididymis without obvious signs.
Women commonly experience vaginal itching, burning, dysuria, dyspareunia, and an often frothy, yellow-green discharge with a foul odor. A “strawberry cervix” may be seen in roughly 5% of cases upon examination.
Men may be asymptomatic or develop mild urethritis. If untreated, the infection can persist, increasing the risk of pelvic inflammatory disease, premature birth, low birthweight, and enhanced HIV susceptibility.
Diagnosis is generally established by microscopic examination of vaginal or urethral samples (wet mount) or nucleic acid amplification testing (NAAT), which offers superior sensitivity. PCR–based methods are increasingly used in both women and men.
Current CDC and WHO guidelines endorse nitroimidazoles—metronidazole and tinidazole—as the only effective oral treatments.
The preferred regimen is metronidazole 500 mg orally twice daily for 7 days, which has been shown to yield superior cure rates compared with a single high dose.
A single dose of metronidazole 2 g orally is recommended, providing high compliance and effective cure in most cases.
Alternatively, tinidazole 2 g orally in a single dose is approved and may offer better gastrointestinal tolerability, with equivalent efficacy.
In cases of metronidazole resistance or treatment failure, extended regimens (e.g. metronidazole 500 mg twice daily for 7 days) or tinidazole may be used, and reassessment is advised.
Effective treatment requires that sexual partners be treated simultaneously, even if asymptomatic, to prevent reinfection. Abstinence or condom use is advised until completion of therapy and resolution of symptoms, typically one week post-treatment.
Alcohol consumption must be avoided during treatment and for at least 24 hours after metronidazole and 72 hours after tinidazole due to risk of a disulfiram‑like reaction.
Preventive measures include correct and consistent condom use, avoidance of multiple sexual partners, prompt testing and treatment of partners, and regular screening for high‑risk individuals. Douching should be discouraged as it disrupts vaginal flora and may increase susceptibility.
TRIMIC Forte L Pessaries - This is a potent triple-action pessary containing metronidazole, miconazole, and Lactobacillus. It is indicated for vaginal infections, including trichomoniasis, candidiasis, and bacterial vaginosis. Use should follow professional guidance, typically one pessary daily at bedtime for several days. It is especially useful when mixed infection is suspected, and restoration of vaginal flora is desired.
Metronidazole 400 mg Tablets offer the core systemic therapy needed for trichomoniasis. This product, sold by Pharmily, can be dosed at 500 mg twice daily (often achievable by 1.25 tablets or prescribing 500 mg formulation) for the recommended 7‑day course in women, or used as part of a 2 g single dose in men in divided tablets. Its high availability and low cost make it a first-line option.
Tinidazole 500 mg Tablets are available in packs of four at Pharmily. Standard therapy involves taking four tablets (2 g total) as a single dose, which is convenient and effective for both women and men. This alternative is especially indicated when metronidazole is not tolerated or compliance is a concern (pharmily.co.ke).
Treatment must be completed even if symptoms resolve early. Persistent or recurrent infection may indicate resistance, inadequate adherence, or reinfection from an untreated partner. Such cases may require extended therapy or specialist referral. Metronidazole and tinidazole should be avoided during pregnancy unless advised, and breastfeeding may warrant temporary suspension. Alcohol is strictly contraindicated during treatment and for 24–72 hours after.
Trichomonas vaginalis infection is both treatable and preventable. For women, metronidazole 500 mg twice daily for 7 days is the recommended regimen, whereas men are generally treated with a 2 g single-dose metronidazole.
An alternative regimen for both sexes is tinidazole 2 g single dose, which may improve tolerability and compliance. Key Pharmily offerings such as TRIMIC Forte L Pessaries, Metronidazole 400 mg Tablets, and Tinidazole 500 mg Tablets support effective therapy within local availability.
Prompt diagnosis, simultaneous partner treatment, completion of therapy, and preventive measures such as condoms and abstinence during treatment are essential in ensuring cure and preventing reinfection. Trichomoniasis can be rendered benign with proper management—ensuring both health and comfort are restored.
1. What are the main symptoms of Trichomonas Vaginitis in women and men?
In women, Trichomonas Vaginitis commonly causes vaginal itching, burning, and a frothy yellow-green discharge with a foul odor. Men may experience mild urethritis or no symptoms at all, making partner testing and treatment very important.
2. What is the recommended treatment for Trichomonas Vaginitis?
According to CDC and WHO guidelines, the primary treatments are Metronidazole 500 mg twice daily for 7 days (for women) or a 2 g single dose (for men). Tinidazole 2 g single dose is an effective alternative for both. Pharmily Kenya offers these trusted formulations.
3. Can both partners be treated together for Trichomoniasis?
Yes. Treating both partners simultaneously is crucial to avoid reinfection. Sexual activity should be avoided or protected with condoms until both partners complete treatment and symptoms resolve, usually within one week.
4. How can Trichomonas Vaginitis be prevented?
Prevention involves using condoms consistently, limiting multiple sexual partners, avoiding vaginal douching, and ensuring regular STI testing. Prompt diagnosis and simultaneous treatment of partners are key to preventing recurrence.