Conditions
Trichomoniasis: discharge with an odor, testing and treatment by video
Trichomoniasis is the most common curable sexually transmitted infection, according to the CDC, and most people have no symptoms. When it does cause them, a typical sign is a fishy-smelling discharge with genital itching. By video, the doctor evaluates you and gives you a lab order for a NAAT test. If appropriate, she prescribes a medicine by mouth and we send your prescription to your pharmacy; your partner needs treatment too.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Severe lower belly pain with fever
- Sudden severe pain, vaginal bleeding or fainting if you could be pregnant
- Sudden, severe pain or swelling in a testicle
- Sexual assault: go to the emergency room or call 911
- Possible HIV exposure in the last 72 hours: go to the ER to be evaluated for preventive treatment (PEP)
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At a glance
Trichomoniasis
Common symptoms
- Itching, burning, redness or soreness of the genitals
- Clear, white, yellowish or greenish vaginal discharge with a fishy smell
- Discomfort when you pee
- Itching or irritation inside the penis
- Burning after peeing or ejaculating
- Other names
- Trich · Trichomonas vaginalis infection
- Usual test
- NAAT test by lab order
- Treatment
- Antiparasitic medicine by mouth, only when the medical evaluation calls for it
- Possible complication
- Early birth and low birth weight in pregnancy
On this page(9)
What is trichomoniasis?
Trichomoniasis ("trich") is an infection with a parasite passed on during sex, usually from a penis to a vagina or from a vagina to a penis. According to the CDC, it is the most common curable STI, and about 70% of people with it have no signs or symptoms.
In pregnancy, according to the CDC, trich makes it more likely that the baby is born early and with a low birth weight.
Trichomoniasis symptoms
When there are symptoms, they can include these (see also the causes of vaginal discharge):
- Itching, burning, redness or soreness of the genitals
- Clear, white, yellowish or greenish vaginal discharge with a fishy smell
- Discomfort when you pee
- Itching or irritation inside the penis
- Burning after peeing or ejaculating
How we care for trichomoniasis by video
You see Dr. Diana Nieves Castro, MD, a Puerto Rico–licensed general practice physician with several years of emergency-department experience. No judgment, in English or Spanish. Join from a private place; visits are not recorded.
The doctor asks about your symptoms, your partners and whether you could be pregnant, and gives you a lab order for a lab near you. The CDC prefers a nucleic acid amplification test (NAAT). The doctor often orders chlamydia and gonorrhea tests too.
If your partner has trich, the doctor considers whether it is appropriate to treat you without waiting for the result. If she needs to see the area, it is done only through the secure visit link; do not send photos by email or text message.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer.
Get tested and get a plan.
Take the order to the lab; the doctor reviews your result with you and tells you the next step.
Price
A doctor visit costs US$79, with no membership, and includes the lab order. You pay the lab for the tests. Reviewing the result is a US$49 follow-up visit. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. See all prices.
Video visit
Doctor visit
US$79
For a new problem, urgent care (non-emergencies), primary care, children, birth control, STIs, skin and acne, and visitors. Includes a doctor's note if you need one.
- You’re charged when you request the visit.
- Full refund if the visit can’t take place
Trichomoniasis treatment and your partner
Trich is treated with a medicine taken by mouth. According to the CDC’s 2021 STI Treatment Guidelines, women usually take a 7-day course and men may take a single dose; the doctor chooses the right one for your case, including in pregnancy. If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
No alcohol. With the medicine most used for trich (metronidazole), MedlinePlus says not to drink alcohol while you take it and for at least 3 days after the last dose, because it can cause nausea, vomiting, cramps, headache and flushing.
For your partner, the CDC recommends treating all current sex partners at the same time so you do not pass it back and forth. Your partner needs their own evaluation with a doctor; the doctor helps you plan how to tell them and when it is safe to have sex again.
According to the CDC, about 1 in 5 people get trich again within 3 months of treatment, and sexually active women should be retested about 3 months after treatment.
If you are pregnant or under 21
If you are pregnant, tell the doctor and your OB-GYN: according to the CDC, treatment is recommended in pregnancy and the medicine is low risk for the baby.
If you are under 21, a parent or legal guardian must sign the consent, stay on camera for the whole visit and show photo ID.
When to go to the ER
For your safety, go to the emergency room or call 911 if you have any of these signs. See when to go to the ER.
- Severe lower belly pain with fever
- Sudden severe pain, vaginal bleeding or fainting if you could be pregnant
- Sudden, severe pain or swelling in a testicle
- Sexual assault
- Possible HIV exposure in the last 72 hours, to be evaluated for preventive treatment (PEP)
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Can trichomoniasis be cured?
How do I get tested for trichomoniasis?
Can I drink alcohol during treatment?
Does my partner need treatment?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (5)
- CDC: About Trichomoniasis (opens in a new tab) (accessed 2026-10-02)
- CDC: Trichomoniasis, STI Treatment Guidelines 2021 (opens in a new tab) (accessed 2026-10-02)
- Metronidazole (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- CDC: Sexually Transmitted Infections Treatment Guidelines, 2021 (opens in a new tab) (accessed 2026-10-02)
- CDC: preventing HIV with PEP (opens in a new tab) (accessed 2026-10-02)