Fast Five Quiz: Vaginal Health

Michel E. Rivlin, MD


October 01, 2021

Unlike chlamydia, which has a peak rate among women aged 19-24 years, the incidence of trichomoniasis is highest among women aged 40-49 years. Trichomoniasis symptoms in women range from no symptoms to severe pelvic inflammatory disease. Women with trichomoniasis frequently report an abnormal vaginal discharge (yellow/gray-green), which may be purulent, frothy, or bloody. Although frothy vaginal discharge is thought to be the classic presentation of trichomoniasis, women with trichomoniasis also commonly report:

  • Abnormal vaginal odor (often described as musty)

  • Vulvovaginal itching, burning, or soreness

  • Dyspareunia (often the major complaint)

  • Dysuria

  • Postcoital bleeding

  • Lower abdominal pain

Given the poor reliability of a patient's medical history and physical findings, the diagnosis of trichomoniasis depends on laboratory testing. Tests for trichomoniasis are quick and can be performed in the medical office. The Centers for Disease Control and Prevention (CDC) now recommend molecular diagnostic tests, when available, to evaluate patients at risk for trichomoniasis.

After a positive diagnosis, treatment should be instituted immediately and, whenever possible, in conjunction with all sexual partners. Expedited partner therapy is a safe and effective means of treating the sexual partners of patients diagnosed with trichomoniasis and should be practiced whenever possible. Both patient and partner should abstain from sex until pharmacologic treatment has been completed and they have no symptoms. For women, the CDC recommends oral metronidazole (500 mg) twice daily for 7 days. Tinidazole (2 g) orally in a single dose is an alternative regimen. Metronidazole gel is effective in less than 50% of patients with trichomoniasis and is not recommended to treat the disease.

Read more information about trichomoniasis.

This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases articles Vaginal Cancer, Bacterial Vaginosis, Vulvovaginitis, Trichomoniasis, and Pelvic Organ Prolapse.

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