Trichomoniasis - Symptoms & Treatment

Trichomoniasis is a protozoal infection of the lower genitourinary tract. It affects about 20% of sexually active women and 10% of sexually active men. The infection usually involves only the vagina or urethra.

The disease occurs worldwide. In women, the condition may be acute or chronic. The prognosis is good, especially if both sexual partners receive treatment concurrently; otherwise, the disease may recur. Symptoms may subside even if the disease isn't treated, although Tichomonas vaginalis infection persists, possibly resulting in abnormal cytologic cervical smears.

Causes

Trichomoniasis is caused by the parasite Trichomonas vaginalis , which is transmitted principally through direct sexual contact. It also can be spread during mutual masturbation and by sharing sex toys.

Trichomoniasis usually is transmitted by intercourse; less often, it is transmitted by contaminated douche equipment and moist washcloths. An infected mother may transmit the infection to her newborn child through vaginal delivery.

Signs and symptoms

Most men with trichomoniasis do not have signs or symptoms; however, some men may temporarily have an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation.

Some women have signs or symptoms of infection which include a frothy, yellow-green vaginal discharge with a strong odor. The infection also may cause discomfort during intercourse and urination, as well as irritation and itching of the female genital area. In rare cases, lower abdominal pain can occur. Symptoms usually appear in women within 5 to 28 days of exposure.

Diagnostic tests 

Culturing a sample of discharge is the most reliable method of diagnosis. A swab is passed through a man's urethra or a woman's vagina to collect a sample. It takes 10 days to obtain results.

In women, a microscopic examination of vaginal fluid, Pap smear, and urinalysis are performed. The cervix is examined for hemorrhaging. Because trichomoniasis often occurs with other STDs, patients are screened for chlamydia, gonorrhea, syphilis, and HIV.

Treatment

Oral metronidazole given simultaneously to both sexual partners effectively cures trichomoniasis. The recommended dosage is 250 mg of oral metronidazole given three times a day for 7 days or one 2-g oral dose.

Oral metronidazole hasn't been proven safe during the first trimester of pregnancy. A pregnant patient in the first trimester may insert a clotrimazole vaginal tablet at bedtime for 7 days for symptomatic relief. Sitz baths may help relieve symptoms.

Prevention

Trichomoniasis is present in the sexually active population of all ages. A monogamous sexual relationship with a known healthy partner can help reduce the risk of this and all other sexually-transmitted diseases.

Barring total abstinence, condoms remain the best and most reliable protection against this and other sexually-transmitted diseases. Condoms must be used consistently and correctly. See safer sex behaviors.