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Trichomoniasis

Trichomoniasis is a common sexually transmitted disease (STD) that affects young, sexually active women. Trichomoniasis is caused by the single-celled protozoan parasite, Trichomonas vaginalis. An estimated 7.4 million new cases occur each year in women and men. About 20% of women develop trichomoniasis of the vagina (trichomonas vaginitis) during their reproductive years

Trichomoniasis sometimes called “trich”- this infection is caused by the parasite Trichomonas vaginalis. Trichomoniasis can affect both men and women but women are much more likely to suffer from symptoms once infected. In fact, only 10% to 50% of men infected will exhibit any symptoms of trichomoniasis. This makes infection of sexual partners very easy.

Trichomoniasis transmission

Trichomoniasis is most commonly transmitted through unprotected sexual intercourse.

Trichomoniasis

Trichomoniasis

Almost 100% of infections occur through penis-to-vagina intercourse or vulva-to-vulva intercourse with an infected partner. Women can become infected through contact with both men and women. Men are more likely to contract the infection from women. The vagina is the most common site of infection in women while the urethra (urinary tract) is the most common site of infection in men. Because the trich protozoa can live outside the body for 45 minutes it is possible to contract trichomoniasis if you come into contact with infected towels, bedding, or bathing suits. However, it is very rare to contract the infection in this way.

About 1 of 5 women develops trichomoniasis of the vagina. Most men with trichomoniasis have no symptoms, but they can still infect their sex partners.

The genital inflammation caused by trichomoniasis can increase women’s susceptibility to HIV infection if she is exposed to the virus. Having trichomoniasis may increase the chance that an HIV- infected woman passes HIV to her sex partner(s).

Trichomoniasis symptoms

Symptoms of trichomoniasis usually appear in women within 5 to 28 days of exposure.
Most common trichomoniasis symptoms include:

Vaginal Discharge
In women, the infection usually starts with a greenish yellow, frothy, fishy-smelling vaginal discharge. Strong vaginal odor is pretty typical for trichomoniasis.
Vaginal discharge can be combined with irritation and soreness in the genital area.
In some women, the discharge is slight.

Vulva irritation and/or Discomfort during intercourse
The vulva may be irritated, itchy and sore. In severe cases, the vulva and surrounding skin may be inflamed, and the labia swollen.
The infection also may cause discomfort and/or pain during intercourse as well as irritation and itching of the female genital area.

Urination problems
Urination may be painful or frequent, as occurs in a bladder infection (UTI). Urinary and vaginal symptoms may occur alone or together.

“Strawberry cervix”
Women may also suffer from “strawberry cervix,” in which lesions form on the cervix and vaginal walls, giving the appearance of redness.

Lower abdominal pain
In rare cases, lower abdominal pain can occur.
About 10% of women with trichomoniasis can experience lower abdominal pain

Combined STD infections
Men are less likely to have symptoms but may have a frothy, pus-like discharge from the penis, and urination may be painful and frequent.

Trichomoniasis and pregnancy

Pregnant women with trichomoniasis could have premature delivery with low birth weight babies – low birth weight is less than 5.5 pounds.

Complications

If left untreated, trichomoniasis can rage on for years. In men, this can cause damage to the bladder and prostate. Prolonged infection in women can cause inflamed fallopian tubes and damage to the tissues of the cervix. “Trich” is also associated with an increased risk of contracting HIV, the virus that causes AIDS. It is thought that if you are infected with “trich”, you are 3 to 5 times more likely to be infected with HIV.

Babies born to women infected with trichomoniasis are often born prematurely or at a low birth weight. “Trich” can cause the lining of the uterus to dislodge or tear, causing your baby to arrive early.

Diagnosis

In most cases doctors suspect trichomoniasis in women with vaginal infections. In women, the diagnosis can usually be made quickly by examining a sample of the vaginal discharge with a microscope and identifying the organism. If results are unclear, the sample is cultured for several days. Occasionally, microscopic examination of the urine detects Trichomonas, but identification is more likely if a urine culture is done.

Tests for other STDs are usually also done because many people with trichomoniasis also have gonorrhea or Chlamydia infection.

Treatment

A single dose of an antibiotic cures most women, but most men need to take an antibiotic for 7 days. Trichomoniasis is easily treated with oral antibiotics. The drug metronidazole is a 90%-95% effective cure for trichomoniasis infections. Pregnant women may also be treated with metronidazole, in order to prevent the “trich” bacteria from threatening pregnancy.

If taken with alcohol, metronidazole could cause nausea and flushing of the skin. The drug may also cause a metallic taste in the mouth, nausea, or a decrease in the number of white blood cells. Women who take the drug may be more susceptible to vaginal yeast infections (vaginal candidiasis). Metronidazole is best avoided during pregnancy, at least during the first 3 months.

Infected people should abstain from sexual intercourse until the infection is cured, or they can infect their partners.

Risk factors

Certain groups are at a higher risk for contracting trichomoniasis. Anyone with immune system disorders or with weakened immune systems is at a heightened risk of infection. This includes people who are diabetic or obese, those who have just given birth, and those who are taking antibiotics or oral contraceptives. If you already have a sexually transmitted disease you are also at an increased risk of contracting “trich”. Trichomoniasis is highly associated with Chlamydia, gonorrhea, and HIV infections.

Prevention

  • Trichomoniasis can only be prevented by abstaining from sex or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
  • If you do have sex, use a condom. Condoms will significantly reduce the likelihood of infection. Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of trichomoniasis.
  • Avoid multiple sex partners, as this will also put you at risk for infection. Investigate the sexual health of your partner and get tested before having sex. If you do have symptoms of trichomoniasis, avoid all sexual contact until you have received and completed treatment.
  • Avoid using other people’s towels or swimsuits and shower after you go swimming. Avoid wearing tightly woven nylon underwear or pantyhose, as this can create a warm and moist environment where bacteria can thrive.
  • Any genital symptom such as discharge or burning during urination or an unusual sore or rash should be a signal to stop having sex and to consult a health care provider immediately.
  • A person diagnosed with trichomoniasis (or any other STD) should receive treatment and should notify all recent sex partners so that they can see a health care provider and be treated. This reduces the risk that the sex partners will develop complications from trichomoniasis and reduces the risk that the person with trichomoniasis will become re-infected. Sex should be stopped until the person with trichomoniasis and all of his or her recent partners complete treatment for trichomoniasis and have no symptoms.

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