Trichomoniasis

Description

Trichomoniasis is a common sexually transmitted infection caused by a parasite. In women, trichomoniasis can cause a foul-smelling vaginal discharge, genital itching and painful urination.

Men who have trichomoniasis typically have no symptoms. Pregnant women who have trichomoniasis might be at higher risk of giving birth to their babies before time.

The treatment for trichomoniasis is taking an antibiotic — either metronidazole (Flagyl), tinidazole (Tindamax) or secnidazole (Solosec). To avoid being infected again, all sexual partners should be treated at the same time. You can reduce your risk of infection with the condom correctly every time you have sex.

Symptoms

The majority of people with trichomoniasis do not have signs or symptoms. However, symptoms may develop over time. When signs and symptoms are different for men and women.

In women, trichomoniasis signs and symptoms include:

  • A large amount of thin, often foul-smelling discharge from the vagina, which may be clear, white, gray, yellow, or green
  • Genital redness, burning, and itching
  • Pain with urination or sex
  • The discomfort in the lower part of the stomach area

In men, trichomoniasis rarely causes symptoms. When men have signs and symptoms, however, may include:

  • Itching or irritation inside the penis
  • Burning with urination or after ejaculation
  • Discharge from the penis

When to see a doctor

Consult your health care provider if you have any of the symptoms of trichomoniasis, or if you become aware that a sex partner has the infection.

Causes

Trichomoniasis is caused by a protozoan cell, a type of small parasite called Trichomonas vaginalis. The parasite is passed between people during genital contact, including vaginal, oral or anal sex. The infection can be transmitted between men and women, the women, and sometimes men.

The parasite infects the lower genital tract. In women, this includes the external genitals (vulva), the vagina, the cervix of the uterus (cervix) and the urinary opening (urethra). In men, the parasite infects the inside of the penis (urethra).

The time between exposure to the parasite and the infection (incubation period) is unknown. But it is thought that for the range of four to 28 days. Even without symptoms, you or your partner can spread the infection.

Risk factors

The risk factors for contracting trichomoniasis include:

  • Multiple sexual partners
  • A history of other sexually transmitted infections (Stis)
  • A previous episode of trichomoniasis
  • Sex without a condom

Complications

Pregnant women who have trichomoniasis, you can:

  • Deliver too soon (before time)
  • Having a baby with low birth weight
  • Give the infection to her baby as the baby passes through the birth canal

Trichomoniasis can cause irritation in the genital area, which can make it easier for other sexually transmitted infections (Stis) to enter into the body, or to pass them to others. Trichomoniasis also appears to make it easier to become infected with the human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS).

Trichomoniasis is associated with an increased risk of cervical or prostate cancer.

Untreated, trichomoniasis, the infection may last from months to years.

Prevention

As with other sexually transmitted infections, the only way to prevent trichomoniasis is to not have sex. To reduce your risk, internal or external use of condoms correctly every time you have sex.

Trichomoniasis

Diagnosis

Your health care provider can diagnose trichomoniasis by an examination of the genitals and laboratory tests.

Your health care provider may also examine a sample of vaginal discharge for women or a swab from the inside of the penis (urethra) to the men under a microscope. If the parasite can be seen under the microscope, no further tests are needed.

If the test does not show the parasite, but your doctor believes you may have trichomoniasis, other tests may be done. Your doctor may order tests that are performed on a sample of fluid from the vagina, penis uretheral swab or sometimes the urine. The tests include a rapid antigen test and nucleic acid amplification test.

If you have trichomoniasis, your provider may also test for other sexually transmitted infections (Stis), so it can also be treated.

Treatment

The treatment of trichomoniasis requires an oral antibiotic that is effective against infections caused by this parasite. The treatment can be administered during pregnancy. The options may include:

  • Megadose. Your health care provider may recommend a large dose (megadose) or metronidazole (Flagyl), tinidazole (Tindamax) or secnidazole (Solosec). Only take these medicines by mouth once.
  • Multiple doses. Your doctor could recommend a number of smaller doses of metronidazole or tinidazole. Take the pills twice a day for seven days. To help remove the infection completely, keep taking this medicine for the full time that your healthcare provider prescribed the medication, even if you begin to feel better after a few days. If you stop using this medicine too soon, the infection may not go away completely.

All sex partners need treatment at the same time. This prevents the spread of the new infection right way (re-infection). And you need to avoid sexual intercourse until the treatment is performed, and the symptoms have disappeared. This usually takes about a week after the end of the last dose of the antibiotic. Tell your health care provider if symptoms do not disappear after treatment.

Drinking alcohol during and for a couple of days after the treatment can cause severe nausea and vomiting. Do not drink alcohol for 24 hours after taking metronidazole, 48 hours after taking secnidazole or 72 hours after taking tinidazole.

Your health care provider will usually repeat the test for trichomoniasis after treatment. A test of two weeks to three months after the treatment you can check to make sure the infection is gone and has not returned to infect.

Even if you have had the treatment that gets rid of trichomoniasis, it is possible to obtain again if you are exposed to someone with the infection.

Preparing for your appointment

Your family doctor, gynecologist or a doctor in an urgent care center can diagnose and prescribe treatment for trichomoniasis.

What you can do

Before the appointment, you can prepare a list that includes:

  • A detailed description of the symptoms, even when they began to
  • Sexually transmitted infections that you've had
  • The number of sexual partners you've had during the last few years

What to expect from your doctor

For women, your doctor will perform a pelvic exam and may take a sample of vaginal fluid for testing. Men will need to provide a urine sample.

Symptoms and treatment of Trichomoniasis