Trichomoniasis

Trichomonas is a common sexually transmitted disease caused by a single-cell parasitic protozoan, Trichomonas vaginalis, which was first discovered in 1836. 

About 5 million Americans develop trichomoniasis every year.  It has been found in:

• 5%-15% of women at gynecology clinics
• 50%-75% of prostitutes in the United States

It is often diagnosed in patients who are already infected with other STDs such as:

• gonorrhea
• nongonococcal urethritis (NGU)

Symptoms

Trichomoniasis  infection frequently has no symptoms. There have been rare cases where the incubation period of the infection has covered years, but usually symptoms appear within 4-20 days of exposure, and include:

In women

• blood spotting in vaginal discharge
• heavy, yellowish-green or gray, frothy vaginal discharge
• infection in the urethra, the tube that carries urine from the bladder out of the body
• itching, burning or pain in the vagina
• lower abdominal pain
• musty vaginal odor
• pain and/or burning when urinating
• pain or discomfort during sexual intercourse (dyspareunia)
• swelling in the groin
• swollen and irritated vagina and cervix
• urinating more than usual
• vaginal or vulval redness
• worsening symptoms when menstruating

In Men

Men rarely have any symptoms, however, if symptoms do occur they include:

• infection of the urethra or prostate gland, which is involved in semen production
• painful and/or difficult urination
• thin, whitish discharge from the penis
• tingling inside the penis

* Men mostly do not show symptoms but it is advisable to seek treatment if their partner has Trichomoniasis as infection is likely.

Transmission

The parasite rarely causes symptoms in men and re-infection of women by untreated partners can often occur.  

It can be spread during:

• anal sex
• mutual masturbation when bodily fluids from one partner come in contact with the other's genitals (in rare cases)
• oral sex
• vaginal sex

Unlike most STDs, Trichomonas can survive for some hours outside the body on infected objects and can be transmitted by sharing:

• bodily fluids
• contaminated bedding
• damp towels
• sheets
• toilet seats

Diagnosis

Trichomonas is a pear-shaped protozoa with a tail (flagellate). 

Diagnosis can be made by:

Culture Tests

A culture of the organism or an antibody test may be done, especially in men, as relatively few of the parasites are found in discharges from the penis

Examination under a Microscope

Samples of vaginal discharge or secretions from the penis are examined under a microscope

Laboratory Testing

Samples of vaginal discharge or secretions from the penis may be sent to a laboratory to see if Trichomonas is present and may take up to 2 weeks for the results

Pap smears

Pap Smears are sometimes used to confirm diagnosis

Treatment

Antibiotics are usually successful (cure rate 95%) even though this infection is not a bacteria.  It is usually administered in a single dose.

Procedure

Sexual partners need treatment at the same time to eliminate the parasite and to prevent re-exposure and re-infection.

Antibiotics used are:

Metronidazole

This antibiotic is also called Flagyl

Caution

If taken with alcohol it can cause severe:

• nausea
• vomiting

Azithromycin

This antibiotic is also called Zithromax and has fewer side effects but is more expensive

5-notroimidazoles

These drugs are successful for both partners

If left untreated Trichomoniasis can:

• be spread to your sexual partner(s)
• cause infections in the urethra or prostate gland in men
• continue to cause uncomfortable symptoms

Prevention

Transmission of this parasite from one person to the next may be reduced by:

• Abstinence from sex until the infection is cured
• Consistent and correct male, latex condom use, put on before starting sex and worn until the penis is withdrawn
• Spermicides and diaphragms which may provide some protection
• Treatment of the male partner

Help Factors

• If you have come in contact with trichomoniasis see your doctor, health professional or urologist immediately
• Know your partner's sexual history
• Limit one's sexual relationship to a single, uninfected partner

Note

• Douching or urinating after sex does not prevent STDs
• Frequent use of spermicides can cause vaginal inflammation

Prognosis

Complications

It has been shown that Trichomoniasis:

• is associated with increased risk of transmission of HIV
• may cause a woman to deliver a low-birth-weight or premature infant