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Trichomoniasis

Trichomoniasis is an infection caused by a one-celled protozoan called trichomonas. This is an extremely common cause of vaginal infections. Trichomoniasis is also known as trichomonas vaginitis, trichomonas vaginalis or sometimes trich (pronounced "trick").

Alternative Names of Trichomoniasis are: sexually transmitted disease, STD, protozoal infection, vaginal infection, trichomonads, syphilis, HIV, gonorrhea, Chlamydia.

Complications of Trichomoniasis

The list of complications that have been mentioned in various sources for Trichomoniasis includes:

  • Low birth weight
  • Prematurity
  • Urinary tract infections
  • Penis infection
  • Vaginitis
  • Bladder infection
  • Urethritis
  • Bartholin's gland inflammation
  • High risk of HIV exposure

Causes of Trichomoniasis

Trichomonis can be transmitted through sexual intercourse. In many instances, however, a history compatible with sexual transmission cannot be documented.

Signs & Symptoms of Trichomoniasis

Women

Vaginal discharge
Vaginal itching
Smelly, itchy, and typically frothy or foamy discharge
Yellow or gray-green discharge
Pain with urination possible
Up to one-third of infected women have no symptoms

Men

The majority of infected men have no symptoms
Urethral discharge
Pain with urination
Pain and swelling in the scrotum (from epididymitis)

Diagnosis of Trichomoniasis

The diagnosis is made by directly observing the trichomonads through a microscope (they are too small to be seen by the naked eye).

  • Trichomonads are pear-shaped and have several flagella (whiplike tails) at one end.
  • This lab test is usually ordered only if the doctor suspects trichomoniasis as a possible diagnosis.
  • In some cases, the doctor may have to send the sample to the laboratory, and the result may not come back right away.
  • The doctor will collect the specimen during a pelvic examination.
  • The doctor inserts a speculum into the vagina and then uses a cotton-tipped applicator to collect a sample.
  • The sample is then placed onto a microscope slide and sent to the laboratory to be analyzed.
  • Trichomonads are seen rarely during urine testing.

A diagnosis of trichomoniasis usually prompts a search for other sexually transmitted diseases, such as syphilis, HIV, gonorrhea, or chlamydia.

Treatments of Trichomoniasis

  1. The most effective drug for treatment of trichomonas is metronidazole. The most common brand name is Flagyl. The dosage is usually a single, 2,000 mg dose; or 500 mg twice daily every day for seven days. Usually, treating the female partner in a sexually active couple is enough. However, if infection recurs, the patient's sexual partner(s) must also be treated.
  2. Side effects of Flagyl may include an allergic reaction; nausea and diarrhea; dryness of the mouth; a tinny, metallic taste; a depression in the white blood cell count (leukopenia); and intolerance to alcohol. Many, but not all, people who drink alcohol within 24 hours after Flagyl therapy experience nausea, vomiting, headache and flushing.
  3. Flagyl should never be used during the first three months of pregnancy or while breast feeding, and some authorities say never in pregnancy.

Prevention of Trichomoniasis

All sexually active persons should consider using latex condoms to prevent STDs and HIV infection, even if they are using another form of contraception. Latex condoms used consistently and correctly are an effective means for preventing disease (and pregnancy). Talk openly with your partner about STDs, HIV, hepatitis B infection and the use of contraception.

When to seek Medical Advice

  1. Vaginal itching and discharge should prompt a visit to the doctor.
  2. Trichomoniasis can easily be diagnosed and treated by your doctor. If your doctor is unavailable or you do not have a doctor, you should seek treatment at an urgent care clinic, medical clinic, obstetric-gynecology clinic, or a hospital's emergency department.

Concerned Doctor
Sharmishtha Patra (M.B.B.S., M.S., M.R.C.O.G. (London))
(Mrs) Umesh N. Jindal (M.D)
Amitav Banerji (MBBS, DGO, MD(Cal), MRCOG(London), DFFP(UK))
Minati Gupta (DGO, MD, FICOG)
Mangala Wani (M.D.,F.R.C.O.G.,I.B.C.L.C.)
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