Trichomoniasis Treatment: Metronidazole & Cure Guide

Quick answer: Trichomoniasis is cured with prescription antibiotics, not over-the-counter remedies. The CDC recommends metronidazole 500 mg twice a day for 7 days for women, and a single 2 g dose for men; tinidazole is an alternative. Cure rates are high, and both partners must be treated at the same time to prevent reinfection.

How Is Trichomoniasis Treated?

Of all the STIs I treat, trichomoniasis is one of the most satisfying — because it's genuinely curable, usually with a short, inexpensive course of pills. It's caused by a parasite, Trichomonas vaginalis, and it only responds to one family of antibiotics: the nitroimidazoles, metronidazole and tinidazole. Nothing else works on it, and there's no effective over-the-counter option.

The regimens the CDC recommends are:

The change I make sure patients understand: since 2021, the CDC recommends the 7-day course for women rather than the old single dose, because the evidence showed the longer course clears the infection far more reliably. A provider prescribes the exact regimen — and I'll say it plainly, self-treating with someone's leftover antibiotics is a common way people stay infected.

Why Do Women and Men Get Different Treatment?

It surprises people, but it's well supported. In a large randomized trial, women given a single 2 g dose were significantly more likely to still test positive a month later than women who took the 7-day course. For men, the single dose still does the job. This is exactly why I push for an accurate diagnosis and the right prescription — the "quick" single-dose option isn't the best choice for women.

How Long Does It Take to Cure Trichomoniasis?

In most cases symptoms start easing within a few days, and the infection is typically gone by the end of the course. Because reinfection is so common, the CDC recommends that women be retested about three months after treatment — and I want to be clear why: it's not that the medicine failed, it's that an untreated partner can hand it right back.

Do Both Partners Need Treatment?

Yes — and honestly, this is the step people skip most. Every current partner should be treated at the same time, symptoms or not, or the two of you simply trade the infection back and forth. I tell patients to hold off on sex until everyone involved has finished treatment and is symptom-free.

What to Avoid During Treatment

• Alcohol — skip it during metronidazole or tinidazole and for at least 24–72 hours after the last dose; the combination can cause nausea, vomiting, and flushing.

• Sex — wait until both partners have completed treatment.

If symptoms hang on afterward, that usually points to reinfection or, less often, a resistant strain that needs a different regimen.

Can You Treat Trichomoniasis While Pregnant?

Yes. Metronidazole is considered safe in pregnancy and the same regimen is used. Trich in pregnancy has been linked to preterm birth and low birth weight, so in most cases it's worth treating rather than waiting — tell your provider if you're pregnant.

When to Seek Urgent Care

• Pelvic or lower-abdominal pain with fever.

• Severe symptoms during pregnancy.

• No improvement after finishing the full course — you may need retreatment or evaluation for another infection.

Frequently Asked Questions

Can trichomoniasis be cured without antibiotics?
No — I get asked this a lot. There's no home or over-the-counter cure; only prescription metronidazole or tinidazole reliably clears it.

How long until I'm no longer contagious?
Wait until you and all partners have finished treatment and symptoms are gone — usually about a week — before having sex again.

Will one dose cure it?
For men, a single 2 g dose is standard. For women, the CDC now recommends the 7-day course, which outperforms a single dose.

Do I need a test of cure?
Routine test-of-cure isn't recommended, but I do have women retested at about three months, because reinfection is common.

The Bottom Line

Trichomoniasis is straightforward to cure with the right prescription — as long as both partners are treated and you steer clear of alcohol and sex during the course. If you have symptoms or a partner tested positive, testing is the first step; you can get tested or ask your provider about the right regimen.

Last reviewed: September 2026

Medical review: This article is for informational purposes only and does not constitute medical advice. Medication and dosing decisions should be made with a healthcare provider. Guidance is based on the CDC 2021 STI Treatment Guidelines and CDC STI testing information.