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Trichomoniasis

Trichomoniasis

Trichomoniasis (TRIK-uh-muh-NEYE-uh-suhss) is a sexually transmitted infection (STI) caused by a parasite. It is sometimes called "trich". Trichomoniasis is the most common curable STI found in young, sexually active women.

 

The parasite is spread through sexual contact. Women can get it by having penis-to-vagina intercourse with an infected man or vulva-to-vulva contact with an infected woman. Men usually get it only from infected women.

 

To prevent reinfection with the organism that causes trichomoniasis, both partners should be treated. The most common treatment for trichomoniasis involves taking one megadose of metronidazole (Flagyl). Infection can be prevented by using condoms and spermicide.

Symptoms

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).

Causes

Trichomoniasis is caused by Trichomonas vaginalis, a flagellated motile protozoan.

 

  • Approximately 174 million people worldwide are infected with this parasite each year, making it the most common curablesexually transmitted infection worldwide.
  • The average size of a trichomonad is 15 mm (they are not visible with the naked eye).
  • Reproduction of the parasites occurs every 8-12 hours.
  • Trichomonas vaginalis was isolated in 14%-60% of male partners of infected women and in 67%-100% of female partners of infected men. It is unclear why women are infected more often than men. One possibility is that prostatic fluid contains zinc and other substances that may be harmful to trichomonads.

 

Is There a Test For Trichomoniasis?

 

To tell if you have trichomoniasis, your doctor will do a pelvic exam and lab test. During the pelvic exam, your doctor may be able to see small red sores inside the vagina or on the cervix. Your doctor will also take a fluid sample from the vagina to look for the parasite under a microscope or to send to a lab. Other tests, like a vaginal culture or DNA test can also be used for testing.

 

If you have trichomoniasis, ask your doctor if you should be tested for other STIs too.

Treatment

Self-Care at Home

 

The treatment of choice is antibioticsprescribed by the doctor. In addition to antibiotics, some alternative medicine therapies are available. These therapies are not known to be beneficial, and no rigorous scientific evidence supports their use.

 

Home therapyshould not be used instead of a doctor's visit and appropriate antibiotics, as this may allow the spread of the condition as well as harmful sexually transmitted diseases, such as syphilis, HIV, gonorrhea, or chlamydia (the author does not advise you to use these alternative therapies but these are listed to be complete).

 

  • Some people feel that natural douches once a day while lying in a warm bath may help. To increase parasite-killing activity, you may add the juice of one lemon to either of the following douches: 
  1. Vinegar douche - 1 teaspoon vinegar to 1 quart warm water.
  2. Live-culture yogurt douche or a solution of Lactobacillus acidophilus.  One-half teaspoon to one cup of water.

 

  • Aromatherapy: Oil of bergamot (Citrus aurantium var bergamia) may help dry up irritating discharge. It can be used in douches or added to bath water.

 

Medical Treatment

 

The treatment of choice is metronidazole (Flagyl), except in the first trimester ofpregnancy, when clotrimazole is used topically. It is important not to drink alcohol while taking this drug (the combination can lead toabdominal pain and vomiting). 

 

Metronidazole (Flagyl)

 

  • A large single dose is as effective as longer term treatment, but increases the risk of side effects such as nausea and vomiting

 

  • Pills taken twice a day for 7 days is an alternative.

 

  • Clotrimazole (Gyne-Lotrimin, Mycelex-7) ifpregnant and having symptoms.

 

  • Medicine is inserted into the vagina at night for 14 days. 

 

  • This will decrease symptoms, but the cure rate is only 20%.

 

Partners

 

  • Because infected male partners often do not have any symptoms, they do not seek medical care. It is important, however, that your sexual partner is evaluated and treated. Otherwise you may become reinfected. 

 

  • Your partner will be given one large dose of metronidazole or may be treated for 7 days. 

 

  • Your doctor may not routinely write an additional prescription for your partner without evaluating him or her first.
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