Trichomoniasis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Trichomoniasis
Trichomonas vaginalis under a microscope
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Vaginal discharge, itching, burning sensation, dysuria
Complications	Pelvic inflammatory disease, infertility, preterm birth
Onset	5 to 28 days after exposure
Duration	Can be long-term if untreated
Types	N/A
Causes	Trichomonas vaginalis
Risks	Multiple sexual partners, unprotected sex
Diagnosis	Microscopy, culture, nucleic acid amplification test
Differential diagnosis	Bacterial vaginosis, candidiasis, gonorrhea
Prevention	Condom use, sexual abstinence
Treatment	Metronidazole, tinidazole
Medication	Antibiotics
Prognosis	N/A
Frequency	122 million new cases (2015)
Deaths	N/A

Trichomoniasis (or trich”) is a very common sexually transmitted disease (STD).

Cause

• It is caused by infection with a protozoan parasite called Trichomonas vaginalis.
• Although symptoms of the disease vary, most people who have the parasite cannot tell they are infected.

Trichomoniasis

Incidence

Trichomoniasis is the most common curable STD. In the United States, an estimated 3.7 million people have the infection. However, only about 30% develop any symptoms of trichomoniasis. Infection is more common in women than in men. Older women are more likely than younger women to have been infected with trichomoniasis.

Transmission

The parasite passes from an infected person to an uninfected person during sex. Women

• In women, the most commonly infected part of the body is the lower genital tract (vulva, vagina, cervix, or urethra).

Men

• In men, the most commonly infected body part is the inside of the penis or (urethra).
• During sex, the parasite usually spreads from a penis to a vagina, or from a vagina to a penis.
• It can also spread from a vagina to another vagina. It is not common for the parasite to infect other body parts, like the hands, mouth, or anus. It is unclear why some people with the infection get symptoms while others do not.
• It probably depends on factors like a person‚Äôs age and overall health. Infected people without symptoms can still pass the infection on to others.

Trichomonas vaginalis

Signs and symptoms of trichomoniasis

About 70% of infected people do not have any signs or symptoms. When trichomoniasis does cause symptoms, they can range from mild irritation to severe inflammation. Some people with symptoms get them within 5 to 28 days after being infected. Others do not develop symptoms until much later. Symptoms can come and go. Men with trichomoniasis may notice:

• Itching or irritation inside the penis;
• Burning after urination or ejaculation;
• Discharge from the penis.

Women with trichomoniasis may notice:

Trichomoniasis world map-DALYs per million females-WHO2012

• Itching, burning, redness or soreness of the genitals;
• Discomfort with urination;
• A change in their vaginal discharge (i.e., thin discharge or increased volume) that can be clear, white, yellowish, or greenish with an unusual fishy smell.

Having trichomoniasis can make it feel unpleasant to have sex. Without treatment, the infection can last for months or even years.

Complications

Trichomoniasis can increase the risk of getting or spreading other sexually transmitted infections. For example, trichomoniasis can cause genital inflammation that makes it easier to get infected with HIV, or to pass the HIV virus on to a sex partner. STDs During Pregnancy Pregnant women with trichomoniasis are more likely to have their babies too early (preterm delivery). Also, babies born to infected mothers are more likely to have a low birth weight (less than 5.5 pounds).

Diagnosis

• It is not possible to diagnose trichomoniasis based on symptoms alone.
• For both men and women, your health care provider can examine you and get a laboratory test to diagnose trichomoniasis.

Treatment

• Trichomoniasis can be cured with a single dose of prescription antibiotic medication (either metronidazole or tinidazole), pills which can be taken by mouth.
• It is okay for pregnant women to take this medication.
• Some people who drink alcohol within 24 hours after taking this kind of antibiotic can have uncomfortable side effects.
• People who have been treated for trichomoniasis can get it again.
• About 1 in 5 people get infected again within 3 months after treatment.
• To avoid getting reinfected, make sure that all of your sex partners get treated too, and wait to have sex again until all of your symptoms go away (about a week). Get checked again if your symptoms come back.

Prevention

• The only way to avoid STDs is to not have vaginal, anal, or oral sex.
• If you are sexually active, you can do the following things to lower your chances of getting trichomoniasis:
• Be in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results;
• Use latex condoms the right way every time you have sex. This can lower your chances of getting trichomoniasis.

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