What is Trichomoniasis?

Overview

Maybe you haven’t heard of this infection. It is the stepchild of sexually transmitted diseases—one that is hard to pronounce, let alone find information about why it is important.

Ironically, trichomoniasis (trick-o-mon-i-a-sis or “trich”) is the most common curable sexually transmitted disease (STD). In recent years, diagnosing and treating this disease has received more attention as new research has shown that it is not as harmless as was once thought.

About 3.7 million folks have protozoal infection, consistent with the U.S. Centers for Disease Control and Prevention (CDC). Most men infected with the parasite Trichomonas haven’t any symptoms. When symptoms occur, men could expertise irritation within the member, discharge or slight burning when elimination or ejaculation. Most women are also asymptomatic. Some ladies with the infection expertise a frothy, chromatic emission with a powerful odor, discomfort throughout intercourse, pain during urination, itching in the genital area or spotting between periods. In rare cases, pain in the lower abdomen can occur. Women infected with Trichomonas area unit additional in danger of feat human immunological disorder virus (HIV) and alternative STDs.

Because protozoal infection is thus common and causes vital risks to women’s health, you’d expect to envision additional interest in its hindrance. There area unit many reasons why this STD has received thus very little attention. First, its symptoms—primarily discharge and irritation of the channel and urethra— area unit delicate and are seen as disturbing however less serious than the aspect effects of alternative STDs. Second, the most common treatments—metronidazole and tinidazole—are highly effective in most women, though some difficulties can arise, such as drug allergies or intolerance orTrichomonas becoming resistant to this class of drugs. No other class of drugs is very effective for treatment.

The organisms that cause protozoal infection area unit protozoans (the simplest, single-cell organism in the animal kingdom). These protozoans, called trichomonads, can infect other areas of the body, but Trichomonas vaginalis is responsible for genital infection and vaginitis. This parasite resides primarily within the channel and/or bladder, where body temperature, low oxygen environment and moisture allow it to grow and multiply.

Trichomoniasis is one in every of the 3 commonest kinds of inflammation. The other types arebacterial vaginosis (BV), which is an overgrowth of anaerobic bacteria found in the vagina, and vulvovaginal candidiasis, more commonly known as yeast infection.

As with BV, some analysis suggests that protozoal infection is related to preterm birth. Women infected with Trichomonas throughout physiological state area unit additional doubtless to possess low birth weight babies (less than five.5 pounds).

Studies additionally link protozoal infection with associate degree augmented risk of HIV transmission (HIV is that the virus that ends up in AIDS). Studies show that girls infected with this STD area unit at higher risk of feat and transmission HIV.

Trichomoniasis is transmitted through sexual intercourse. It is most common in people who are at their peak of sexual activity (teens and 20s), but it is found in higher rates among older women than other STDs. Having multiple sex partners and infection with alternative STDs area unit primary factors that increase a woman’s risk of infection.

In very rare cases, trichomoniasis may be transmitted by a pregnant woman to her baby during childbirth. Pregnant women with trichomoniasis are more likely to deliver early and to give birth to a low birth-weight baby (less than 5.5 pounds). Their babies are also more likely to have conjunctivitis.

In the us, about 3 percent of women are infected. Among ladies infected with alternative STDs, such as gonorrhea, the rate of trichomoniasis is higher. For reasons not entirely clear, African American women are 5 to 10 times more likely have trichomoniasis than Hispanic or Caucasian women.

Diagnosis

A significant range of ladies infected with protozoal infection haven’t any noticeable symptoms. If symptoms develop, they usually occur within five to 28 days after exposure to an infected partner. However, in some cases, the symptoms may be delayed for longer. The most common symptoms area unit emission, irritation, itching and burning during urination.

Trichomoniasis most frequently presents as a yellowish-green emission with a powerful odor. Itching and soreness of the vagina and vulva are common. Some women experience vague abdominal pain. Trichomoniasis will occur with alternative infections, particularly pelvic inflammatory disease and bacterial vaginosis.

The majority of men infected with Trichomonas don’t have symptoms. The most common symptom is discharge from the member or burning with elimination. When men have symptoms, they often subside without treatment after a week or more.

For both men and women, a diagnosis based on symptoms is inadequate because many of these symptoms are shared with other inflammatory conditions of the vagina and cervix, such as bacterial vaginosis and yeast infections.

For women, the foremost common thanks to diagnose protozoal infection is by physical examination of the girdle space by a health care skilled and by staring at a sample of channel fluid under a microscope (called “wet mounts”) for the presence of protozoa. A girdle examination will reveal tiny red ulcerations on the channel wall or cervix. The wet mount technique, however, is accurate only about 60 percent to 70 percent of the time, as protozoa may be hard to find or mistaken for normal cells. It can also yield false positives. There are many rapid-diagnostic kits on the market which will diagnose infection in ten to forty five minutes. These tests additionally keep company with the danger of false positives.

More reliable tests have been developed, such as the polymerase chain reaction (PCR) test, a type of nucleic acid test that uses enzymes to better detect the virus in the culture. It is very effective in identifying T. vaginalis in ladies and is changing into additional pronto on the market.

Treatment

The standard medication used for treating protozoal infection square measure Flagyl (Flagyl) and tinidazole (Tindamax). In most cases, Trichomonas infection is cured in ladies with one oral dose of 2 grams of either drug. Both of those prescribed drugs square measure within the nitroimidazole category. Metronidazole has been found to be safe in maternity.

All sexual partners of associate infected person ought to be treated. An infected person ought to abstain from sex throughout treatment and till all symptoms depart, more or less per week or 2 once treatment. Because of the high rate of reinfection (up to seventeen % among 3 months), sexually active ladies might want to contemplate obtaining rescreened 3 months once treatment. This is particularly necessary for HIV-infected ladies United Nations agency even have protozoal infection, as a result of they need an excellent higher rate of return.

For those who fail treatment, longer courses of metronidazole or tinidazole are recommended by the Centers for Disease Control and Prevention (CDC). Patients United Nations agency still have associate infection once one dose of Flagyl ought to take five hundred milligrams of Flagyl orally double daily for seven days. If this second course of medication fails, the government agency says to contemplate treating with 2 grams daily for 5 days of either Flagyl or tinidazole. If these therapies fail to cure the infection, further treatment should be discussed with a specialist.

You should take metronidazole or tinidazole with food and avoid drinking alcohol for 24 to 72 hours after taking the drugs.

 Prevention

Prevention of trichomoniasis is similar to that for other sexually transmitted diseases (STDs). Protective measures include:

  • Use a latex condom every time you have sex.
  • Limit your number of sex partners.
  • Get tested if you think you have an STD and have your partner tested, too.

Facts to Know

  1. Trichomoniasis is that the commonest curable sexually transmitted illness within the u. s.. According to the CDC, about 3.7 million people in the United States have trichomoniasis.
  2. Trichomoniasis is more common among African American women. The reason for this is not clear. Lack of access to medical care in economically challenged communities may play a role.
  3. Trichomoniasis increases a woman’s risk of preterm birth or delivery of a low birth weight baby.
  4. It is necessary that sexual partners of infected ladies be treated. Although protozoal infection is usually well in males, if left untreated it can cause urethral infections, particularly urethritis, and can lead to reinfection of the woman.
  5. Because a check for canal infection isn’t essentially a district of a routine girdle communicating, you cannot assume your health care skilled can check you for protozoal infection. You should request trichomoniasis screening if you have symptoms or if you have been in contact with a high-risk sexual partner.
  6. You can have more than one type of vaginitis at the same time. It is possible to have trichomoniasis and bacterial vaginosis together, each of which can be treated with metronidazole.
  7. If you visit your health care professional to see if you have a vaginal infection, you should schedule your examination when you are not having your period.
  8. It is easy to misdiagnose trichomoniasis or bacterial vaginosis as a yeast infection because yeast infection also causes an unpleasant discharge. Treatment for yeast infections is different than for trichomoniasis or BV, so an accurate diagnosis is important.

Key Q&A

  1. How do I know if I need to see my health care professional?Pay attention to your body. Call your health care professional if you experience any unusual symptoms, such as: a change in the color, odor or consistency of vaginal fluid; vulvar irritation; itching; and burning, frequent or painful urination.
  2. What if I am allergic to the 5-nitroimidazole drugs (metronidazole or tinidazole) or am not responding well to them?Up to 10 percent of women do not respond to standard treatment. For those who fail treatment, a longer course of metronidazole is recommended by the Centers for Disease Control and Prevention (CDC). If this second course of medication fails, the CDC recommends two grams daily for five days of either metronidazole or tinidazole.If you develop a rash in response to the 5-nitroimidazole medication, there are other medications you can try, but they have poor cure rates. If you’re allergic to tinidazole and Flagyl, your provider may suggest desensitizing you to these medications so you can undergo treatment.
  3. What are my chances of having trichomoniasis reoccur?Treatment is successful in most women, and once the organisms are killed they don’t come back unless you are exposed again to an infected partner.
  4. What is the relationship between vaginitis and excessive douching?The healthy vaginal ecosystem requires just the right balance of bacteria flora. These bacteria make natural acids that keep abnormal bacteria from becoming predominant. Douching may disrupt the pH balance of the vagina and lead to bacterial vaginosis, which may increase a woman’s risk of acquiring trichomoniasis.
  5. What about diagnosing and treating trichomoniasis in men?The organisms that cause trichomoniasis often don’t cause symptoms in males. Consequently, most men never seek treatment because they don’t know they are infected. Diagnosis in men is usually made with a urine culture specifically for Trichomonas. If your sexual partners are not treated, it is likely you will become reinfected.
  6. What is considered normal vaginal discharge?For clean ladies, vaginal discharge is usually cloudy white in appearance. Discharge typically will increase within the middle of your oscillation, and during ovulation it changes consistency, appearing similar to egg whites. Symptomatic ladies with protozoal infection expertise a frothy, chromatic discharge with a robust odor, presumably let alone discomfort throughout intercourse, painful excretion or venereal itch.