What you should know about trichomoniasis
https://www.medicalnewstoday.com/articles/307896
Medically reviewed by Carolyn Kay, MD on May 20, 2020 New — Written by Lori Smith, BSN, MSN, CRNP
Trichomoniasis is a sexually transmitted infection. A person can pass it on through vaginal, oral, or anal sex.
A parasite called Trichomonas vaginalis causes trichomoniasis, or trich, which is highly curable if a person seeks treatment. However, only about 30% of people with trich experience symptoms, according to the Centers for Disease Control and Prevention (CDC).
Without treatment, trich can lead to complications. It can affect a pregnancy, and it also appears to increase the risk of getting and passing on HIV.
Trichomoniasis is one of the most common sexually transmitted infections (STIs) in the United States, where the CDC estimate that it affects close to 3.7 million people. It is the most common curable STI.
Causes and spread
T. vaginalis, the parasite that causes trich, can pass from one person to another during sex. A person can transmit it during oral, anal, or vaginal sex or through genital touching.
In females, trich is most likely to affect the lower genital tract. In males, it affects the urethra, the tube through which urine passes.
Other parts of the body, such as the anus, hands, or mouth, cannot usually become infected.
The following people have a higher chance of getting trich:
females
people with more than one sexual partner
those with a history of trich or other STIs
people who have unprotected sex
As the number of sexual partners that a person has increases, so does their risk of getting trich.
Symptoms
Symptoms may appear between 5 and 28 days after exposure, or they may appear later or not at all.
When symptoms are present, they can affect males and females differently.
Minor symptoms include irritation, but someone with a more severe case may have inflammation with discharge.
Possible symptoms in females include:
frothy, foul-smelling vaginal discharge, which may be clear, white, gray, yellow, or green
vaginal discharge with blood
genital irritation
discomfort during sex or when urinating
swelling in the groin
frequent urination
in rare cases, lower abdominal pain
Symptoms in males may include:
discharge from the urethra or penis
itching in the penis
burning sensations after ejaculating or urinating
frequent need to urinate
pain when urinating
Complications
Trichomoniasis can lead to several complications, including those below.
Problems during pregnancy
Experts have linked trichomoniasis with complications during pregnancy, including:
preterm birth
early rupture of the membrane
low birth weight in newborns
infertility
A woman can sometimes pass on the infection to the newborn during delivery, but this is rare.
It is safe to receive treatment with metronidazole during pregnancy.
Other problems
Trich may increase the risk of reproductive tract infections.
At least one study suggests that there may also be a link between trich and human papillomavirus (HPV), the virus that causes cervical cancer. More research is necessary, however, to clarify the association.
HIV risk
A trich infection can increase the risk of getting HIV and other STIs, especially in females.
Scientists believe that this increased risk could be due to:
inflammation
a reduced immune response
changes in the balance of vaginal flora, in females
These factors may lower a person’s natural protection from the virus.
Tests and diagnosis
To diagnose a trichomoniasis infection, a doctor will:
carry out a pelvic exam
take a sample of vaginal or penile discharge for examination under a microscope
take a vaginal swab for a culture test in a laboratory
The results of a lab test will come back in about a week.
Preparing for the appointment
Women should aim to schedule the appointment for a time when they are unlikely to be menstruating.
Before the appointment, they should avoid using deodorant on the vulva, as this masks odor and can cause irritation. The doctor may also advise them to avoid vaginal intercourse or inserting any object, including tampons, into the vagina for 24–48 hours beforehand
A Pap (smear) test does not check for trich. If a person has a clear Pap test, they may still have trich or another STI.
As trich increases the risk of passing on HIV, people with HIV should also have a trich test at least once a year.
If the result is positive
If the test results are positive, a doctor will prescribe treatment and discuss what to do next.
The person will need to:
inform all of their sex partners, as they will also need a test
take the whole dose or course of treatment to stop the infection from coming back
avoid sexual contact until the treatment is complete
seek further advice if symptoms remain a few days after finishing a course of antibiotics
The doctor may also recommend having tests for other STIs.
Treatment
Trich is easy to treat in males and females, including during pregnancy.
Treatment usually involves taking a single dose of an antibiotic by mouth. A doctor may also prescribe a vaginal suppository or a cream to apply topically.
Antibiotic medications that kill parasites include metronidazole (Flagyl) and tinidazole (Tindamax).
People should not consume alcohol while taking metronidazole, as there may be an adverse reaction, which can lead to abdominal cramps, nausea, headaches, and flushing.
If symptoms continue after taking the treatment, a person should go back to see their doctor again.
Breastfeeding after treatment
People should not take tinidazole while breastfeeding.
Metronidazole is safe to use, but a doctor may suggest waiting 12–24 hours after taking it before breastfeeding.
Prevention
To prevent infection or reinfection, any sexual partners should also receive treatment.
Ways of preventing the risk of infection or reinfection include:
limiting the number of sexual partners
avoiding sex for 7–10 days after treatment for trich
not using a douche, as this can affect the healthy bacteria in the vagina
limiting or avoiding the use of recreational drugs and alcohol, as these increase the risk of unsafe sex
using a condom for protection during sex
A condom can prevent transmission to some extent, but it is not fully reliable because the parasite can pass from person to person on areas of the body that it does not cover.
Anyone who has symptoms or thinks that they have been exposed to trich should speak to a doctor.
Takeaway
Trichomoniasis is a sexually transmitted infection. It spreads easily and can lead to complications, but effective treatment is available.
Treatment can prevent complications and stop trich from spreading to another person.