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What is trichomoniasis?

by Alison Bowler


Trichomoniasis or “Trich” is an infection caused by the organism Trichomonas vaginalis. This is a single celled flagellated protozoan. Vaginitis in women is the most common clinical presentation of Trichomonas infection. The American Social Health Association has estimated that there are about 7.4 million new cases of trichomoniasis each year in the USA.

This organism can infect men and women but men rarely exhibit any symptoms. Symptoms occur more commonly in uncircumcised rather than circumcised men. The occasional symptoms that men do exhibit, with this infection, include a mild urethral discharge, urethral irritation and a burning sensation on urination or ejaculation.

The symptoms in women are much more obvious. There is usually a profuse, odorous, frothy, greenish-yellow colored vaginal discharge. In addition, they may have an itching of the genital area. They may also experience increased irritation on urination or during sexual intercourse. Very occasionally, the woman may feel some pain in the lower abdominal area. However, not all women exhibit symptoms when infected with Trichomonas.

Although frequently transmitted by sexual intercourse trichomoniasis may also be transmitted by sharing a hot tub with an infected person. The use of shared towels, washcloths or bathing suits has also been cited as a source of infection. It is thought the organism can live for up to forty-five minutes outside of the human body allowing transmission by this means.

It is rare that Trichomonas vaginalis is isolated from men but diagnosis in a woman is relatively easy. Internal examination with the use of a speculum sometimes shows small red ulcers on the cervix or the walls of the vagina. Where these ulcers occur on the cervix, the condition is sometimes called strawberry cervix. Some of the discharge or a vaginal swab can be collected and placed in a suitable agar based carrier medium for transport to the microbiology laboratory. Microscopic examination of a wet preparation from the swab will show the characteristic motile Trichomonas. Where only low numbers of infecting organisms are present inoculation of a specialized liquid medium, which is examined microscopically at 1 to 2 day intervals for a week, can aid diagnosis.

Treatment of trichomoniasis is by the use of the drug metronidazole also known as Flagyl®. Con-current treatment of any sexual partners even if they are asymptomatic is recommended as they may present a source of re-infection. The assumption being made that if the woman is infected her male partner is also infected.

Some studies seem to show a correlation of low birth weight or premature babies to mothers who are infected with Trichomonas during pregnancy. There may also be an increased risk of transmitting HIV when someone is also infected with Trichomonas vaginalis. Further studies into these areas are on going.

This article is for information only, not as a guide to self-diagnosis and treatment. A diagnosis of trichomoniasis requires a consultation with a suitably qualified medical practitioner. In addition to diagnosing and treating trichomoniasis, a doctor can check for any other STDs present.

Reference Sources:

CDC Fact Sheet

eMedicine Health

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