Trichomoniasis is a common sexually transmitted infection that can cause symptoms in both men and women. However, it is possible for some men to carry trichomoniasis for years without experiencing any symptoms.
What is trichomoniasis?
Trichomoniasis is caused by infection with a protozoan parasite called Trichomonas vaginalis. This parasite is spread through sexual contact, most often through penis-to-vagina intercourse. However, it can also be spread through other intimate physical contact as well.
In women, trichomoniasis typically causes symptoms such as:
- Green, yellow, or gray vaginal discharge
- Vaginal itching or irritation
- Pain during urination or intercourse
- Unpleasant vaginal odor
However, it’s estimated that up to 50% of infected women do not have any symptoms.
In men, trichomoniasis can cause:
- Discharge from the penis
- Burning after urination or ejaculation
- Itching or irritation inside the penis
But again, many infected men have no symptoms at all. Estimates range from 50-80% of infected men being asymptomatic.
Can men carry trich without symptoms for years?
Yes, it’s definitely possible for men to have trichomoniasis for years without knowing it. Here’s why:
- The parasite can persist in the urethra or prostate gland for a long time, even without causing noticeable symptoms.
- Because symptoms are often mild or absent, infected men may simply not realize they carry the infection.
- Since testing for trichomoniasis is not routine, many cases go undiagnosed.
- The infection can be passed back and forth between partners through sex.
Some studies have detected T. vaginalis parasites in men who did not have symptoms for over 5 years. Theoretically, the infection could persist even longer than that in some individuals.
Factors that increase risk
Certain factors can make it more likely for a man to unknowingly carry trichomoniasis for a long time. These include:
- Older age – Symptoms seem to be less common in older men infected with trich.
- Uncircumcised – Uncircumcised men appear to be at higher risk of asymptomatic infection.
- HIV-positive – Men with weakened immune systems tend to get less severe trichomoniasis symptoms.
- High-risk sexual history – Having multiple past partners increases exposure risk.
Potential complications
Although asymptomatic, long-term trichomoniasis infection in men has risks. Possible complications include:
- Spreading the infection – Men can unknowingly pass trichomoniasis to partners for years.
- Prostatitis – Chronic prostate gland infection and inflammation.
- Infertility – In rare cases, trichomoniasis may impact sperm count and motility.
- Higher HIV risk – Trichomoniasis infection causes genital inflammation that may increase susceptibility to HIV if exposed.
Additionally, female partners of infected men are at risk of complications like pelvic inflammatory disease, infertility, and higher likelihood of HIV transmission.
Diagnosis and testing
Since most cases of trichomoniasis in men cause no symptoms, diagnosis requires laboratory testing. This includes:
- Microscopic exam – Checking a urine sample under a microscope for signs of T. vaginalis parasites.
- Culture testing – Putting a urine or semen sample in a special growth medium to allow parasites to multiply and confirm infection.
- Nucleic acid amplification test (NAAT) – Testing urine for T. vaginalis DNA.
The sensitivity of these tests varies. NAAT is considered the most accurate.
The CDC recommends screening for trichomoniasis in sexually active men who:
- Have new or multiple partners
- Have had past STIs
- Engage in high-risk sexual behaviors
- Have female partners with trichomonas vaginalis infection
Testing should also be done if unexplained urethritis symptoms are present.
Treatment
Trichomoniasis is curable with prescription anti-parasitic medication:
- Metronidazole – This is the most common trichomoniasis treatment. It is taken orally as a single high 2 g dose, or a lower daily dose for one week. Metronidazole has over a 90% cure rate.
- Tinidazole – This related medication is also FDA approved to treat trichomoniasis. It is given as a single 2 g oral dose. Some studies show tinidazole may have higher cure rates and quicker symptom relief than metronidazole.
It is vital that male sexual partners of women diagnosed with trichomoniasis also receive treatment. Even if asymptomatic, the male partner likely carries the infection too. Both partners should complete treatment before having sex again to prevent reinfection.
Prevention
Steps that may help prevent contracting or transmitting trichomoniasis include:
- Using condoms correctly every time you have sex.
- Limiting the number of sexual partners.
- Avoiding sex with partners who may be infected.
- Practicing mutual monogamy with an uninfected partner.
- Getting regular STI testing if at higher risk.
Conclusion
In summary, trichomoniasis is a common STI that men can carry asymptomatically for many years. This increases risks of transmitting the infection to partners and developing complications like prostatitis or infertility. Screening high-risk individuals and treating positive cases in both partners is important. With proper testing and treatment, the spread of asymptomatic trichomoniasis infection in men can be reduced.