References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Trichomoniasis and urinary tract infections (UTIs) are two different conditions that can cause similar symptoms — burning when urinating, pelvic discomfort and unusual discharge. You can’t get trichomoniasis from a UTI, but it’s possible to have both at the same time. Knowing the difference matters because they need different treatments.
Here’s how to tell them apart.
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What Each Condition Is
| Feature | Trichomoniasis | UTI |
|---|---|---|
| Cause | Parasite (Trichomonas vaginalis) | Bacteria (usually E. coli) |
| Type of infection | STI | Not usually an STI — gut bacteria entering the urinary tract |
| Main site | Vagina, urethra, penis | Bladder, urethra, sometimes kidneys |
| Discharge | Yes — frothy, yellow-green, smelly | Usually none |
| Cloudy or smelly urine | Sometimes | Common |
| Treatment | Metronidazole | Antibiotics (e.g. nitrofurantoin, trimethoprim) |
Overlapping Symptoms
- Burning when urinating
- Frequent or urgent urination
- Discomfort in the lower abdomen or pelvis
- Cloudy or strong-smelling urine
These overlaps mean you can’t self-diagnose based on symptoms alone.
Distinguishing Features
Suggests trichomoniasis
- Unusual vaginal discharge — frothy, yellow-green, foul-smelling
- Genital itching
- Pain during sex
- Recent new partner
Suggests UTI
- Strong urge to urinate even when bladder is empty
- Passing small amounts frequently
- Blood in urine
- Lower abdominal pain
- Fever (if kidney involvement)
Can You Have Both?
Yes, it’s possible to have a UTI and trichomoniasis at the same time, particularly if you’ve had recent sexual exposure. Each would need its own treatment.
Getting the Right Diagnosis
- UTI is diagnosed by urine dipstick and sometimes culture
- Trichomoniasis is diagnosed by swab or NAAT test
- If symptoms persist despite UTI treatment, STI testing should be considered
- If symptoms don’t fit a typical UTI, think about STIs
Treatment
- UTI — usually a 3-day course of antibiotics for women; longer courses or different antibiotics for men or complicated cases
- Trichomoniasis — metronidazole, usually for 5-7 days or as a single 2g dose
Using the wrong antibiotic won’t treat the other condition. Proper testing gives proper treatment.
Read more: What is trichomoniasis? | Home UTI tests | Trichomoniasis vs chlamydia
Frequently Asked Questions
Can a UTI cause trichomoniasis?
No. They are different conditions with different causes.
Should I get tested for trichomoniasis if UTI treatment isn’t working?
Yes. Persistent urinary symptoms after UTI treatment should prompt STI testing.
Can metronidazole treat a UTI?
Not usually. Standard UTI antibiotics like nitrofurantoin or trimethoprim target the common bacteria; metronidazole targets parasites and anaerobic bacteria.
Related reading
- Trichomonas Test Using PCR
- What Is Trichomonal Vaginitis?
- What Happens If Trichomoniasis Is Left Untreated?
- Can Trichomoniasis Be Confused With Chlamydia?
- Can You Get Trichomoniasis if Nobody Cheated?
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
