What is trichomoniasis – in sexually transmitted diseases

Commonly called trich, a sexually transmitted disease that produces an estimated 5 million new cases in the United States every year, according to a 2000 report from the Centers for Disease Control and Prevention. Mainly an infection of the urogenital tract, it usually occurs in certain sites the urethra in men and vagina in women. It is pronounced trick-oh-moenyeuhsis. This disease is also called trichomonas ( trick-oh-moe-nass ).

Cause

Trichomoniasis is caused by the single-celled protozoan parasite Trichomonas vaginalis. It is spread through penis to vagina intercourse or vulva to vulva contact with an infected partner. A female can contract this disease from an infected man or woman, but men usually contract it from infected women only. Women are more likely to have symptoms than are men, but both the woman and her sexual partners must be treated.

Symptoms

It is not unusual for a person with trichomoniasis to have no symptoms. When women do have symptoms, these may include burning, itching, frothy and smelly vaginal discharge (gray or yellow green), vaginal or vulvar redness, painful or frequent urination, lower abdominal pain, and discomfort during intercourse. The problems appear within five to 28 days of exposure. Typically, if a woman is going to have symptoms, she has them within six months of being infected. Sometimes the symptoms are worse after menstruation.

Men, on the other hand, rarely have symptoms. If they do, these may include painful urination, a penile discharge that is white and thin, and tingling inside the penis.

Testing

To test for trichomoniasis, a health care provider does a physical examination and a lab test. A pelvic exam of a woman may reveal the characteristic small red ulcerations of the vaginal wall or cervix.

For diagnosis of trichomoniasis, a doctor collects a secretion sample from the patient s penis or vagina. This is either sent to a lab or examined under a microscope in the doctor s office to check for the presence of Trichomonas species. In men, the parasite is often hard to detect.

Treatment

Both sex partners need to be treated even when there are no symptoms (men can transmit the disease to sex partners). A person with trichomo-niasis is treated with antibiotics usually a single dose of metronidazole (Flagyl) given by mouth. The individual taking this drug should not drink alcoholic beverages (which may cause nausea and vomiting). In a few weeks, symptoms in infected men may disappear without treatment, but this is deceptive because a man with tri-chomoniasis can still infect female partners until he has been treated and cured. Therefore, it is important for both partners to be treated at the same time to eliminate the parasite, and a couple should not have sex until treatment has ended and both are symptom-free.

If a person is treated but remains infected, the doctor usually prescribes the same drug at a higher dose and for a longer period or more than one drug may be needed. To prevent reinfection during treatment, one should avoid sexual intercourse entirely.

Complications

Trichomoniasis has been associated with an increased risk of transmission of HIV and low-birth-weight babies. The reason is that the genital inflammation of trichomoniasis may invite HIV infection if a woman is exposed to it. If a woman is HIV-positive and has trichomoniasis, too, she is more likely to transmit HIV to a sex partner.

A pregnant woman with trichomoniasis may experience premature rupture of the membranes, resulting in preterm delivery. In rare cases, a woman can give her baby trichomoniasis during delivery. If diagnosed, a child should be treated. A pregnant woman who does have tri-chomoniasis should consult her doctor about this problem.

When a baby or child does have trichomoniasis, it is possible that the mother spread infection during childbirth; it may point to sexual abuse if the disease is in a young child; and in a teen, it may indicate sexual abuse or sexual activity. If sexual abuse or activity is suspected, there is a need for evaluation for other sexually transmitted diseases as well. Treatment is necessary for any infant, child, or teen who has trichomoniasis.

Prevention

Trichomoniasis is spread to partners through sexual contact. Thus, use of a latex condom during every sex act provides some protection. Also, it is possible that trichomoniasis may be transmitted by infected sheets and towels, so it is a good idea not to share these items with someone who is infected. It is important for male partners to be treated even though they almost always have no symptoms.

Sexually active individuals need to know that condoms do not provide complete protection against all sexually transmitted disease; that is because sores, lesions, and infective organisms may occur in places that a condom does not cover, and thus the partner can be exposed to the infection.

Another caveat for prevention is to limit the number of sex partners and avoid alternating partners. The best course of action is sexual abstinence or sexual activity limited to one uninfected partner.

A person who believes infection may have occurred should avoid sexual contact and see a doctor for treatment. Genital symptoms such as an unusual discharge, genital itching, or burning during urination should be red flags that something is wrong.

A person who discovers that he or she has tri-chomoniasis (or any other sexually transmitted disease) has a responsibility to notify recent sex partners.

Also, someone who has had trichomoniasis should be aware that she or he can still be infected again. No immunity exists.