Trichomoniasis

Trichomoniasis (or Trichomonas vaginalis, TV) is an infection of the vagina and is caused by a parasite (a flagellate protozoan) that lives in the lower genitourinary tract. The disorder can involve the vagina, urethra and bladder in women. In men, it can affect the prostate gland and urethra.

 

Symptoms and signs

The symptoms varies from women to women. Some may not have any symptoms at all and may not be aware of this infection. Infected men may have no symptoms as well. Typical symptoms are:

  • Vaginal discharge which is foul-smelling, frothy and it is most noticeable after sexual intercourse or after menses.  The discharge color may be greenish or yellowish.
  • Vaginal itching and discomfort.
  • Redness of the vaginal lips (the labia) and vagina.
  • Painful urination especially if the labia is inflamed and the urine touches the surrounding area.

Causes

This is due to a parasite called Trichomonas vaginalis. The transmission from person to person is almost exclusively via sexual intercourse. It may live in its host without producing symptoms. Since it is usually transmitted sexually, both the sexual partners must receive treatment to eliminate it completely.

Complications

Trichomonas infection in women is associated with increased risk of acquiring other sexually transmitted infections, including HIV (human immunodeficiency virus). During pregnancy, it may be associated with complications such as premature birth and low birth weight babies.

Diagnosis

The diagnosis is usually made from the clinical history and the presence of abnormal vaginal discharge seen during the speculum examination. The cervix may appear inflamed. Confirmatory test will require a laboratory studies of the vaginal discharge. Sometimes, the Pap smear (Thin Prep) may report the presence of the trichomonas.

Prevention

  • Use condoms during sexual intercourse.
  • Limit your sexual partners. Multiple sexual partners will increase your risk of acquiring trichomonas or other sexually transmitted infections.
  • Treatment should involve both partners to prevent re-infection.

Expected outcome

Usually curable with treatment.

Treatment

  • Both sexual partners need to be treated at the same time. The medication commonly used is metronidazole. While on this medication, you should not drink alcohol as it can interact with the drug and cause significant nausea, vomiting, sweating, weakness, and other symptoms.
  • Do not douche as it may make it worse.
  • Wear cotton underpants or pantyhose with a cotton crotch.
  • Delay sexual relations until treatment is completed and symptoms have subsided.  Make sure your sexual partner has completed the treatment.
  • No special diet instructions except those involving alcohol.
  • Discuss with your doctor regarding screening for other sexually transmitted infections.

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