- Also Known As:
- Trichomonas Testing
- Trich Testing
- Trichomonas Vaginalis Testing
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Test Quick Guide
Trichomoniasis is a sexually transmitted disease (STD) caused by an infection with the parasite Trichomonas vaginalis. This parasite is spread from person to person during sex, most often through penis-to-vagina or vulva-to-vulva contact. It is uncommon for this infection to affect another part of the body such as the mouth, hands, or anus.
Trichomoniasis testing detects the Trichomonas vaginalis parasite in a sample of urine or body fluid taken from a person’s genitals. A health care provider may order trichomoniasis testing when someone complains of symptoms, is at an increased risk of this infection, or has recently finished treatment for this common STD.
About the Test
Purpose of the test
The purpose of a trichomoniasis test is to find an infection with the parasite Trichomonas vaginalis. Trichomoniasis testing may be used for screening, diagnosis, or monitoring:
- Screening for trichomoniasis looks for an infection in patients without symptoms. Screening is recommended for women and anyone with a vagina at an increased risk of infection.
- Diagnostic testing describes using a test to determine the cause of a person’s symptoms. The majority of people with this infection don’t develop symptoms, but approximately 30% will have symptoms similar to those caused by other STDs.
- Monitoring tests are used after a person finishes treatment for trichomoniasis. Because a significant number of patients are reinfected by an untreated partner, checking again for trichomoniasis several months after treatment ends is an important follow-up test.
What does the test measure?
Trichomoniasis testing looks for evidence of the parasite Trichomonas vaginalis.
Several laboratory tests may be used to detect trichomoniasis. The test method selected for an individual depends on their anatomy and test availability.
Wet-mount microscopy is the most common method of diagnosing trichomoniasis in women and anyone with a vagina. During this test, the patient’s doctor examines a sample of vaginal fluid under a microscope and looks for the Trichomonas vaginalis parasite. This testing method is quick and practical, allowing doctors to detect the parasite during a patient’s appointment and prescribe treatment immediately.
Nucleic acid amplification testing (NAAT) is considered the gold standard for detecting a trichomoniasis infection and can be used in people of all genders. This test can identify the genetic material of the parasite, called DNA or RNA, in a sample of urine or a swab of fluid from the vagina or cervix. While more time consuming than wet-mount microscopy, NAAT is better at detecting this infection.
Cultures allow health professionals to attempt to grow and detect the parasite in a laboratory. This test can accurately detect trichomoniasis, but it requires three to seven days for results to become available. This test is still commonly performed if NAAT test results are negative. In patients whose infections are resistant to common treatments, cultures may also be used to try various treatments in the lab and see which is the most effective, which is known as drug susceptibility testing.
Rapid antigen testing is a quick method of detecting Trichomonas vaginalis antigens in vaginal fluid. Antigens are substances that cause a person’s immune system to react against the parasite. This test can be performed in a doctor’s office and results are available in 10 to 15 minutes.
When should I get trichomoniasis testing?
To help decide if trichomoniasis testing is appropriate, a doctor starts by discussing the patient’s symptoms and performing a physical exam as well as a pelvic exam in patients with a vagina. Doctors recommend testing for trichomoniasis when a patient is at a high risk of contracting this infection, has symptoms suggestive of infection, or has completed the prescribed treatment.
Screening for trichomoniasis is recommended for several groups who are at an increased risk of acquiring this STD. How often to get tested depends on the patient’s specific circumstances. For men and anyone with a penis, screening is not recommended. Screening is often recommended for sexually active women and anyone with a vagina if:
- They have been diagnosed with HIV
- They live or receive care in an area where this infection is common, including correctional facilities
- They have new or multiple sex partners
- They have a history of STDs
Diagnosing trichomoniasis in patients with symptoms of this infection relies on one of several test methods that can detect Trichomonas vaginalis. When symptoms occur, they often begin around 5 to 28 days after infection. The frequency and type of symptoms a patient may experience depends on a person’s anatomy.
In men and anyone with a penis, symptoms appear in less than 25% of patients. Symptoms of trichomoniasis in this group include:
- Discharge from the urethra
- Burning after ejaculating or urinating
- Irritation in the penis
- Testicular pain
- Cloudy urine
In women and anyone with a vagina, only a small portion experience symptoms soon after infection. Symptoms may become more common over time and get worse during menstruation. When they occur, symptoms of this infection can include:
- Abnormal discharge from the vagina
- Discomfort during and after urinating
- Irritation and redness in the vagina
- Bleeding after sex
Diagnostic testing may also be performed in some women and people with a vagina if signs of trichomoniasis are detected during a routine Pap smear. If a Pap smear indicates a possible asymptomatic infection, a doctor may recommend wet-mount microscopy and a NAAT, culture, or rapid test to confirm a diagnosis of trichomoniasis.
Monitoring patients after treatment for trichomoniasis helps to ensure that patients don’t become reinfected by an untreated partner after finishing therapy. In women and anyone with a vagina, some will become reinfected, and repeat testing for trichomoniasis is recommended within 3 months of completing treatment or sooner if symptoms return.
Because the frequency and timing of trichomoniasis testing depends on several factors, it’s important for patients to discuss recommendations for testing with their doctors.
Finding a Trichomoniasis Test
How to get tested
Testing for trichomoniasis can be performed in a variety of settings, including hospitals, doctor’s offices, and community health clinics.
Trichomoniasis testing is ordered by a doctor or other health care provider. Before screening patients who aren’t experiencing symptoms, a health care provider can determine the patient’s risk of acquiring trichomoniasis and recommend a schedule for regular testing if necessary.
In patients experiencing symptoms of trichomoniasis, the health care professional will order the most appropriate test to rule out or confirm trichomoniasis as the cause of symptoms.
Can I take the test at home?
At-home trichomoniasis tests are available to detect this common STD at home. Using a self-collection test kit, you can obtain a sample at home and send it to a laboratory for analysis.
At-home trichomoniasis tests use either NAAT or nucleic acid probe technology to find evidence of an infection with Trichomonas vaginalis in a sample of urine or a swab collected from the vagina.
Regardless of the results of at-home trichomoniasis testing, patients should follow up with their doctor for confirmation and a discussion of test results.
How much does the test cost?
The cost of trichomoniasis testing depends on many factors including who orders the test and where it is conducted. When trichomoniasis testing is ordered by a health professional, the cost of testing may be paid for by a patient’s health insurance. Even with health insurance, though, there may be some patient costs such as copays and deductibles.
For patients without health insurance, the cost of trichomoniasis testing may be paid out of pocket. Testing costs may include an exam fee, technician fees, and the cost of the trichomoniasis test itself.
If you’re concerned about the cost of testing for trichomoniasis, contact your local health department or a community-based organization that provides free or low-cost STD testing.
Taking a Trichomoniasis Test
Trichomoniasis testing may be performed using a sample of urine or a sample of body fluid taken from the genitals using a swab or small brush. Samples used for testing can be collected by a medical professional or by the patient themselves.
Before the test
There are no special precautions to take before a trichomoniasis test. Before collecting a sample for a trichomoniasis test, a health care provider may perform a physical exam that includes looking at your genitals for signs of trichomoniasis.
During the test
The first step in testing for trichomoniasis usually involves collecting a sample and performing wet-mount microscopy. Samples may be taken from the penis or vagina with a small brush or swab. After preparing the samples, a doctor examines them under a microscope for the parasite Trichomonas vaginalis. The collection process may be uncomfortable, but the discomfort is typically very brief.
If you are asked to provide a urine sample, you may be instructed on providing a clean catch sample. To obtain a clean catch sample, you may be given a cleansing pad to clean your genitals and a container to collect your sample. After using the cleansing pad, you start urinating into the toilet before moving the collection container under your urine stream. Once you’ve collected sufficient urine, you finish urinating in the toilet and then return the collection container to your health care provider.
After the test
There are no risks or side effects of trichomoniasis testing. You can return to normal activities after the test is complete.
Trichomoniasis Test Results
Receiving test results
Trichomoniasis test results may be available from within a few minutes to several days after testing depending on the type of test being conducted. Results of a culture usually take additional time to allow the parasite to be grown in the laboratory.
Your doctor may discuss your test results over the phone or in a follow-up appointment. Test results may also be available through an electronic medical record or an online health portal.
Interpreting test results
Trichomoniasis test results are typically reported as positive or negative. Test results reflect whether evidence of the parasite Trichomonas vaginalis was detected in the test sample.
A positive test result indicates a diagnosis of trichomoniasis that requires treatment with a prescription medication. If an infection is found, your sexual partner(s) should also be tested and treated.
A negative test result indicates that the parasite was not able to be detected in the sample. If trichomoniasis is still suspected, a different testing method may be used to confirm the initial test result.
Are test results accurate?
Trichomoniasis testing is widely used to detect the parasite Trichomonas vaginalis. Various factors affect the accuracy of this test including the type of laboratory method used and the quality of the test sample.
The accuracy of wet-mount microscopy can vary based on the doctor’s experience performing the test and how quickly the test is performed after the sample is collected. When the sample is evaluated within an hour of collection, it can accurately diagnose 30% to 64% of infections. The ability of this test to detect an infection decreases if an hour passes before the sample is analyzed.
Cultures can correctly detect an active infection in 70% to 85% of patients with trichomoniasis, although this can vary based on the type of test sample being evaluated.
Newer laboratory methods, including NAATs, nucleic acid probes, and rapid antigen tests are very accurate tests that detect trichomoniasis in most patients who have the infection. The accuracy of these tests vary by laboratory method, brand of test conducted, and the type of sample used in testing.
Do I need follow-up tests?
Follow-up testing is common after an initial test for trichomoniasis.
If you’re diagnosed with trichomoniasis, it’s important to refrain from having sex until you and your sex partners have completed treatment. This usually takes around seven days. Follow-up trichomoniasis testing is recommended to ensure that you aren’t reinfected with this parasite and is typically conducted two weeks to three months after you finish treatment.
If your initial test is with wet-mount microscopy and is negative, further testing is still often necessary. To confirm a negative test result, samples collected from the penis or vagina may be used for NAAT or other methods of trichomoniasis testing.
Questions for your doctor about test results
Many people find it helpful to ask their doctor specific questions about their test results. Questions you may find helpful to discuss with your doctor include:
- What type of test was used?
- What is my trichomoniasis test result?
- Based on my test results, are any follow-up tests necessary?
- What should I tell my sex partners about my test result?
- How often should I be tested for trichomoniasis and other STDs?
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