Trichomoniasis in men is treated with a single oral dose of an antibiotic, typically clearing the infection within a week. The standard treatment is a one-time 2-gram dose of metronidazole, taken by mouth. Most men can expect symptoms like burning during urination or penile discharge to fade within several days of taking the medication.
The Standard Treatment
The CDC recommends metronidazole 2 grams as a single oral dose for men with trichomoniasis. You take the pills once and the treatment is done. An alternative option is tinidazole, also given as a single 2-gram oral dose. Both belong to the same class of antibiotic and work the same way, killing the parasite that causes the infection.
Most men notice improvement in symptoms like urethral irritation, burning with urination, and discharge within a few days. However, you should wait at least one week after both you and your partner have finished treatment before having oral, vaginal, or anal sex again. Having sex sooner risks reinfection, which is the most common reason the infection comes back.
Why Partner Treatment Matters
Treating your sexual partner at the same time is essential. If your partner isn’t treated, you’ll almost certainly get reinfected the next time you have sex, even if your own treatment worked perfectly. This is the single biggest reason trichomoniasis keeps coming back.
If your partner can’t or won’t visit a doctor, ask your provider about getting medication for them directly. While the CDC formally endorses this approach (called expedited partner therapy) for chlamydia and gonorrhea, many providers apply the same logic to trichomoniasis since the treatment is a simple oral dose. The legality varies by state, so your provider can tell you what’s available where you live.
Getting Diagnosed
Trichomoniasis in men can be tricky to confirm because many men have no symptoms at all. When symptoms do appear, they typically include itching or irritation inside the penis, burning after urination or ejaculation, and a thin discharge.
The most reliable test is a nucleic acid amplification test (NAAT), which detects the parasite’s genetic material. In clinical studies, NAAT testing on male urine samples was 100% sensitive, meaning it caught every positive case, with 98.4% specificity. A urine sample is the preferred specimen type for men, making the test straightforward. Older methods like wet mount microscopy, where a lab technician looks for the parasite under a microscope, miss infections in men far more often than NAAT does.
There are currently no official screening guidelines recommending routine trichomoniasis testing in men. Most men get tested because a female partner was diagnosed, or because they have symptoms. If a partner tells you she tested positive, getting tested yourself before treatment can confirm the diagnosis, but many providers will simply treat you based on the exposure alone.
Avoiding Alcohol During Treatment
Both metronidazole and tinidazole can cause an unpleasant reaction if combined with alcohol: nausea, vomiting, stomach cramps, headache, and flushing. You need to avoid alcohol entirely while taking the medication and for a period afterward.
For metronidazole, the package labeling recommends waiting at least 48 hours after your last dose, though many pharmacies advise 72 hours to be safe. For tinidazole, the recommendation is 72 hours (3 full days) after your last dose. This includes alcoholic beverages and any products containing alcohol or propylene glycol, which shows up in some medications and food products.
What Happens if the Infection Persists
If symptoms don’t resolve after the initial single dose, the reason matters. If you were reexposed to an untreated partner, your provider will typically prescribe the same single 2-gram dose of metronidazole again, since the original treatment likely worked but you were simply reinfected. If reexposure has been ruled out, the next step is a longer course: metronidazole 500 mg twice daily for seven days.
True antibiotic resistance is uncommon but does occur. When infections persist despite the seven-day regimen and reinfection has been excluded, providers move to higher-dose protocols. These can include taking 2 grams of tinidazole daily for seven days, or in more stubborn cases, 14-day courses combining high-dose oral medication with other treatments. Secnidazole, a newer drug in the same antibiotic family, has shown promise for resistant infections as well.
Risks of Leaving It Untreated
Because many men have no symptoms, it’s tempting to assume the infection isn’t doing any harm. That assumption is wrong. Untreated trichomoniasis in men can lead to urethritis (inflammation of the urethra), prostatitis (inflammation of the prostate), and epididymitis (inflammation of the tube behind the testicle). Persistent infection has been linked to impaired sperm function and reduced fertility.
The parasite can travel up the urethra and reach the prostate, which is particularly concerning for older men who already have an enlarged prostate. In these cases, trichomoniasis can worsen urinary symptoms like frequent urination, painful urination, and chronic inflammation. There’s also a well-documented connection to HIV: trichomoniasis causes genital inflammation that makes it easier to contract or transmit HIV, and the parasite increases HIV shedding in semen.
Even without symptoms, treating the infection protects both your own health and your partner’s. Trichomoniasis in women carries more severe consequences, including increased risk of preterm birth, so clearing the infection in male partners is an important part of the broader picture.